Metformin alone is beneficial in management of patients of PCOS but the effect of combined therapy i.e. metformin along with lifestyle modification is clearly superior to the results of therapy alone. Hence, it can be concluded that a combination of lifestyle modifications with metformin therapy would be an appropriate therapy for managing PCOS patients.

Introduction: According to American College of Obstetricians and Gynecologists (ACOG) and other organisations such as the Society of Family Planning (SFP) and American Society for Reproductive Medicine (ASRM), abortion services are considered as an essential component of comprehensive healthcare. Such services are considered as a time-sensitive issue, as delay in getting comprehensive abortion services may be associated with significant impact on physical health, wellbeing and mental health of the individual. Aim: To determine proportion of women presenting to Gynaecologyy Outpatient Department (OPD) with unsupervised use of abortion pills and to estimate the percentage of anaemia among these women. Materials and Methods: The present observational study was conducted on 148 women attending the Gynaecology OPD in People’s Hospital and seeking treatment for complications due to unsupervised use of abortion pills during the study period of 18 months. A thorough history was obtained and a thorough physical examination was conducted. Haemoglobin estimation and Ultrasonography (USG) was done to determine complications. Data was compiled using MS Excel and results were expressed in terms of frequency and percentages and mean±SD. Results: During the study period, a total of 360 cases with abortions were registered, of them 150 cases were unsupervised attributing to 41.7% cases. Out of 150 females with unsupervised abortions, 2 females did not give consent to participate and thus a total of 148 females were enrolled. Consumption of unsupervised abortion pills resulted in incomplete abortion in 77 (52%) cases, while complete abortion was reported in only 22 (14.9%) cases. Other complications observed in a few cases were septic shock, in 7 (4.7%) haemorrhagic shock in 4 (2.7%), secondary infertility in 3 (2%), inevitable abortion in 3 (2%), ruptured ectopic pregnancy in 3 (2%) and chronic ovarian ectopic in 1 (0.7%). Missed abortion was documented in 20 (13.5%) cases after complete examination and in 8 (5.4%) cases viable intrauterine pregnancy was diagnosed. Mild, moderate and severe anaemia was observed in 19 (12.8%), 98 (66.2%) and 12 (8.1%) females respectively. Conclusion: The unsupervised use of abortion pills not only increases maternal morbidity but also has been associated with life threatening complications such as septic shock, haemorrhagic shock, ruptured ectopic pregnancy etc. Anaemia is one of the most common complication of unsupervised pill consumption and preventing the latter may obviate the need for blood transfusion.

Introduction: Doppler ultrasonography, by comparing systolic and diastolic waveforms helps in assessment of uteroplacental circulation. Since preeclampsia has ethnic and geographical variations, it is important to understand the prediction modalities in various populations. Aim: To investigate the role of elevated Pulsatility Index (PI) and presence of diastolic notch using uterine artery doppler in early pregnancy in predicting development of preeclampsia among pregnant women. Materials and Methods: A prospective cohort study was conducted on pregnant females visiting the antenatal clinic or Outpatient Department or admitted in the Department of Obstetrics and Gynaecology at People's College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India, from November 2019 to October 2021. All cases were subjected to uterine artery doppler study, between 11-14 weeks of pregnancy, to note pulsatility index and diastolic notch. All the participants were then screened periodically during their antenatal visits for development of features of preeclampsia and were followed-up monthly upto 20 weeks, every 15 days upto 32 weeks and then weekly till delivery. Pregnancy outcome were measured in terms of presence or absence of preeclampsia. Data was compiled using Microsoft Excel and analysed using Statistical Package for Social Sciences (SPSS) IBM software version 20.0. Categorical data was expressed as frequency and proportions whereas continuous data was expressed as mean and standard deviation. Results: The present study was conducted on a total of 116 cases with the mean age of 26.75±4.31 years. Out of 116 cases, 26 cases developed preeclampsia. Diastolic notch was present in 17 cases (65.4%) patients with preeclampsia and 23 cases (25.6%) non preeclampsia patients. Pulsatility index of more than 1.71 was noted in 14 cases (53.8%) cases with preeclampsia where as 87 cases (96.7%) with non preeclampsia had pulsatility index of less than 1.71. The specificity of diastolic notch 74.4% where as that of pulsatility Index was 96.7 % and the diagnostic accuracy of diastolic notch 72.4% where as that of pulsatility index was 87.1%. Conclusion: Uterine artery doppler is a promising tool for predicting development of preeclampsia by analysing both PI as well as diastolic notch in uterine artery. Doppler had high overall diagnostic accuracy for preeclampsia.

Background: Iron deficiency anemia continues to be a serious problem in developing countries resulting in spectrum of adverse events in pregnant women. The first choice for prophylaxis and treatment of mild IDA in pregnancy is oral iron therapy. However, in patients with moderate and severe anemia, oral therapy takes very long time and compliance could be a big issue in our country. Thus, pregnant women with moderate anemia should be better treated with parenteral iron therapy. Postpartum women were eligible for the study with hemoglobin level <10 g/dl, while those with sickle cell anemia, aplastic anemia, megaloblastic anemia, etc., or having allergy to parental iron were considered not eligible for this study. The eligible women were randomly categorized to receive intravenous iron sucrose and intravenous ferrous carboxymaltose. Aims and Objectives: (1) To Compare ferrous carboxymaltose with iron sucrose in treating iron deficiency anemia in postpartum period (2) To assess the adverse effects and patient compliance. Materials and Methods: A comparative, prospective, and randomized distributed in 50 patients within the Department of Obstetrics and Gynecology, MGM Medical College and Hospital, Navi Mumbai. The subjects were randomized into two group, first group receiving iron sucrose, whereas second group receiving ferrous carboxymaltose. Results: Study, 25 women received iron sucrose and 25 women received ferrous carboxymaltose. There was significant higher increase in hemoglobin levels at 6 weeks in ferric carboxymaltose (FCM) group as compared iron sucrose group hemoglobin levels. There was significant higher increase in ferritin levels at 2 and 6 weeks in FCM group as compared iron sucrose group hemoglobin levels. There was significant higher increase in reticulocyte count at 6 week in FCM group as compared iron sucrose group reticulocyte count. Conclusion: Ferric carboxymaltose is safe and efficient in treatment of iron deficiency anemia in postpartum women as compared to iron sucrose with lesser adverse effect and better patient compliance.

Background: Successful pregnancy results from reciprocity between placental and maternal cardiovascular system. Intra-uterine growth restriction (IUGR) is a condition which arises from insufficiency of placenta and can be seen as variations in waveforms in uterine artery (UtA). In our study, we studied, whether predictive accuracy of various UtA Doppler indices for IUGR in first trimester early enough to provide an intervention for prevention of IUGR, as it was a leading cause of neonatal morbidity and mortality.Methods: The study design was a prospective observational study. UtA Doppler was done at 11-14 weeks in 120 pregnancies attending the outpatient and inpatient department of obstetrics and gynaecology, PCMS, Bhopal. The left and right UtA velocity waveforms were studied. Mean pulsatility index (PI), mean resistive index (RI) and diastolic notch were noted. Results obtained were analyzed and tabulated.Results: Amongst these, 25.86% developed IUGR. First trimester UtA mean RI and PI were remarkably elevated in patients who developed IUGR on follow up. No relationship was noted between diastolic notch and IUGR. Mean RI and PI were found to be good predictors of IUGR. Using receiver operating characteristics (ROC) curve, the best cut-off of mean RI and mean PI to detect IUGR was 0.68 and 1.56 respectively.Conclusions: UtA Doppler at 11-14 weeks of gestation recognizes a huge proportion of women who will develop IUGR.