Background: One among the three chief obstetric causes of bleeding in first trimester, ectopic pregnancy is the first thing to rule out as a gestation is suspected. The present study observes and analyses sociodemographic distribution, risk factors, presentation, diagnosis and treatment modalities in a tertiary care centre.Methods: An observational cross-sectional study, conducted among patients who were diagnosed and managed in department of obstetrics and gynaecology of a tertiary care centre. Data analyzed and explained as frequency, percentage, mean and standard deviation.Results: Age group between 21 to 30 years (69.9%) and multigravida (68.5%) are high risk for ectopic pregnancy (EP). Menstrual history was regular in 86.3%. Risk factors identified were previous abortion (30%) and history of pelvic inflammatory disease (30%). In 80.9% pain in abdomen was presenting complaints followed by bleeding per vaginum (60%), amenorrhoea (60%) and nausea and vomiting (32.9%). Right salpingectomy was most common in 43.8%, followed by left salpingectomy in 28.8%, methotrexate in 15.1%, left salpingo-ophorectomy in 5.5%, right salpingo-opherectomy in 5.5% and removal of tubal abortion in 1.3% patients. Laparoscopy was chosen route in majority 64.4% patients.Conclusions: Ectopic pregnancy - a gynecological catastrophe as well as a major challenge to the reproductive performance of women worldwide, should be considered a relevant public health issue. By providing adequate materials, manpower, well-equipped health facilities as well as a prompt and efficient referral system, good access roads and efficient transportation, will ensure early presentation in hospitals and prompt management of cases.

Background: Hypertensive disorders are the common cause of maternal death which affecting nearly 5-10% of pregnancies all over the world. Pre-eclampsia develop from inadequate trophoblast invasion of the maternal spiral arteries and Doppler values permits non-invasive evaluation of uteroplacental circulation and is of great importance in the management of high risk pregnancies. The aim of the study was to assess the findings of Doppler data in predicting pre-eclampsia and comparison of the efficacy of uterine artery Doppler and umbilical artery Doppler.Methods: The study comprises of 100 women with high risk pregnancy attending antenatal clinic at Geetanjali Medical College and Hospital, Udaipur were subjected to uterine and umbilical artery Doppler Study. Women with high risk pregnancy between 26-32 weeks of gestation were studied with colour Doppler. This was a prospective study over a period of 1 year from 2015-2016.Results: The results of the study revealed that 5 out of 100 participants developed pre-eclampsia. Out of different parameters, notch is the best predictor of pre-eclampsia with high sensitivity and highest PPV for uterine artery Doppler and S/D ratio is considered to be best indicator for umbilical artery Doppler. Regarding efficacy, umbilical artery Doppler is more predictive than uterine Doppler.Conclusions: Doppler study can be used for the prediction of pre-eclampsia to reduce maternal morbidity and mortality.

Background & Objectives: Anaemia has been reported to be associated with adverse pregnancy outcomes, especially when presenting in the last trimester. In addition to prevalent common causes of anaemia in pregnant women, poor replenishment of iron stores after a pregnancy event is specific to women with higher birth orders. Anaemic women presenting in the third trimester are more prone to maternal complications such as infections, toxaemia, antepartum haemorrhage, cardiac failure, pre-eclampsia as well as fetal hazards too such as low birth weight, pre-term deliveries, developmental anomalies, and even neonatal death. When presented near term there are higher chances of feto-maternal morbidity and mortality. In the current study, analysis is done of feto-maternal outcomes, routes of delivery of women, causes of anaemia in multigravida women in the third trimester suffering from moderate to severe anaemia in a tertiary care centre of Western Rajasthan of India.Methods: A prospective observational clinical study was conducted on patients attending Geetanjali Hospital over a period of 18 months. A total of 70 consecutive multigravida pregnant women having moderate to severe anaemia in the third trimester were selected. Statistical analysis of the data collected was done and a p-value <0.05 was taken as significant.Results: Moderate and severe anaemia in the study population were 44.28% and 55.71%, respectively. The mean haemoglobin level of all study groups was 7.0 gm%. Pre-eclampsia, placenta praevia, postpartum haemorrhage (PPH), congestive cardiac failure (CHF), neonatal intensive care unit (NICU) admission, preterm birth (PTB), low birth weight (LBW), intrauterine death (IUD), low Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score, and birth asphyxia records were investigated. Of the patients studied, 18.57% had PPH, 15.71% had pre-eclampsia, 8.57% had IUD, and 37.14% newborns were LBW.Interpretations and Conclusion: Multiparity itself is a major risk factor of anemia. Anemia presenting in the third trimester of pregnancy is a proxy indicator of care received by gravid women in the early antenatal period. In combination, a multigravida in the third trimester with less time to restock iron and vitamin stores may result in considerable maternal as well as perinatal mortality and morbidity.

Since there are several methods to identify, clinically the most common method of detecting IUGR is the serial measurement of fundal height and abdominal growth. Symphysio-fundal height normally increases by 1cm per ABSTRACT Background: Intrauterine growth restriction is a complication that arises due to decrease in uteroplacental blood flow during pregnancy. This decrease is associated with a pathological condition of spiral arteries thought to arise during placentation in first trimester of pregnancy. Thus, it might be possible to predict the development of these conditions by assessing uteroplacental blood flow in pregnancy with colour Doppler. The aim of the study was to assess the findings of Doppler data in predicting IUGR and finding the best predictors of IUGR in uterine and umbilical artery Doppler. Methods: In this prospective study, total of 100 women with high risk pregnancy attending Department of Obstetrics and Gynecology at Geetanjali Medical College and Hospital, Udaipur were subjected to uterine and umbilical artery Doppler Study. Women with high risk pregnancy between 26-32 weeks of gestation were studied with colour Doppler. This study was carried over a period of 1 year from 2015-2016. Results: Out of total 100 patients, 8 were found to have IUGR. Out of different parameters, Notch is the best indicator with high sensitivity and highest positive predictive value (PPV) of 50% followed by combination of parameter as it had the highest sensitivity of 62.5% for uterine artery Doppler. S/D Ratio is the best indicator with high sensitivity and highest positive predictive value (PPV) of 25% and 40% respectively followed by RI with highest sensitivity of 42.86% for umbilical artery Doppler. Conclusions: Value of Doppler assessment of uteroplacental circulation in predicting IUGR and is very useful in improving pregnancy outcome.

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