Purpose of the Study To study the use of partogram in the analysis of spontaneous labour at term in primigravida with cephalic presentation. Methodology Partographic analysis of labour was done in 200 primigravidae. Partographic variables are plotted, and the study population was divided into three groups. Group I: Cervix dilatation and descent curve falling to the left of alert line; Group II: Cervix dilatation and descent curve falling to the right of alert line; and Group III: Cervix dilatation and descent curve falling to the right of action line. Maternal and neonatal outcomes were studied in each of three groups. Results Amongst the 200 primigravid labours analysed, 133 (66.5 %) belonged to group I, 40 (20.0 %) belonged to group II and 27 (13.5 %) belonged to group III. Mean durations of active phases of labour were 4.1 h, 6.9 h and 9.6 h, in groups I, II and III, respectively. In group I, 130 women (97.7 %) delivered vaginally, 3 (2.3 %) underwent LSCS. In group II, 29 (72.5 %) delivered vaginally, 4 (10 %) delivered instrumentally and 7 (17.5 %) underwent LSCS, and in group III, 5 (18.5 %) delivered vaginally, 7 (25.9 %) delivered instrumentally and 15 (55.5 %) delivered by LSCS. Conclusion Mean duration of active phase of labour increased as the partographic curve fell to the right of alert and action line. Increased rates of instrumental deliveries, LSCS, babies with lower APGAR score at 5 min, and NICU admissions were observed in group III compared with groups I and II.

Purpose of the Study This study is undertaken to emphasize the role of ultrasonography in the diagnosis of ectopic pregnancy and clinical analysis of the same in a tertiary care referral hospital. Methodology One hundred patients with provisional diagnosis of ectopic pregnancy were studied. Physical examination, urine pregnancy test, transabdominal scan using 5 MHz transducer or transvaginal ultrasonography of 7 MHz was done. The diagnosis of ectopic pregnancy was confirmed by direct observation by laparotomy or laparoscopy (which was taken as gold standard). Results The study showed ectopic pregnancy was most common in gravida 2 and in age group 26-30 years with most of them having married life \10 years. One or more risk factors were found in 66 % of cases. 54 % of cases presented with acute symptoms, 14 % of cases in shock. Among clinical presentation pain abdomen, history of amenorrhea, bleeding per vaginum, abdominal tenderness, and cervical motion tenderness was most common. In ultrasonography, complex mass in adnexa was present in 60 % of cases and hemoperitoneum in 50 %. 96 % of cases were tubal pregnancy with most of them tubal rupture. In 98 % of cases, radical surgery was done. Salpingectomy was the most common surgery done (90 %). There was no negative laparotomy in this study. There was no maternal mortality in this series. Conclusions In all the 100 cases of ectopic pregnancy studied, the ultrasonography provided definitive diagnosis resulting in 100 % sensitivity and 100 % specificity, predictive value of positive test being 100 %. Ultrasonography done in earlier weeks of gestation had sensitivity of 96 % and false negative 4 %.

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Background: Thrombocytopenia is defined as a platelet count of less than 150×103 μl. It is commonly diagnosed and has attracted more interest from researchers during recent years, especially in Hypertensive disorders of pregnancy. This study was done to estimate the incidence of thrombocytopenia in pregnant women diagnosed with hypertensive disorders of pregnancy and to correlate its severity with the degree of thrombocytopenia.Methods: In the study 150 women admitted in the OBG Department at Rajarajeswari Medical College and Hospital, Bengaluru during August 2015-August 2016 were included. Hypertensive disorders of pregnancy cases were classified into: Gestational hypertension, mild preeclampsia, severe preeclampsia, haemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome and eclampsia. The incidence and severity of thrombocytopenia along with maternal and foetal complications encountered in the five groups were analysed. Data were arranged in Microsoft Excel version 2010, and statistically analysed by SPSS version 23.Results: Preeclampsia- mild (29.25%) and severe (22.5%), accounted for most of the cases followed by eclampsia (3%) and gestational HTN (1.5%). Among these hypertensive patients, mild thrombocytopenia was noted in 60 cases (40%), moderate thrombocytopenia 48 (32%), severe thrombocytopenia 12 (8%), and normal platelet counts 30 (20%) were noted. Poor maternal outcome was seen 10.67% cases due to HELLP syndrome and postpartum haemorrhage. Poor foetal outcome was seen in 16% cases due to intrauterine growth restriction and perinatal mortality.Conclusions: Hypertensive disorders of pregnancy is recognized as a major cause of gestational thrombocytopenia. Careful follow up during and after pregnancy is recommended.