Background: Ovarian tumors usually presents as adnexal masses which may be benign or malignant. Accurate and timely diagnosis of an adnexal mass is a challenge for the gynecologists. Currently clinical examination, ultrasonographic assessment and ovarian tumour markers (CA 125, beta hCG, AFP, LDH) are routinely done at our centre to evaluate patients with ovarian tumours. The study was designed to evaluate the ability of RMI 4 to discriminate benign ovarian tumor from malignant ovarian tumor in patients attending Department of Obstetrics and Gynaecology, S.M.S. Medical College, Jaipur.Methods: 200 patients diagnosed to have ovarian tumours were included in the study after obtaining written consent. Ultrasonographic characteristic, menopausal status and serum CA 125 levels were documented preoperatively. Risk of malignancy index 4 was calculated and correlated with histopathological diagnosis.Results: At a cut-off point of 450, RMI 4 had a sensitivity of 67.5% (95% CI: 50.87-81.43%), specificity of 98.75% (95.56-99.85%), positive likelyhood ratio of 54, negative likelyhood ratio of 0.33, a positive predictive value of 93.1%, negative predictive value of 92.4% and diagnostic accuracy of 92.5%.Conclusions: RMI 4 is a simple, cost effective, reliable scoring system that is easily applicable method in primary evaluation of patients with ovarian tumours with a sensitivity of 67.5% and specificity of 98.75%.

INTRODUCTIONEctopic pregnancy (EP) is the leading cause of maternal death during the first trimester of pregnancy, accounting for approximately 10% of all pregnancy-related deaths. 1 It still remains a serious health problem for women of childbearing age.2 A ruptured ectopic pregnancy is a true medical emergency. Morbidity due to ectopic pregnancy is in the form of infertility and ectopic recurrence. Although the total number of intrauterine pregnancies has declined over the past three decades, there has been a rise in the incidence of ectopic pregnancy as a result of an increased and persistent exposure to its risk factors and partially due to improved ability in making an earlier diagnosis. 4,5 As the morbidity and mortality associated with extrauterine pregnancy are directly related to the length of time required for diagnosis, the increased awareness and knowledge of the risk factors for it could enable an early and accurate diagnosis of the disease, resulting in earlier intervention.Numerous studies have been done to explore the risk factors for ectopic pregnancy and it was found that the main risk factors for ectopic pregnancy are conditions or procedures which cause tubal damage. The exact role and strength of these factors have not been definitively determined. Very few studies have been done in our state to find various risk factors for ectopic pregnancy therefore; the present study was designed to identify potential risk factors and to evaluate their contribution in ectopic pregnancy. ABSTRACTBackground: Morbidity and mortality associated with ectopic pregnancy are directly related to the length of time required for diagnosis. Knowledge of risk factors for ectopic pregnancy will help an obstetrician to suspect and diagnose the condition early. Therefore, the present study was designed to identify potential risk factors and to evaluate the contribution of the risk factors in ectopic pregnancy. Methods: Study population consists of 65 women with ectopic pregnancy and for each ectopic case one woman with first trimester intrauterine pregnancy was recruited as control. Data were retrieved from all through a structured proforma. Data were analyzed statistically. Results: Various significant risk factors for ectopic pregnancy found were pelvic inflammatory disease, tubal ligation, age above 30 yrs, previous use of IUCD, low socio-economic status, tubal infertility and genital tuberculosis while no significant association was seen with smoking, age below 30 years, history of prior induced abortion, oral contraceptive pills and clomiphene citrate. Conclusions: Increase awareness and knowledge of risk factors will help obstetricians to suspect and diagnose ectopic pregnancy early and accurately and enable them to plan medical treatment. Surgical treatment will be reserved for ruptured ectopic pregnancy and haemodynamically unstable patients.

INTRODUCTIONMultiple pregnancy remains one of the highest risk situations for the mother, foetus and neonate despite recent advances in obstetrics, perinatal and neonatal care. Twin pregnancies have increased rates of obstetric and perinatal complications compared to singletons such as risk of miscarriage, pre-eclampsia, post-partum haemorrhage, preterm labour, iron and folic acid deficiency anemia, polyhydramnios, discordant foetal growth, abnormal vascular communications, foetal malformations, cord complication, still births and increased rate of caesarean section.1 Although twins occur in approximate 1 in 80 pregnancy, they account for 12.2% of preterm births and 15.4% neonatal death. ABSTRACTBackground: Multiple pregnancy remains one of the highest risk situations for the mother, foetus and neonate despite recent advances in obstetrics, perinatal and neonatal care. Twin pregnancies have increased rates of obstetric and perinatal complications compared to singletons Objective of present study was comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy in Obstetrics and Gynaecology Department of S.M.S. Medical College, Jaipur. Methods: This was a hospital based, prospective observational study done in the Department of Obstetrics and Gynaecology. S.M.S. Medical College, Jaipur from April 2015 to March 2016. 150 women with twin pregnancy and 150 women with singleton pregnancies at gestation age of 28 weeks and above coming for delivery and consented for the study were included in the study. Women with chronic medical disorder or chronic hypertension were excluded from the study. Maternal and neonatal outcome recorded and analysed. Results: Occurrence of twin in our study was 2.82%. Risk of preterm labour was about nine times higher in twin pregnancies than the singleton (OR: 2.74, 95% CI; 1.4494-5.1884, P value 0.001). The risk of premature rupture of membrane was increased by 2.74 times in twin pregnancies (OR:2.74; 95% CI: 1.4494-5.1884, p value .001). There was 3-time increased risk of malpresentation (OR 3.14; p value .00002) and 2.28 times increase in hypertensive disorder (OR 2.28; 95% CI: 1.0727-4.8823, p value .03) in twin pregnancies. The risk of asphyxia and septicaemia was 2.5 times more in twins. Conclusions: Twin pregnancy is a high-risk pregnancy with more complications in mother and foetus and is a great challenge for obstetrician. So, it should be managed carefully at tertiary care centre to reduce the maternal and perinatal mortality and morbidity.

Background: Hypertensive disorders of pregnancy are the common medical disorders in pregnancy. The present study was conducted to compare oral labetalol and oral nifedipine in hypertensive disorders of pregnancy. Subjects and Methods: The present study was conducted on 60 pregnant women. Preterm or term pregnant women with severe preeclampsia/ eclampsia and BP ≥160/100 mm Hg were included in the study. Patients were divided into 2 groups of 30 each. Group I patients were given oral labetalol and group II were given oral 10 mg Nifedipine. Results: Primi was seen in 18 in group I and 17 in group II, G2 6 in group I and 5 in group II, G3 4 in group I and 5 in group II and G4 2 in group and 3 in group II. The difference was non-significant (P> 0.05). In group I, SBP was 174.2 mm Hg in group I and 166.4 mm Hg in group II, DBP was 112.6 mmHg in group I and 110.8 mm Hg in group II. The difference was significant (P< 0.05). Conclusion: The study concluded that oral Nifedipine better in terms of lowering blood pressure in pregnant ladies, although the difference was nonsignificant.

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