Objective To test the hypothesis that women with high serum beta-HCG levels in early pregnancy are at higher risk of developing PIH. Methods Serum beta-HCG estimation was done by CLIA method in 200 women between 13 and 20 weeks of gestation, selected randomly for this study from July 2008 to Aug 2009. Multiple of median (MOM) was calculated from charts of norms available for that week of pregnancy. They were followed till delivery for development of PIH and pregnancy outcome and results analysed statistically with Chi-square test and Z test. Results Out of 200 cases, 178 (89 %) were finally evaluated. Of whom 22 (12.36 %) cases developed PIH. Beta HCG levels were considered raised if the levels were [2MOM.20 (83.33 %) out of 24 cases with beta HCG levels [2MOM developed PIH against 2 (1.2 %) cases out of 154 having beta HCG levels B2 MOM (P value\0.001).Also, higher levels of beta HCG are associated with increased severity of PIH (P value \0.01). The sensitivity was 90.91 %, specificity was 97.44 % and positive predictive value was 83.33 %. Conclusion The study concluded that the serum beta HCG estimation at mid trimester (13-20 weeks) is a good predictor of PIH and higher levels of beta HCG are associated with increased severity of PIH.

The aim was to study the abnormal menstrual patterns of adolescent girls, the cause of dysfunction, and the associated factors in relation to the menstrual disorders. MATERIAL & METHODS: A prospective study done in department of obstetrics & gynaecology SMS Medical College from June 2010-June 2012. 120 adolescent girls between 12-19 yrs of age with menstrual disorders excluding dysmenorrhoea, primary amenorrhoea &pregnancy related bleeding problems were included in the study. After detailed history, examination all had an ultrasound, thyroid profile & serum prolactin levels. Other investigations done if required according to clinical profile of the patients RESULTS: 50% of the girls presented at 18-19 years. 83.3% attained menarche between 12-14 years of age Menorrhagia & oligo-hypomenorrhea were the most common dysfunction, i.e 26.7% each, abnormal investigative profile was more common in patients with oligo hypomenorrhea, 40% of patients with oligo and/or hypomenorrhea had PCOS, 14% had hyperprolactinaemia,7% had hypothyroidism. 1/3 of these patients had normal hormonal & USG findings. Majority (72.2%) of the patients with menorrhagia and /or metrorrhagia had normal hormonal and USG findings. CONCLUSIONS: Evaluation of bleeding problems in adolescents is justified, before considering them as normal physiological transition. Although most problems are explained by anovulation other causes must be considered & excluded Hormonal evaluation of these patients is justified & reveals unsuspected pathology.

INTRODUCTION:Nearly 20% of all confirmed pregnancies end in spontaneous abortion. Misoprostol's use in early pregnancy failure is varied and dose and route are not well established. AIM: To study the efficacy of sublingual misoprostol in causing expulsion of products of conception in early pregnancy failure. METHODS: Women with an ultrasound diagnosis of early pregnancy failure, less than 12 weeks gestation were included in the study. Tablet Misoprostol 600 mcg was given six hourly sublingually for 3 doses. All observations were noted and analyzed. RESULTS: Mean gestational age was 7.946+1.2 weeks. Mean induction abortion interval was 18.241+1.2 hours. Women with gestational age six to eight weeks had least mean induction-abortion interval time of 17.38+2. Mean dose required was 1564mcg.Efficacy of protocol was 92.85% in achieving complete abortion. CONCLUSION: The regime had 92.85% efficacy, acceptability (90%) and few side effects. Thus by using a lower dose and appropriate interval between two doses (six hours), the side effects were lessened with high efficacy.

OBJECTIVES: To investigate whether endometrial thickness on the day of hCG administration is a predictor of intrauterine insemination (IUI) success. MATERIAL AND METHODS: Three hundred and eighty women undergoing IUI cycles are analysed for Endometrial thickness on the day of hCG administration, Endometrial thickness measurement was done on the day of HCG administration. Correlation between endometrial thickness and factors such as age, dominant follicle numbers, stimulation protocols and pregnancy rate were assessed& compared between pregnant and non pregnant patients. A similar comparison was made between ongoing pregnancies and those that resulted in a loss in a University hospital-based infertility center from Dec 2011-Nov 2012. Main Outcome Measure(s): Endometrial thickness versus IUI outcome. RESULTS: In 220 couples, 365 cycles performed. Pregnancy rate was 14.5%. 90% of pregnancies were ongoing. The mean age of females was 28.6 & mean ET was 8.1mm +-1.47. The mean ET in age range 17-25 yrs was 7.4±1.98 mm and in age range of >40 years was 6.9±1.7 mm (p=0<001HS). With increasing the number of 16-18 mm follicles pregnancy rate was 16%, 11% &15.6% with 1,2 & >3 follicles . No statistically significant correlation was found between the two. INTRODUCTION:To obtain a higher likelihood of achieving pregnancy, IUI is usually synchronized with ovulation, either in a natural or a stimulated cycle. The overall success of IUI varies, with pregnancy rates between 5 and 26% per cycle (1). During ovulatory cycles, pattern and thickness of endometrial is variable. After menstruation, endometrium is thin and becomes thicker gradually. Although many studies were done about affecting factors on endometrial thickness in infertile women, over the years, but the results is still unclear ( 2 ,3).The aim of this study was to determine the effect of some factors such as age, number of follicles on the endometrial thickness and its impact on pregnancy in intrauterine insemination cycles. OBJECTIVE:To discover the factors contributing to endometrial thickness, and to assess the impact of endometrial thickness on pregnancy rates (PRs) according to these factors. MATERIAL &METHODS:In this study we have evaluated a total of 365 IUI cycles at SMS Medical College Jaipur (Dec 2011 to Nov 2012 infertile women considered for intrauterine insemination (IUI). Endometrial thickness measurement was done on the day of HCG administration. Cycles were natural/stimulated with letrozole 5 clomiphene citrate and/or gonadotrophins (HMG/FSH). Letroz5 50-100 mg clomiphene citrate (D3-D7), followed by 75-150 IU of gonadotrophins added Correlation between endometrial thickness and factors such as age, total follicle number and pregnancy rate were assessed. Ovarian (Follicle maturation) and endometrial responses monitored by serial TVS D9-13. 5000-10000 IU HCG administered (when at least one follicle mean diameter was >18 mm. On the day of hCG administration, TVS scan measure endometrial thickness &

Background: Entanglement of umbilical cord around the foetal neck is a common finding at ultrasonography. A nuchal cord occurs when the umbilical cord becomes wrapped around the foetal neck by 360°. Nuchal cord is very common, with the prevalence rates of 6-37%. Up to half of nuchal cords resolve before delivery.Methods: This study was conducted on 100 women irrespective of parity with healthy singleton term pregnancies with cephalic presentation in the department of obstetrics and gynaecology, SMS Medical College Jaipur. They were included in study after applying inclusion criteria and a written informed consent was taken. Strict fetomaternal monitoring was done during labour and data was interpreted in terms of percentage.Results: Out of 100 cases 71% delivered vaginally, 29% underwent caesarean section. None of the caesarean was done for cord around neck as the only indication. The indications for caesarean section were previous caesarean (34.4%), preeclampsia (13.7%), severe oligohydramnios (31%) and non-reassuring foetal heart rate (20%). Among the women who delivered normally, 53% had single loop, 29.5% had two loops, 14% had three loops and 2% had more than 3 loops. Among women who underwent caesarean section, 65% had single loop, 31% had two loops and 14% had more than two loops. Regarding neonatal outcome 9% neonates were admitted in NICU for reasons like meconium aspiration (33.3%), preterm (44%) and preeclampsia (22%).Conclusions: Cord around neck per se is not an indication for caesarean section and these cases can be delivered vaginally if careful intrapartum monitoring is done.