Background: Induction of labor is a common procedure in obstetrics. It is usually performed when risk of continuing a pregnancy is more than benefit of delivery. Cervical ripening has got a close relationship with the success rate of delivery. Although there are many methods for cervical ripening, in this study Foley’s catheter and intra-cervical PGE2 gel are compared for labor induction and cervical ripening.Methods: This is a prospective randomized comparative study, undertaken in the department of obstetrics and gynecology, Tata Main Hospital, Jamshedpur. 70 cases in which labor was induced with Foley’s catheter were compared to other 70 cases who were induced with PGE2 gel.Results: The commonest indication for induction in Foley’s and PGE2 gel group was pregnancy induced hypertension. There was significant increase in the post induction Bishop’s score in both the groups. The induction to delivery interval was significantly lower in Foley’s group as compared to PGE2 group (p<0.0001). Neonatal outcomes were comparable in both groups. Incidence of side effects were more in PGE2 group.Conclusions: Foley’s catheter is safe and effective method for induction of labor compared to PGE2 gel with significant improvement in Bishop’s score and shorter induction delivery interval.

Background: Incidence of gestational diabetes mellitus (GDM) is increasing worldwide. GDM provides a window of opportunity for the primary prevention of the type 2 diabetes by preventing transgeneration transmission to fetus. Insulin in management of GDM has many drawbacks, so use of OHAs has been increased worldwide.Methods: Randomized control trial was performed in patients with GDM who required medical management. Subjects were randomized into two groups and treated with Metformin and Glyburide, results were compared.Results: While comparing efficacy of metformin and glyburide in this study for maternal variables; the failure rate of metformin was found to be 9.39 times higher compared to glyburide. Glyburide was associated with 9.5 times more risk to develop hypoglycemia in mother compared to metformin. While comparing neonatal variables nursery admission was found to be more and statistically significant in neonates whose mother has received glyburide compared to metformin (p=0.03, RR=2.26). Though statistically insignificant, LGA fetuses and neonatal hypoglycemia were 2.1 times more in glyburide group compared to metformin.Conclusions: Though glyburide can be effective alternative to metformin and insulin for GDM, it is associated with higher risk of maternal hypoglycemia, neonatal hypoglycemia, LGA fetuses and higher rate of nursery admissions compared to metformin. Higher adverse neonatal outcomes with glyburide use question the widespread use of glyburide as first line management modality in GDM and also as an alternative to insulin as advised by many groups.

No abstract

No abstract

Introduction: Elective myomectomy at the time of cesarean section has been traditionally discouraged because of the fear of massive obstetrics haemorrhage. The management of myoma during caesarean section (CS) is still a controversial issue. At times, myomectomy is mandatory to effect delivery during caesarean section. Increasing evidence suggests that myomectomy can be performed concurrently with caesarean section without an increased risk of blood transfusion or hysterectomy. Case Report: A second gravida presented at term with transverse lie with big anterior lower segment fibroid with low lying placenta. Caesarean section was required for fetal distress and alive 2.45kg weighted male infant with Apgar score of 9 at one minute, was born. As uterine incision could not be closed because of the myoma, myomectomy was performed during caesarean section unavoidably. Both the mother and baby had favourable outcome. Conclusion: Caesarean myomectomy can be safely performed in majority of patients with myomas in properly selected cases.