Introduction Better diagnosis and early referral due to increased health care coverage have increased the cesarean deliveries at tertiary-care hospitals of India. Improvements in the health care system raise many concerns and need of cross-checking system in place to counter the problems pertaining to patient education and participation of patient. While most of the cesarean sections are done in good faith for the patient, it does not escape the purview of consumer awareness and protection. Materials and methods This cross-sectional study was undertaken at a tertiary level government institution to understand the level of awareness of 220 patients regarding the various aspects of cesarean delivery which are essential for women to know before giving an informed consent. Results 71 % of the women had knowledge about the indication and need to do cesarean delivery. Of these, only one-third (25 % of total women) were properly explained about procedure and complications. Other demographic and social characteristics were also evaluated. Discussion While the health care schemes have had their improved results, the onus lies upon the caregivers to improve and maintain the quality of health care in these tertiary-care government hospitals in proportion to the increase in patient load. The results of this study highlight the need for proper counseling of patients regarding complications of cesarean section. The fact that only 25 % of 123total cases were explained proper procedure and complication as opposed to 71 % of patients having proper knowledge about the indication of cesarean section points out the lack of information in seemingly ''informed'' consent. The way forward To bring about awareness about the risks and complications of cesarean section, there is a need that patients be counseled during the antenatal visits, specifically when patients visit near term for antenatal check up.

Objectives:The primary objective of the following study is to determine the demographic patterns of women presenting as sterilization-failure and secondary is to evaluate possible etiological factors for failure and lay standard guidelines to reduce failure rate.Materials and Methods:The present study is retrospective study conducted in Department of Obstetrics and Gynecology, Government Medical College and Hospital-based on the case records maintained in our institution over a decade (April 2002-March 2012).Results:Over a decade, 140 cases of sterilization-failure with longest interval of 20 years have been documented out of 80 (57.14%) cases were of minilaparotomy (minilap), 53 (37.86%) laparoscopic tubal ligation and 5 (3.57%) were lower segment cesarean section. In 84 cases (60%) sterilization were performed in Primary Health Centre (PHC). Only 58 (41.43%) patients reported failure in 1st trimester (<12 weeks). 14 cases (10%) were of ectopic pregnancy. There were 25 cases (17.86%) of spontaneous recanalization. In 27 cases (19.29%) failure was due to improper surgical procedure and rest 54 (38.57%) have conceived due to tuboperitoneal fistula.Conclusion:Female sterilization even though considered as permanent method of contraception, recanalization is possible even 20 years after procedure. Maximum cases of failure were with minilap and those were performed at PHC. The most common cause of failure was tuboperitoneal fistula. Ectopic pregnancies were seen in 10% of cases. Proper counseling of patient is must. There is a need to stick to standards of sterilization procedure to prevent future failure.

Background: Considering higher rate of postoperative wound complications in Government set up hospitals, this study was an attempt to compare incision time, incisional blood loss, hospital stay, post-operative pain and postoperative wound complications when subcutaneous tissue is opened with either scalpel or electrocautery in elective gynaecological surgeries after keeping all other clinical and surgical variables same i.e. age, BMI, haemoglobin, incision depth and hospital stay.Methods: This was a prospective observational comparative study conducted in one of the tertiary teaching hospital in Western Maharashtra, India over 12 months. All patients (n=100) were divided into 2 groups. Group A in which skin and subcutaneous tissue was dissected by using scalpel and Group B in which after skin, anterior abdominal wall was opened by using electrocautery. Data analyzed for indication, incisional blood loss, incision time, postoperative pain, wound complications and hospital stay.Results: There were no significant association between preoperative diagnosis and the development of a post-operative wound complications. Mean incision blood loss was found to be significantly higher in group A compared to group B patients. Postoperative pain was significantly higher in group A (P value <0.05). Among wound complications, no statistically significant differences were seen regarding wound complications for the two groups.Conclusions: Electrosurgical dissection for abdominal incision is safe, less time consuming and with less blood loss during subcutaneous incision and produces less postoperative pain. We conclude that the method of subcutaneous tissue incision was unrelated to the development of postoperative abdominal incision problems.

Background: Female sterilization is the most requested permanent contraceptive method worldwide and one of the most frequently performed elective, intra-abdominal surgical procedure in reproductive-age women. Even though considered as simple and safe procedure, complications do occur including death. Methods: The primary objective of the following study is to determine the demographic patterns of women presenting as sterilization complications and secondary is to evaluate possible etiological factors leading to complications and lay standard guidelines to reduce complication rate. Results: Over a decade, 103 cases of female sterilization related complications were documented, out of 14 cases (13.6%) were of laparoscopic tubal ligation and rest 89 were minilaparotomy (86.4%). In 3 cases tubal ligation was not performed as surgeon was not able to either open peritoneal cavity or find fallopian tubes due to adhesions (2.91%). In 70 cases (67.96%) sterilization were performed in primary health centre (PHC). Four patients (3.88%) required hospital stay of more than a month with longest stay being 43 days. Exploratory laparotomy with surgical intervention was done in 34 cases (33%). Two patients (1.94%) died due to tubectomy complications due to septicemia and encephalitis. Conclusions: Female sterilization is very popular and commonly performed permanent method of sterilization but complications can happen and many of them are preventable with proper screening and selection of cases with proper evaluation before surgery. There is a need to have proper training in sterilization and to stick to standards of sterilization procedure to minimize chances of complications.