Background: Pre eclampsia (PE) is a life threatening multisystem disorder, unique to pregnancy, complicating approximately 28% of pregnancies in developed countries and approximately 5-8% in developing countries. It is the 2 nd most important cause of maternal mortality in the world. The search for an ideal predictive test for PE still remains a major challenge for obstetricians. Objectives: To study whether ultrasonologically identified placental laterality can be used as a predictor of pre eclampsia. To assess the incidence of pre eclampsia and other feto-maternal outcome with centrally located placenta and those with laterally located placenta. Methods: This prospective study was conducted on 250 uncomplicated primigravidas with singleton pregnancy attending the antenatal clinic from January 2016 to June 2017. Patients were subjected to ultrasound examination and placental location was determined between 18-24 weeks and again between 32-36 weeks period of gestation. These cases were followed till the delivery. Results: Out of total 250women, 148 had central placenta, in which 8 (5.41%) developed preeclampsia, while 102 had lateral placenta, in which 40 (39.22%) developed preeclampsia. Thus, in total 48 women developing PE, 40 (83.33%) had lateral placenta whereas, only 8 (16.67%) had central placenta. The difference was found to be statistically significant as p value is <0.001, sensitivity is 84% and specificity is 70%. Conclusion: From the above study we concluded that women with laterally located placenta determined by USG have 5 times greater risk of developing PE. So, placental laterality is a simple yet reliable and cost effective predictive screening test for pre-eclampsia.

Neuromyelitis optica spectrum disorder (NMOSD) is a demyleinating disease of the central nervous system. NMOSD is characterized by severe relapse of optic neuritis, longitudinal extensive myelitis and the presence of anti aquaporin-4 IgG (AQP4-IgG) in serum. Female factors like genetic, epi-genetic, or hormonal, may play an important role in pathogenesis. Female gonadal hormones, estrogen and progesterone, rise significantly during pregnancy, and decrease during the postpartum period. We are reporting a case of Gravida 2 Para1 Living1 Abortion 0 with full term with known case of acute neuromyelitis (on treatment for 3 years). Patient delivered vaginally, post natal period was uneventful.

INTRODUCTIONThird stage of labour begins after the delivery of the fetus till the expulsion of the placenta and membranes. 1 Though the third stage constitutes short span of time, it is the phase of maximum maternal mortality and morbidity.One of the major hazards being post partum haemorrhage. PPH complicates approximately 4% of vaginal deliveries and 6% of caesarean deliveries. WHO statistics suggest 30% of maternal deaths worldwide with an estimated 1.25 million cases and morbidity in 20 million women annually are due to PPH. 2,3Uterine atony is the most common cause constituting about 80-90% of cases.4 So, we have to aim at increasing the tone of the uterus by using uterotonic drugs to reduce PPH. Various uterotonic drugs is available like Oxytocin, Ergometrine, Prostaglandins.5 To prevent and treat PPH, literature strongly suggests the use of active management of 3rd stage 6 which includes use of Oxytocin at the time of delivery of anterior shoulder, controlled cord traction, ABSTRACT Background: Post partum haemorrhage is the most common cause of maternal morbidity and mortality. Misoprostol is a prostaglandin analogue, used for management of post partum haemorrhage. It can be used by various routes with minimal side effects. This study is done to compare the different routes of administration of Misoprostol for the third stage management and their side effects. Objectives of present study were to estimate the amount of blood loss, to assess the maternal side effects of drug, to know the haemoglobin deficit, to know the duration of third stage of labour. Methods: This was a prospective hospital base study of 150 women delivery at obstetrics and gynaecology department at ESICMC Model Hospital, Rajajinagar. They were randomized into 3 groups of 50 patients each. They received 400 µg of misoprostol either orally or rectally or sublingually immediately after delivery of the fetus. The primary outcomes analysed were amount of blood loss duration of third stage of labour haemoglobin deficit and their side effects Results: The amount of blood loss and haemoglobin deficit was least in sublingual group which was statistically significant. Need of additional oxytocics was less in sublingual and oral group, though it was not statistically significant. Conclusions: In the present study, sublingual Misoprostol was found to be more effective in reducing blood loss during third stage of labour.