Background: To compare size of the caesarean scar and residual myometrial thickness (RMT) between continuous single non-interlocking and Babu and Magon technique for uterine closure following primary elective caesarean section (CS).Methods: An observational prospective cohort study was conducted at 6 weeks and 4 months postpartum following primary elective CS. Group A included 25 patients who underwent continuous single layer technique and Group B included 25 patients who underwent Babu and Magon technique for uterine closure. Baseline demographic profile, obstetric score, details of the CS and associated complications were studied. Two-dimensional Transvaginal ultrasonography (TVS) measurements of the length, width and depth of the caesarean scar and RMT were compared.Results: Mean age of study population was 29.6 years. Malpresentation (44%) was the most common indication for CS. Mean Bishops score at the time of CS was <4. The duration of surgery (-2.8 min, 37.96 ±5.660min) and estimated amount of blood loss (-51.6 ml, mean 671.20 ±136.208ml) was less in Group A compared to Group B (40.76 ±4.68min, 722.80±132.083ml respectively). The caesarean scar measurements were similar in both groups at both visits. The mean RMT in Group B at 6 weeks and 4 months postpartum (8.05mm±2.06 and 7.10mm±2.04 respectively) was statistically higher than Group A (6.23mm ± 1.76 and 5.36mm ± 1.70 respectively), p=0.002.Conclusions: We conclude that Babu and Magon technique for uterine closure in caesarean section could result in better healing of the scar and probably reduce the adverse outcomes in subsequent pregnancies.

Liver disease is a potentially serious complication seen in pregnancy occurring more in developing countries. The advances in understanding of the diseases with timely diagnosis and management have resulted in a significant reduction in the adverse outcome occurring both in the mother and the fetus. Aim and objective: To study the fetomaternal outcome due to the various causes of liver diseases in pregnancy. Materials and methods: • Study design: Observational prospective study. Study setting: The study was conducted in the Department of Obstetrics and Gynaecology, Government Medical College, Kozhikode from March 2016 to September 2017, a total of 18 months. • Study subjects: Pregnant patients with liver diseases who presented as jaundice and attended the Department of Obstetrics and Gynaecology during the study period were included in the study. Nonpregnant ladies with jaundice were excluded from the study. • Methodology: A detailed history, clinical examination, and necessary investigations were done for all cases. Results: The observations from this study were as follows: The total number of deliveries in this period was 24060. The number of cases with liver diseases complicating pregnancy was 52. Thus the incidence of liver diseases complicating pregnancy was 0.22%. In this study, out of the 52 cases of liver diseases complicating pregnancy, 18 (34.6%) were found to be due to hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. Maximum number of cases were between 34 weeks and 37 weeks of gestation (40.4%). Of the total 52 cases, 23 underwent cesarean delivery and 29 had vaginal delivery. There was one case of maternal death which was due to fulminant hepatic failure in a case of hepatitis A. The perinatal mortality rate in this study was 122 per 1,000 cases of liver diseases. Conclusion: Early diagnosis and prompt management of cases may decrease the perinatal and maternal morbidity as well as mortality to a greater extent.

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BACKGROUND Pre-eclampsia is defined as the development of new-onset hypertension in the second half of pregnancy often accompanied by new-onset proteinuria with other signs and symptoms. Proteinuria is defined by the excretion of 300 mg or more of protein in a 24-hour urine collection. To avoid time consumed in collection of 24-hour urine specimens, efforts have been made to develop faster methods to determine concentration of urine protein. Preliminary studies have suggested that 12-hour urine protein collection maybe adequate for evaluation of pre-eclampsia with advantage of early diagnosis and treatment of pre-eclampsia as well as potential for early hospital discharge and increased compliance with specimen collection. The aim of the study is to evaluate and correlate spot urine albumin and 12-hour urine protein with 24-hour urine protein in pre-eclampsia. MATERIALS AND METHODS A diagnostic evaluation study-a 24-hour urine protein, 12-hour urine protein and spot urine albumin results are analysed. Correlation of 12-hour urine protein and spot urine albumin with 24-hour urine protein is analysed using SPSS software. The strength of correlation was measured by Pearson's correlation coefficient (r). Student's t-test and Chi-square tests were used to compare patients with and without 24-hour urine protein ≥300 mg. Probability value of <0.05 was considered statistically significant. RESULTS Of the 300 patients in the study, 111 women had 24-hour urine protein ≥300 mg, 12-hour urine protein was ≥165 mg in 115 patients, 12-hour urine protein estimation correlate with 24-hour urine protein with r value 0.983 and p value 0.000. Sensitivity 94.5%, specificity 94.7%, positive predictive value 91.3% and negative predictive value 96.7%. Spot urine albumin was 1+ or above in 67 patients and was nil or trace in 233 patients. Spot urine albumin correlate with 24-hour urine protein with r value 589 and p value 0.000, sensitivity 45.94%, specificity 91.5%, positive predictive value 76.11% and negative predictive value 74.2%. CONCLUSION The high correlation of 12-hour urine protein >165 mg with 24-hour urine protein ≥300 mg suggest that this test has role in the evaluation of women with suspected pre-eclampsia and could be substituted for 24-hour urine protein as a simple, faster and cheaper method.