after obtaining approval from the institutional ethical committee. Analysis of the progress of labour was done in five hundred women with the help of modified WHO partograph. The study population was divided into three groups. Group I had a total observed duration of active stage six hours or less and their cervicograph remained on or to the left of the alert line. Group II had total observed duration of active phase between more than six hours and less than ten hours and their cervicograph remained between the alert and action line. Group III, who had the duration of observed active phase more than 10 hours, had their cervicograph crossing the action line. The different types of abnormal labor were studied. The maternal and fetal outcomes were assessed.Results: 80.8% of the women belonged to group I, 15.2% to group II and 4% to group III. Surgical interference increased as the labour curve moved to the right of the alert line. Use of partogram helped in overall reduction in the duration of labour. Timely intervention reduced the incidence of prolonged labour and its sequelae. 19.2% of the women showed abnormal labour . Severe complications were successfully averted. There were no cases of maternal death, puerperal sepsis, ruptured uterus or fresh still births. Overall neonatal mortality rate was also reduced. Conclusions:The use of modified WHO partograph significantly improves the outcome of labour in both maternal & neonatal perspective. The WHO partograph should be used in all maternity units with incorporated management guidelines.

Background: Leimymoma is one of the commonest benign tumours encountered in women during the reproductive age. One quarter of these women may be symptomatic. When surgical management is indicated, myomectomy may be considered as the procedure of choice. Myomectomy can be complicated by severe intraoperative haemorrhage. One of the methods to reduce blood loss during myomectomy is the mechanical application of tourniquet.Methods: A prospective observational single arm study was done with 24 women who underwent open myomectomy to determine the utility of tourniquet in reducing blood loss during the procedure.  Women of reproductive age group, having symptomatic fibroid, not responding to medical therapy, not completed their family and with total uterine size not exceeding 20 weeks were included in the study while those with pregnancy, concomitant adenomyosis, cervical or broad ligament fibroid, bleeding diathesis were excluded. The 7-French pediatric feeding tube was used as tourniquet. Our primary end point was intra-operative blood loss. Secondary outcome measures included operative morbidity and blood transfusion rates.Results: It was seen that application of the tourniquet considerably reduced the amount of blood loss and made resection of the myoma much easier. 83.3% patients had a blood loss less than 200ml and the rest between 200ml and 400ml. For majority of the patients (75%) the postoperative change of PCV was between 1 and 2%.Conclusions: The infant feeding tube form of tourniquet is cheap, safe, readily available, effectively reduces blood loss during myomectomy while not adding to the complications due to the operation.

BACKGROUNDHysteroscopy is evolving as a promising imaging modality in the diagnosis of intrauterine pathologies associated with abnormal uterine bleeding due to its non-invasive nature and employability as a screening technique in diagnosing early endometrial neoplastic changes. Aim-To find out the role of hysteroscopy in diagnosing intrauterine pathology in patients with abnormal uterine bleeding. Objectives-To determine and evaluate efficacy of intrauterine pathology associated with abnormal uterine bleeding among premenopausal and post-menopausal women by hysteroscopy and to compare with histopathology.

Pelvic organ prolapse is the descent of the pelvic organs (uterus or bladder or rectum) from their normal anatomical position, in varying combination, into or beyond the vagina as a result of failure of the ligamentous and fascial supports. Sometimes the resulting vaginal eversion or protrusion is so massive it may cause outflow obstruction of one or both ureters. Here authors present a case of a 62 year postmenopausal woman having massive vaginal eversion leading to obstructive uropathy and chronic renal insufficiency. The prolapse was corrected by Sacrohysteropexy.

Background: The incidence of leiomyomas ranges from 20 to 25% in women aged 30 years and above. Gynaecologists prefer abdominal hysterectomy over myomectomy due to a reported recurrence rate of 10% during a 5 year follow-up period. This study aimed to explore the differences in risk between abdominal myomectomy and hysterectomy in treatment of uterine fibroids. Methods: The study was conducted at the department of obstetrics and gynaecology in a tertiary care hospital at puducherry during April 2016 by retrospective analysis of past records like patient charts and operative notes of myomectomies and hysterectomies conducted during the period of May 2013 to March 2016. Those abdominal hysterectomies and myomectomies done for uterine fibroids were included for the study. Results: The study included a total of 145 subjects, 43 among them underwent abdominal myomectomy and 102 underwent total abdominal hysterectomy. There was a significant difference in age (p<0.001) and parity (p<0.001) between the two groups. Most of the anthropometric, intra-operative and post-operative parameters were not much different between the myomectomy and hysterectomy groups. Conclusions: Myomectomy can be preferred over hysterectomy for managing uterine fibroids in young nulliparous and primiparous women who want to preserve their fertility for a pregnancy in the near future, as there is no significant difference in the intra/post-operative morbidity between the two surgeries.