Background: Contemporary obstetrics has witnessed improved maternal and fetal outcomes, owing to several advances. Any source of maternal hyperthermia that results in significant core temperature increase (>38.9°C), could potentially affect the fetus.  Hence a study was planned to know the effect of fever on maternal and fetal outcome.Methods: This was a retrospective cohort analysis of case-records, of patients admitted in the Department of Obstetrics and Gynecology at tertiary care centre, Mumbai, between May 2007 and October 2009. The main parameters of assessment included incidence of fever in pregnancy, causes of fever, effect of episode(s) of fever on maternal and fetal outcomes, effect of specific infection on maternal and fetal outcomes, impact of fever on antepartum, intrapartum and postpartum phasesResults: The incidence of fever was 10.5%. the common cause of fever was malaria (15%), urinary tract infection (14%), viral (14%), respiratory tract infection (18%), and typhoid (7%). Seventy eight percent had fever in third trimester. The most common antenatal complication observed was preterm (13%), premature rupture of membrane (12%), oligohydramnios (8%), intrauterine growth retardation (26%). The rate of LSCS was 13% in study group and the most common indication was fetal distress and meconium stained amniotic fluid.Conclusions: In the present study on fever during pregnancy and its maternal and fetal outcomes, fever was associated with a definite impact on maternal and fetal outcomes. Preterm and IUGR were the most common fetal complications. Duration of fever was linearly associated with poor outcomes. Different causes of fever also had different impact on maternal and fetal outcome. Preterm IUGR, MSAF were more common with malaria and tuberculosis. Abortion was more commonly seen in first trimester fever, whereas preterm, PROM in the third trimester fever. Hence it is suggested that fever during pregnancy needs to be promptly investigated and treated to have a better outcome.

Background:Although rare in modern obstetrics, emergency peripartum hysterectomy (EPH) remains a life-saving procedure, in the event of uncontrollable postpartum hemorrhage. Observations regarding the causes and outcomes of EPH provide valuable insights relevant to the current management perspectives in obstetrics. This study is intended to assess the contemporary prevalence, indications, and outcomes of EPH, at a Tertiary care referral institute. Methods: A descriptive observational study was conducted as a retrospective analysis of patient-records, over a span of 3 years January 2011-December 2013, in the department of obstetrics and gynecology, at the KEM hospital, in Mumbai. Cases of EPH were analyzed for information, maternal age, parity, gestational age, type of delivery, indications for EPH and outcomes of the procedure. Results: The average annual incidence rate was1 per 1000 deliveries. 44% of the cases had an indication of abnormal placentation. 60% of the cases had caesarean section deliveries. Multiparity, previous LSCS, and gestation period of <37 weeks, were the commonly observed associations. 52% of cases required ICU admission. Maternal mortality rate was 8%. 20% of the cases had intrauterine fetal death. Conclusions: Abnormal placentation was evident as the leading cause of uncontrollable hemorrhage. This is possibly in view of a continual improvement in the management of uterine atony, reduced incidence of uterine rupture, and importantly, a rising trend of caesarean section delivery. This calls for more thoughtful considerations, regarding decisions for caesarean section delivery, in obstetrics practice.

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B Lynch is a conservative surgical procedure for Atonic PPH not responding to medical line of treatment very few complications of this procedure have been reported. We describe B-Lynch suture erosion through the uterine wall identified on 16 day postpartum. A 24 year old primigravida underwent a primary low transverse cesarean section at term indication being primigravida with breach presentation intra-operatively there was torrential blood loss and uterus remained flabby despite treatment with uterotonics drugs delayed absorbable suture was used to place B-Lynch suture for control of the hemorrhage and had sepsis for which she had to undergo obstetric hysterectomy.

Anti-rabies vaccines containing animal-brain tissue give rise to a variety of neurological complications including ADEM. MRI performed in a child with ADEM following such vaccination showed hyper-intense signals in cortex, thalami and basal ganglia. The changes are similar to those in postinfectious ADEM. Demyelination seen following vaccination may be due to immune reaction against myelin. Encefalomielite acuta disseminata successiva alia somministrazione di vaccino antirabbia della prima generazioneStudio RM RIASSUNTO -I vaccini anti rabbia contenenti tessuti cerebrali animali danno origine a una varieta di complicazioni neurologiche, fra le quali l'ADEM, encefalomielite acuta disseminata.Lo studio RM in un bambino affetto da tale complicanza a seguito di una vaccinazione, ha mostrato un ipersegnale delta corteccia, dei talami e dei nuclei delta base. Le modificazioni osservate sono simili a quelle dell'ADEM post-infettiva.La demielinizzazione seguente alia vaccinazione puo essere determinata da una reazione autoimmune alla mielina. Figure 1 T2 weighted MRI coronal scan shows a hyperintense signal in the basal ganglia and subcortical white matter. Figura 1 Scansione RM coronale, pesata in T2: segnale iperintenso nei gangli della base e nella sostanza bianca sottocorticale.