Background: Perinatal asphyxia is a major cause of neonatal and childhood morbidity and mortality. Electronic foetal monitoring is used routinely to know the condition of the baby during Intrapartum period. Normal trace correlates highly with absence of acidemia at birth. Abnormal trace needs further evaluation. In order to better define the metabolic status of the new born, umbilical lactate levels have been measured. Objectives of this study were to determine the validity of umbilical cord blood lactate levels in predicting the adverse early neonatal outcome in babies with intrapartum foetal distress and to compare the validity of umbilical cord blood lactate and umbilical artery pH in predicting adverse neonatal outcome in babies with intrapartum foetal distress.Methods: 295 pregnant women with abnormal CTG in active labour were subjected for estimation of cord blood lactate and umbilical artery pH immediately after delivery and were compared in predicting adverse neonatal outcome.Results: In the present study specificity of serum lactate (97.7%) and umbilical artery pH (95.97%) was almost similar in babies with Apgar <7 at 1 minute and 5 minutes, but sensitivity of serum lactate (23.14%) and cord ph (31.4%) was less in babies with Apgar score ≤7 at 1 minute. Area under ROC showed serum lactate is more accurate in predicting adverse neonatal outcome compared to umbilical artery pH.Conclusions: Umbilical cord blood lactate is more specific than umbilical artery pH in predicting adverse neonatal outcome. Area under ROC (at 95th percentile) shown serum lactate is more accurate in predicting adverse neonatal outcome compared to umbilical artery pH at birth.

Background: Adolescence is a transient and dynamic period between childhood and adulthood, characterised by several changes in the body and the child’s mind. The World Health Organization defines adolescents as young people aged 10-19 years, but changes may begin before and continue after this age group. Adolescents constitute over 21.4% of population in India. Adolescence is a period of enormous physical and psychological change for young girls. Hormonal events play a key role in this transition. One of the major physiological changes that take place in adolescent girls is the onset of menarche, which is often associated with problems of irregular menstruation, excessive bleeding and dysmenorrhea. The aim of this study was to determine the proportion of various gynecological problems among adolescent girls seeking care at a tertiary care centre, Kolar, Karnataka, India.Methods: A cross sectional study was conducted during March 2016 to March 2018 among all adolescent girls (10-19 years) with gynecological problems attending inpatient and outpatient Department of Obstetrics and Gynecology. A pre-tested semi-structured questionnaire was used to collect information regarding their socio-demographic characteristics, gynecological history, family history, obstetric history, documentation of general physical examination and other investigations. Data entered using Microsoft Excel and analysed using SPSS v20.Results: A total of 720 adolescent girls sought care for gynecological problems in the study period with more than 80% of the cases belonging to the age group between 15 and 19 years. Of the 720, 362 (49.8%) had some type of menstrual disorders. Of these 362 cases about 41 of them were a case of puberty menorrhagia (11.32%) and 89 cases were of dysmenorrhea (22.37%). Among 720 cases, 290 (40.2%) of them were diagnosed of teenage pregnancy; among which 34 of them were unwanted pregnancy. Other presentations include vaginal discharge, urinary tract infection, mass per abdomen, trauma to genital tract and turners syndrome (two cases).Conclusions: The study shows around half of the adolescent girls are having menstrual disorders. One third were teenage pregnancies with most of them been ‘wanted’. This alarming finding calls for strengthening of adolescent programme with targeted health education and behavioural change. Setting up a separate adolescent clinics is necessary for efficient management of menstrual disorders in adolescents.

Background: The polycystic ovarian syndrome (PCOS) is an abnormality of young women of reproductive age. Between 20-50% of women with PCOS are normal weight or thin, and the pathophysiology of the disorder in these women may be related to a hypothalamic-pituitary defect that results in increased release of LH. PCOS and Thyroid disorders share certain common characteristics, risk factors, and pathophysiological abnormalities. In this study we have compared the serum TSH levels in obese and non-obese PCOS women to detect if there is a significant difference in the occurrence of hypothyroidism based on the BMI.Methods: Non-pregnant women attending the gynecological OPD diagnosed with PCOS as per Rotterdam criteria were included. Serum TSH was done in all women diagnosed as PCOS and based on their BMI women were either included in obese or non-obese group using Asian cut-off for BMI and the values compared.Results: In the present study 152 women were included. Women with low BMI and normal BMI were grouped as lean PCOS or non-obese PCOS and the overweight and obese women together were grouped as obese PCOS. The total number in the lean group was 28 and 124 in the obese group. Raised serum TSH levels were observed in 23.02%(35) women out of which 17.14%(6) belonged to the non-obese group and the remaining 82.85%(29) to the obese group. Among the 152 women thyroid enlargement was seen in 1.3%(2). Both women had raised serum TSH levels and both belonged to the obese group.Conclusions: The results of our study seem to indicate that thyroid dysfunction in PCOS women developed irrespective of presence or absence of obesity.

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