Pretreatment with mifepristone 12 h before intravaginal misoprostol significantly improves the induction abortion interval.

INTRODUCTIONPremature rupture of membranes (PROM) refers to a patient who is beyond 37 weeks' gestation and has presented with rupture of membranes (ROM) prior to the onset of labor. Preterm premature rupture of membranes (PPROM) is ROM prior to 37 weeks' gestation. Spontaneous premature rupture of the membranes (SPROM) is ROM after or with the onset of labor. Prolonged ROM is any ROM that persists for more than 24 hours and prior to the onset of labor PROM occurs in approximately 10% of pregnancy. ABSTRACTBackground: Premature rupture of membranes (PROM) refers to a patient who is beyond 37 weeks' gestation and has presented with rupture of membranes (ROM) prior to the onset of labor. Patient with PROM presents with leakage of fluid, vaginal discharge and pelvic pressure, but they are not having contraction. It occurs in 3 percent of pregnancies and is the cause of approximately one third of preterm deliveries. It can lead to significant perinatal morbidity, including respiratory distress syndrome, neonatal sepsis, umbilical cord prolapse, placental abruption, and fetal death. Appropriate evaluation and management are important for improving neonatal outcomes. The risk of intrauterine infection increases with the duration of ROM. Evidence supports the idea that induction of labor, as opposed to expectant management, decreases the risk of chorioamnionitis without increasing the cesarean delivery rate. Methods: The present prospective study was conducted in the Department of Obstetrics and Gynecology and associated Dr. B.R.A.M. Hospital Raipur (C.G.), India from January to December 2013 among the patients diagnosed as premature rupture of membrane with women complain of leaking attending antenatal OPD and antenatal ward. On admission detailed history was taken. General and Systemic examination were done including Per Abdomen, Per Speculum and per vaginum carried out and investigations were done as per protocol. Diagnosis of PROM was confirmed by any of this method. Continuous monitoring of maternal and fetal condition done, antibiotics was given intra/ post natal period. P/ V exam were done when necessary. Investigations done and maternal and fetal outcome were noted. Results: More number of unbooked cases was found in study group in comparison to control group. Maximum women were in the age group of 20-25 years. Majority of cases in both the groups had pregnancy more than 36 weeks. PROM results in oligohydramnios due to drainage of liquor amnii. Majorities of the babies were underweight among mothers with PROM. Thus the better fetal outcome was associated with term gestational age. Higher chances of maternal complication were found among mothers with PROM. Conclusions: From the above study, it can be concluded that PROM is associated with poor fetomaternal outcome. Early diagnosis and prompt management is required for better outcome of mother and baby.

Objective. The objective of the study was to assess the serum vascular endothelial growth factor (VEGF) levels in peripheral blood of patients with pregnancy-induced hypertension (PIH) and find association between serum VEGF levels and PIH. Methods. Thirty-five PIH subjects, 35 normal pregnant females, and 20 normal healthy females were included in the study. Detailed history, clinical examination, and relevant biochemical parameters were assessed; serum VEGF levels were estimated using Double-antibody enzyme-linked immunosorbent assay. Results. The study groups were found to be age matched (p = 0.38). VEGF level in the pregnancy-induced hypertensive group (median = 109.19 (3.38 ± 619)) was significantly higher than the normal pregnant (median = 20.82 (1.7–619)) and control (median = 4.92 (1.13–13.07)) group and the difference between these three groups was significant (p < 0.0001). The 3 groups are found to be significantly different in terms of RBS (p = 0.01), urea (p < 0.0001), creatinine (p = 0.0005), AST (p = 0.0032), ALT (p = 0.0007), total protein (p = 0.0004), albumin (p < 0.0001), calcium (p = 0.001), and sodium (p = 0.02), while no statistically significant difference was found between total bilirubin (p = 0.167), direct bilirubin (p = 0.07), uric acid (p = 0.16), and potassium (p = 0.14). Conclusion. Significantly higher levels of serum VEGF were noted in PIH subjects compared to normal pregnant and control subjects.

Introduction: Magnesium sulphate is the anticonvulsant of choice in prevention and control of eclamptic convulsions. Pritchard's regimen is the most popular time-tested regimen used. However, owing to concerns of toxicity, several low dose regimens have been introduced considering the lower body mass index of Asian women.

OBJECTIVE: To assess the incidence of placental laterality in second trimester and the incidence of hypertensive disorders in laterally situated placenta in comparison to centrally situated placenta. MATERIAL & METHOD: It was an observational randomized study which was conducted between July 2013 to Sept. 2014 at Pt. JNM Medical College, Raipur. Participant were uncomplicated pregnant women having 18-24weeks gestation attending antenatal clinics who underwent obstetric sonography including placental localization. Women were observed till delivery. Analysis was done for site of implantation of placenta and its correlation with PIH or associated complication if any. RESULTS: Total of 130 women considered for the study, 93/130(71.5%) had central implantation of placenta and 37/130(28.4%) have lateral type of placentation. The ratio was almost same in primi as well as in multigravida. Incidence of hypertensive disorder in pregnancy in selected cohort was 28/130(21.5%). High incidence of Pregnancy induced hypertension was associated with lateral placenta i.e. 51.3% (19/37) as compared to central placenta i.e. 9.7% (9/93) (P value <0.0001). This suggests more than 5 times high possibilities of development of PIH in laterally situated placenta in comparison to central implantation. CONCLUSION: Laterally located placenta is associated with increased risk of development of preeclampsia. Prediction of preeclampsia by second trimester USG guided placental localization is simple, cheap, noninvasive, safe and effective screening method.