Background: Bacteriuria is a major risk factor for developing symptomatic urinary tract infection which is associated with significant maternal and fetal risks. Various studies have put a prevalence of asymptomatic bacteriuria between 2-10% in pregnancy. Maternal and fetal complications like gestational hypertension, anaemia, premature delivery, IUGR, and low birth weight are commonly associated with pyelonephritis which occurs as a result of undiagnosed or inadequately treated infections of the urinary tract. The primary objective was to find out the prevalence of asymptomatic bacteriuria in pregnancies less than 28 weeks gestation in our hospital and to study the various adverse pregnancy outcomes in the study group.Methods: This was a cross sectional study done over a period of 12 months at this tertiary care centre in Government sector in Trivandrum, Kerala. A sample size was calculated statistically and 400 women with gestational age less than 28 weeks attending the outpatient department were included in this study. A structured proforma, urine microscopy and urine culture and sensitivity were the study tools.Results: Prevalence of asymptomatic bacteriuria in our study population was 8.25%. Commonest pathogen isolated was E.coli in 57.14% cases. Maternal morbidity was higher in women with asymptomatic bacteriuria (24.2%) than those without (12.5%). Fetal morbidity in women with asymptomatic bacteriuria was 24% whereas it was 12.5% in those without it. Preterm labour, preeclampsia and prematurity were the common morbidities noted.Conclusions: Since pregnant women with asymptomatic bacteriuria were at an increased risk of adverse maternal and fetal outcome, routine screening for asymptomatic bacteriuria preferably in the first trimester is highly recommended.

INTRODUCTION Dengue is an acute mosquito-borne viral infection that places a significant socioeconomic and disease burden in India. 1,2 Classic dengue fever (DF) is defined by the World Health Organization as an acute febrile illness with two or more of the following signs or symptoms: intense headache , retro-orbital pain, myalgia, arthralgia, rash, leukopenia and hemorrhagic manifestations. The clinical severity of disease has a wide spectrum, and according to the World Health Organization (WHO) dengue classification scheme, there are four grades ranging from uncomplicated dengue fever (DF) to dengue hemorrhagic fever (DHF) and devastating dengue shock syndrome (DSS). DHF is currently defined by the following four World Health Organization (WHO) criteria:  Fever or recent history of fever lasting 2-7 days  Any hemorrhagic manifestation.

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Background: Near misses are defined as pregnant women with severe-life threatening conditions who nearly die but, with good care or good luck survive. Because near miss situation occurs more frequently than maternal death, more comprehensive and statistically reliable analysis could be conducted to assess the quality of maternal care and to develop evidence-based management protocols. The objectives of this study were to evaluate the determinants of near miss maternal mortality in a tertiary referral Government medical college hospital in Trivandrum, Kerala.Methods: Case control study from a defined delivery population with three randomly selected pregnant women as controls for every case. Study was conducted at Department of Obstetrics and Gynecology, Medical College Hospital Trivandrum, Kerala, India. Study duration was one year. Study population were patients admitted in Obstetrics and Gynecology Department, fulfilling the WHO criteria of near miss.Results: Of the primary determinant factors of near miss in this study, preeclampsia contributed the main role, followed by hemorrhage and eclampsia. During the antenatal period, preeclampsia was the major determinant followed by eclampsia. Hemorrhage was the major determinant in intra op /intra natal cases and next was eclampsia. Postpartum hemorrhage, eclampsia and preeclampsia were the major determinants in post-partum /post op cases. Among the associated indicators assessed, low socioeconomic status, anaemia, high body mass index, referral status, placenta praevia and caesarean section were statistically significant.Conclusions: Detailed analysis of near miss cases helps in identifying risk factors. It helps in formulating preventive strategies, and helps us in tackling the delays in referral process.

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