Objectives: To determine the efficacy and the safety of the single dose MgSo4 ('VIMS') regimen in treating eclamptic seizures and their effect on the maternal and foetal outcomes.Methods: A prospective, observational study was conducted in the period from 2003 to 2007. 513 eclamptic women who were admitted to the Dept of OBG, VIMS, Bellary, received single doses of 4g diluted 50% Mgso4 intravenously, with simultaneous 4g 50% MgSo4 intramuscularly. The recurrent seizures, maternal mortality and the perinatal mortality were measured.Results: 9.16% of recurrence (11.66%-16.49%), 3.3% of maternal mortality (1.8%-4.9%) and 24.8 % ( 21.1%-28.7%) of perinatal mortality were observed. The statistical analysis was done by using confidence intervals, standard deviations, means and the Standard normal "Z" test. Conclusion:The single dose MgSo4 regimen is effective and safe in controlling eclamptic convulsions. The 'VIMS' regimen can be used at First Referral Units, before shifting the patients to tertiary care centres. This approach has special implications in the developing countries, especially at the primary care level, where the standard obstetric care is not widely available.Joshi suyaJna D, VeerenDraKumar Cm

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Background: Stress of labor pain disturbs the maternal autonomic functions and liberates catecholamines which predisposes to dysfunctional labor and compromise fetal oxygenation. Freedom from pain improves the environment for both mother and fetus and therapy improves obstetric outcome. The objective of the study was to evaluate the efficacy of programmed labor protocol in providing shorter, safer and relatively pain free deliveries. Methods: 100 primigravidae with term pregnancy (37-41 wks) meeting inclusion criteria were enrolled in the study. Alternate women were allocated to two groups-study group (50) and control group (50). Programmed labor protocol was initiated in study group and control group were managed expectantly as per hospital protocol. Feto maternal outcome variables were noted. Results: In study group there was a marked reduction of the active phase of labor. The mean duration of cervical dilatation was nearly double (2.3+/-0.3 cm/hr) than the control group (1.2+/-0.4cm/hr) resulting in shortening of the duration of both first as well as second stage in the study group. In the study there was 66% of women has good pain relief 20% of women has moderate pain relief. No neonatal mortality or life threatening complications were seen in both the groups. Conclusions: Programmed labor protocol can be used by all clinicians with high benefit and safety margin.

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