Indian Journal of Obstetrics and Gynecology

Background: Maternal morbidity and mortality has been a major World Health Organization concern over the years, especially in India. This paper reports uterine rupture with hypovolemic shock managed at Cama and Albless Hospital, Mumbai. Skilled care before, during and after childbirth can save the lives of women and newborn babies. Between 1990 and 2015, maternal mortality worldwide dropped by about 44%. Between 2016 and 2030, as part of the Sustainable Development Goals, the target is to reduce the global maternal mortality ratio to less than 70 per 100 000 live births. Case Presentation: Mrs. NN aged 30 years, G5P4L4, from Bhiwandi , Thane was admitted to our Department with decreased foetal movements and history of labour pain for 6 hours which stopped an hour ago. Patient gives history of trial of labour at home after which she went to IGMC Bhiwandi where she was diagnosed with an intrauterine foetal demise and hence was referred to CAMA Hospital. She underwent a total abdominal hysterectomy and blood transfusion. Her post-operative stay in hospital was uneventful. Conclusion: Uterine rupture is a complication that can be eliminated under conditions of best obstetric practice. The survival of patients after uterine rupture depends on the time interval between rupture and intervention, and the availability of blood products for transfusion. We must focus on creating awareness to conduct trial of labour and delivery in a hospital setup with trained personnel.

Keywords: Uterine; Hypovolemic shock; Transfusion; Post Partum Haemorrhage. 

Abdominal pregnancy is extremely rare and is generally missed during antenatal care. It is a form of ectopic pregnancy wherethe embryo or fetus is growing in abdomen, outside the uterus; excluding fallopian tube, ovary and broad ligament. As most of the patients usually present with non-specific complaints, diagnosing this condition becomes challenging. Even in our case, diagnosis was made accidentally. Thus, this condition should be meticulously sought for, diagnosed and managed well in time.

Keywords: Abdominal Pregnancy; Ectopic Abdominal Pregnancy; Ectopic Pregnancy; Incidental Finding. 

Cervical cancer is one of the leading cancers in women with an estimated 500,000 new cases every year of which 80% occur in developing countries. Early detection and appropriate timely treatment of its preinvasive lesions reduces the mortality. The Papanicolaou test introduced by George Papanicolaou as cervical pathology screening test in 1941 was performed using cells from transformation zone helps in early detection. Pap test can detect 75% endometrial cancers and 90% cervical cancers. Aim: To study the cytological pattern of cervicalsmear in patients attending gynaecology outpatient department, Govt Rajaji Hospital, Madurai. Materials and Methods: Among 10143 cases attended OPD of Govt Rajaji Hospital (Gynaec) Madurai between the periods of June 2016 to December 2016. 528 patients with complaints of white discharge pervaginum subjected to Pap smear screening. Results: Among 528 Pap smear 198 showed normal study, 262 were inflammatory smear, 63 had inadequate sample material, 1 atrophic smear, 1 dysplasia, 1 metaplasia. Conclusion: Pap smear is highly sensitive in detecting abnormal cervical smear according to our study.

Keywords: Cervical Cytology; Pap Smear; Bethesda System. 

The aim is to study the incidence of congenital anomalies in Government Rajaji hospital attached to Madurai Medical College, Madurai. Among the 3288 births during October 2016 to January 2017, there were 74 babies with congenital anomalies, among these 19 babies had neural tube defects. Results were analysed & compared with other studiesreported in the literature. Overall incidence of congenital anomalies 2.25% and theincidence of CNS anomalies was 33.7%. The incidence of neural tube anomalies was 0.57%

Keywords: Neural Tube Defects; Anencephaly; Spina Bifida; Hydrocephalus. 

The rapid spread of the Zika Virus (ZIKAV) infection, had become global threat to humanity and of the concern for all over the world. Data regarding ZIKAV in pregnancy are very less, mainly from case reports that show of association between maternal ZIKAV infection, fetal microcephaly, and intracranial calcifications. Although the presently the exposure of ZIKAV is limited to western countries. But with the increasing International tourism and growing medical tourism, the possibility of future exposure from endemic to other areas, making this disease pandemic cannot be denied. The objective of this review is to present the current literature regarding ZIKAV and its effect on pregnancy and possible management of pregnant patient with potential exposure to ZIKAV.

Keywords: Zika Virus; Pregnancy; Diagnosis; Complications; Management. 

The study was conducted in kadur taluk, chikkamangalore district, to study the prevalence of the recurrent urine tract infection in the post-menopausal women. The causative organism, the associative risk factors and, their antimicrobial pattern were studied. A total of 230 women were included in the study conducted over one year. Following a written consent,midstream urine specimens were collected and the culture tests were done by a quantitative method whereas antimicrobial sensitivity was determined by using the Kirby-Bauer method. 32 women were found to have recurrent UTI. UTI was significantly associated with age, prolapse, diabetes, and poor blood sugar control. Escherichea coli (E. coli) was the most commonly isolated organism. Gram negative pathogens were found to be highly sensitive to cefoperazone, piperacillin and tazobactum.

Keywords: Prevalence; Diabetic Mellitus; Recurrent Urinary Tract Infection; Pathogen; Antibiotic

Active management of labor is a part and parcel of modern obstetrics. Various drugs have been tried to hasten cervical dilatation so that problems and hazards of prolonged labor both for the mother and fetus are minimized without increasing maternal or perinatal mortality and morbidity. To compare the effect of drotavarin versus hyoscine on shortening duration of 1st stage of labor is assessed. Methods: A prospective study conducted in Department of Obstetrics and Gynecology, ESIMC PGI MSR Bangalore, Karnataka. Data collected from One Hundred pregnant women in active labor, labor accelerated using drotaverin and hysocin , duration of labor was compared among groups. Result: The two groups Group A using hyoscine butylbromide, Group B using Drotaverin, were compared with regards to rate dilatation of cervix and duration of first stage labor. Average time to full cervical dilatation was significantly less in Group B in both nulliparas and in multipara. Similarly, the average rate of cervical dilatation was significantly more in Group a, both in nulliparas and in multipara. Conclusion: Hyoscine butylbromide is more efficacious than drotaverine hydrochloride for cervical dilatation and reducing duration of active phase of 1st stage of labor.

Keywords: Hyoscine Butylbromide; Drotaverin; Duration of 1st Stage; Cervical Dialation; Labor Augmentation. 

A prospective study was conducted to determine the incidence and pattern of orofacial injuries among eclamptic patients at Ummaid Hospital, Dr. SNMC Medical College, and Jodhpur between May 2016 to October 2016. The incidence of orofacial injuries was 56.94%. Most injuries were due to bites during convulsive episodes. The type of antenatal care received had an influence on the incidence of orofacial injuries and there was a correlation between the number of convulsions and orofacial injuries. Obstetricians and other healthcare providers should be familiar with the ways of preventing these injuries and seek early maxillofacial consultation when they occur.

Keywords: Orofacial Injuries; Eclampsia. 

Introduction: Polycystic ovarian syndrome (PCOS) is the most frequent endocrinological disorder affecting 5-10% of women in the reproductive age. Aims and Objectives: To study Clinical profile and Associated Factors in the patients of Polycystic Ovarian Syndrome. Material and Methodology: This was cross-sectional study carried out at the OBGY Dept. of the tertiary health care center during the one year duration i.e. March 2015 to March 2016 in all patients who shows clinical features of PCOD were screened with the help of USG attending those who showing multiple cyst on USG with other clinical criteria was diagnosed as patients of PCOD The detailed history like age and various clinical features and risk factors were asked.During the one year period, total 40 patients were included into study. Result: The majority of the patients were in the age group of 20- 25 -37.5% followed by 25-30-25% and in the age group of 15-20 were 20%, and in 30-35 were 10% and 35- 40 were 7.5%. The most common clinical features were Dysfunctional Uterine Bleeding (DUB) were in 80% followed by Oligomenorrhea in 72.5%, Hirsutism in 62.5%, Obesity in 57.5%, Anemia in 45%, Diabetes in 30%. The most common Associated /risk factors were Obesity (BMI>30) in 62.5% followed by , Diabetes 37.5, F/H of Infertility in 30%, F/H of PCOD in 27.5%, Lack of physical exercise in 22.5%, Eruption of Wisdom teeth in 17.5%. Conclusion: It can be concluded from our study that average age of the patient was 20-25 for the appearance of disease and most common clinical features were Dysfunctional Uterine Bleeding (DUB) followed by Oligomenorrhea Hirsutism and most common Associated / risk factors were Obesity (BMI>30) in 62.5% followed by, Diabetes, F/H of Infertility etc.

Keywords: Polycystic Ovarian Syndrome; Diabetes; Dysfunctional Uterine Bleeding (DUB). 

Objective: To analyse the perinatal outcome in pregnancies associated with oligohydramnios onset after 34 weeks of pregnancy. Method: All pregnant women who attended our antenatal OPD and had an ultrasound diagnosis of oligohydramnios at or after 34 weeks of gestation were followed up till delivery. The patients diagnosed with oligohydramnios and with gestational age less than 37 weeks were given hydration therapy. Perinatal outcome was observed for the patients having oligohydramnios from the 34 to 40 weeks of gestation. Result: Patients with idiopathic oligohydramnios responded to hydration therapy better than that of those with oligohydramnios alongwith risk factors (75% Vs 20%). The perinatal outcomes of idiopathic group were much better than patients having risk factors [meconium staining liquor (12.5%, 17.2%; p value 0.3907), APGAR score <7 at 5minutes (3.13%, 12.9%; p value 0.0162), NICU admission (5.2%, 19.35%; p value 0.0026) and no neonatal death in idiopathic group versus 6 neonatal death in high risk group]. Both the groups had higher induction of labour (57.6%,, 44.08%; p value <.005) and caesarean section rate (61.46%,73.12%). Conclusion: Isolated oligohydramnios responds to hydration therapy and have better perinatal outcomes than that of oligohydramnios with risk factors. Induction of labour rate is higher in idiopathic group, but caesarean section rate is higher in oligohydramnios with risk factors.

Keywords: Idiopathic Oligohydramnios; Oligohydramnios with Risk Factor; Hydration Therapy; Perinatal Outcome. 

15% of maternal deaths in pregnancy and post natal period are due to cerebrovascular accidents (1). Severe pre eclamptic toxemia, eclampsia, genital tract infection and operative delivery are major contributors (2).The study has been undertaken to find potential risk factors for peripartum or postpartum stroke and intracranial venous thrombosis and prevention of catastrophe. All pregnant and puerpereal patients at Pacific Institute of Medical Sciences, Village Umarda, Ambua Road, Udaiur Rajasthan have been selected for the study for the duration of three years from 2014 to 2017. There were total 12 cases of cerebrovascular accident in pregnancy and puerperium. It is a retrospective study and risks were calculated on the basis of age, parity, mode of delivery, socio economic status, presence or absence of pre eclampsia. It has been observed that Stroke was more common in age more than 31 years (41.66%) para three and more (75%) post partum (41.66%) caesarean delivery (58.33%) severe pre eclampsia (58.33%). 33.33% were tobacco users and 66.66% were severely anemic and there were 16.66% maternal deaths. Regular antenatal checkup, prevention of preeclampsia and infection can bring down maternal mortality and morbidity to minimum.

Keywords: Cerebral Venous Thrombosis; Stroke; Ischemic Stroke; 

Background: Technological improvements in ultrasound machines and the use of high frequency vaginal probes allow investigators much closer access to the ovaries. The transvaginal ultrasound determinations of either the number of follicles of 2–5 mm diameter or the ovarian volume have been reported to define ovarian reserve and predict reproductive outcomes. Ovarian volume also predicts the occurrence of clinical pregnancy after IVF treatment. Aim: To assess ovarian volume as a predictor for ovarian response following ovulation induction and to correlate ovarian volume with FSH levels and other ultrasonographic parameters used to assess ovarian response. Methodology: A total of fifty infertile women with a history of primary or secondary infertility were included for study. The patients were asked to come on their 3rd day of menstruation, during which a thorough history, systemic examination and blood and radiological investigation were done. Ovulation was then induced using clomiphene citrate 50 mg/day from day 3 to day 7 of the cycle. To assess the post induction ovarian response patients were requested to come on day 12 for assessing the ovarian response through transvaginal ultrasound. Results: In the present study 60% of patients were within 30yrs of age. 58% of the patients had total ovarian volume <8.6cm3. The total ovarian volume showed a negative correlation with the age. There was a positive correlation between number of follicles, size of follicles and total ovarian volume. Endometrial thickness had a weakly positive correlation with total ovarian volume. Basal FSH had no correlation with the ovarian response to ovulation induction. Conclusion: Ovarian volume can be determined before initiation of down-regulation and provides the clinician with a measurement of ovarian reserve that is determined readily, inexpensively, and with minimal invasiveness. Ovarian volume measurement should be an integral part of infertility evaluation.

Keywords: Total Ovarian Volume; Infertility; Ovarian Reserve; FSH. 

Dysfunctional uterine bleeding is abnormal uterine bleeding in the absence of any palpable pelvic pathology and the most common encountered condition in gynecology. Thyroid abnormalities have been suggested as an imporatant to affect the menstrual pattern and probable cause cause of that bleeding. The present study is a cross-sectional study of 150 women with abnormal uterine bleeding in the reproductive age group undertaken in Government Medical College and Hospital over a period of 1 year. It was done to ascertain the correlation between thyroid dysfunction and AUB. The history was elicited according to the proforma. Anthroprometric measurements were taken and a detailed examination was done. T3, T4 and TSH levels were evaluated in the fasting rate and the results interpreted. In this study among 81 patients with menorrhagia, 15 patients (18.52%) had clinical hypothyroidism and 7 patients (8.6%) had subclinical hypothyroidism. This correlates with study by Andrew weeks in 1987 of 650 women with menstrual disturbances at the Jessop hospital who have stated that hypothyroidism is a greatly under diagnosed cause of menorrhagia. Some patients have a normal serum TSH despite low T3 and T4. This is explained by a downward resetting of the threshold for TSH inhibition. TSH setpoint for a particular serum T3, T4 increases with age and is also altered by personal and familial character. TSH values tend to change more rapidly because the half life of TSH is much shorter. The incidence of thyroid dysfunction in the population with AUB is 26.5% according to our study and hence selective screening of this population would result in a higher yield. A major benefit of routine testing is the earlier detection of unsuspected overt thyrotoxicosis or subclinical hypothyroidism or hyperthyroidism. Most clinicians advocate treatment of women with elevated TSH levels in view of risk of hypothyroidism subsequently. The Body Mass Index showed a significant correlation (p<0.001) with thyroid dysfunction. Hypothyroidism was associated with obesity. The Study showed a significant correlation between thyroid profile (T3, T4 and TSH) and AUB (p=0.076). The study showed significant association of menorrhagia with hypothyroidism and hypomenorrhea, oligomenorrhea were associated with hyperthyroidism

Keywords: Dysfunctional Uterine Bleeding; Thyroid Function Tests; Oligomenorrhea; Menorrhagia 

Background: Hysterectomy is the most common surgery performed in gynecological practice. At present there are three main types of hysterectomy operations in practice for benign diseases-Abdominal hysterectomy (AH), vaginal hysterectomy (VH) and Laparoscopic hysterectomy (LH). Vaginal route for non-descent uterus is an acceptable method of hysterectomy. The objective of present study was to compare the operating duration, intraoperative and postoperative complications between Non descent vaginal hysterectomy (NDVH) and Total abdominal hysterectomy (TAH) in non-descent uterus. Methods: The study was conducted in the postgraduate department of obstetrics and gynecology for a period of 18 months between April 2014 to October 2015 in a tertiary care referral centre. Results: 100 patients were included in the study, 50 patients underwent non-descent vaginal hysterectomy and labeled as group A and 50 patients were underwent total abdominal hysterectomy and labeled as group B. It was observed that intraoperative complications and postoperative complications were less in group a patients and operating time is also less with group A patients when compared with group B patients. Conclusions: It was concluded that NDVH is associated with lesser intraoperative blood loss, faster recovery, and early ambulation, less operative and less postoperative morbidity when compared to TAH. Ndvh is a less invasive technique with shorter hospital stay.

Keywords: Hysterectomy; Non-Descent Vaginal Hysterectomy; Total Abdominal Hysterectomy. 

Introduction: Severe preeclampsia remote from term, a clinical challenge arises in the 0.3% of pregnancies in which hypertension develops before 34 weeks. The decision to deliver at early gestational age (GA) requires weighing the risks of iatrogenic prematurity against the risks of prolonging the pregnancy which is also called expectant management. Aims & Objectives: To study the effect of expectant management of severe peelcampsiaon pregnancy outcome. Material and Methods: Patients presenting with signs and symptoms of severe preeclampsia Presence of 2+ or more proteinuria on dipstick, Systolic blood pressure >/=160 mm of Hg and diastolic blood pressure >/=100mm of Hg, presence of one or more imminent signs of eclampsia ) and gestational age 26-34 weeks were randomized (into either G1(n=50) i.e. expectant management group or G2 (n=55) aggressive management group) after thorough clinical examination, laboratory testing, ultrasonography. Results: Parameters such as age, parity, body mass index, gestational age, blood pressure at admission, presence of imminent signs and all laboratory investigations are similar in both the groups.The mean prolongation of pregnancy was 9.9 in the expectant group, with an averagefetal weight gain of 150 gms. There is significant (p<0.005) improvement in neonatal survival, birth weight, need for NICU stay and ventilatory support without maternal morbidity in expectant group. Conclusion: Though there are controversies between the previous randomised studies, our study Established a higher perinatal survival and birthweight without causing increased morbidity to mother and neonate especially in neonates <30 wks GA

Keywords: Expectant Management; Perinatal Mortality; Stillbirth; Severe Preeclampsia; 26-30 Weeks. 

Urinary tract infections are one of the most common infections encountered in clinical practice. Untreated bacteriuria during pregnancy is associated with adverse maternal and perinatal outcomes. This study was done to detect the prevalence of asymptomatic bacteriuria in pregnancy and the bacterial profile and antibiotic susceptibility pattern of the uropathogen. This was a hospital based prospective study conducted in the Obstetrics and Gynecology Department of a tertiary care teaching hospital. Total of 232 women were included in the study after using exclusion criteria. Clean catch mid stream urine sample was collected and the sample was cultured. The organism was identified and antibiotic susceptibility was tested and data obtained was analyzed. Total of 86 patients (37.1%) were identified to have significant bacteriuria. Maximum numbers of patients were in the age group 20-25 years (37.3%) followed by 34.8 % in the age group 25-30 years. Asymptomatic bacteriuria was more frequent in multigravida (72.1%) than in primigravida (27.9%). Asymptomatic bacteriuria was most frequent in third trimester (39.5%) followed by first trimester (32.6%) and least in second trimester (27.9%). E coli was found to be the most common organism followed by Staph Aureus and Acinetobacter baumannii. Most of the organisms were sensitive to nitrofurantoin, cefotaxime, clindamycin and ciprofloxacin. High incidences of undiagnosed asymptomatic bacteriuria in pregnancy lead to complication during pregnancy to mother and fetus. Hence it is important to do urine culture in all trimesters of pregnancy and treat appropriately if bacteriuria is detected.

Keywords: Asymptomatic Bacteriuria; Pregnancy; Urinary Tract Infection. 

Introduction: Acute cases of Abruptio Placentae results in intrauterine death and stillborn baby, while chronic abruption results in intrauterine growth restriction, low birth weight and preterm labour and perinatal death. Less attention has been paid on the study onplacental separation and perinatal outcome along with preterm labor among the cases coming to referral hospital like Banaras Hindu university in which placental separation and perinatal outcome along with preterm labor has been studied. We studied how many extremely preterm, very preterm and moderate to late preterm deliveries were there in mothers with abruption. Material & Methods: The study took place in Sir Sunder Lal Hospital, Banaras Hindu University, Varanasi, North India. Singleton pregnancies who were diagnosed as having placental abruption clinically based on clinical features and confirmed, were taken in this study. Results: Study period was June 2015-July 2016. Incidence of abruption was found to be higher among illiterate women (p value 0.006, Chi Square value 10.11). Socioeconomic status and stillbirth tablealso showed incidence higher among lower socioeconomic status group (p value 0.007, Chi Square 7.18). Conclusions: Our study indicates that babies born to mothers with abruption placentae were preterm and had poor outcome. Most of the time it is due to premature delivery. In clinical situations there should be low threshold for diagnosis of placental abruption, more so in cases of unexplained vaginal bleeding or preterm labour.

Obstetrical teaching throughout this century has included the concept that meconium passage is a potential warning of fetal asphyxia. An association among meconium stained liquor, fetal compromise and perinatal morbidity is well known. Objective: The present prospective study is to know the prevalence of meconium at term, the mode of delivery and perinatal outcome in our hospital. Methods: A prospective study conducted over 6 months in Department of Obstetrics and Gynecology, ESIMC PGI MSR Bangalore, Karnataka. Data collected from all labouring women with meconium stained liquor on either spontaneous or artificial rupture of membranes, were enrolled for the study after obtaining written and informed consent. Result: In our study out of 1680 delivered women 118 women were with MSAF, with prevalence of 7% of MSAF. 36 women Delivered by FTVD with prevalence of 30%, 82 women by LSCS with prevalence of 70%. With NICU admission for MAS is 15%. Conclusion: Meconium stained amniotic fluid during labour & delivery is associated with increased caesarean section. So the outcome of meconium stained amniotic fluid during labour & delivery is unpredictable.

Keywords: Meconium Stained Amniotic Fluid; Meconium Aspiration Syndrome; Thick Meconium. 

Background: Thyroid disorder is second most common cause of endocrine disorder in women of child bearing age. Pregnant women with hypothyroidism have a greater risk of early and late obstetric complications such as miscarriage, anaemia, gestational hypertension, placental abruption, premature delivery, post partum haemorrhage and admission of their baby to neonatal intensive care (particularly for RDS). Aims and objectives: To find out prevalance of hypothyroidism in pregnancy and to determine association of foetomaternal outcome with hypothyroidism. Material and Methods: A prospective study was conducted in 107 patients who came to routine antenatal clinic or admitted in labour room of Kamla Raja Hospital, Gwalior over a period of one year (from 1st May 2009 to 30th April 2010) and patients were divided in to two groups hypothyroid positive are study group and those negative were control group. Their fetomaternal outcomes were noted. Conclusion: Present study concludes that there is high prevelance of hypothyroidism 24.29% in this study. Incidence of hypothyroidism is higher in women >35 years of age and significant association of PIH, preterm, very low birth weight and ICU admission were seen.

Keywords: Hypothyroidism; Foetomaternal Outcome; Obstetric Complications. 

Introduction: Appropriate assessment of gestational age is of paramount importance in obstetric care. Uncertain gestational age has been associated with adverse pregnancy outcome including low birth weight, spontaneous preterm delivery and perinatal mortality. Objectives: To evaluate the usefulness of fetal femur length in Assessment of Gestational Age in Third Trimester. Materials and Method: In the present study total 100 pregnant female attending antenatal clinic of the study institute in third trimester were enrolled. Detailed demographic profile including age, address etc was obtained. Detailed history regarding the exact knowledge of her LMP, cycle regularity and duration of cycle was taken. All patients then underwent detailed examination i.e. general and systematic examination. The gestational age at time of scanning was confirmed by LMP, and abdominal examination. All the women in the study underwent ultrasonoghraphy. The ultrasound was done by a single operator to avoid bias in observations. All the fetal parameters were assessed and special attention was given to the femur length. The collected data was entered in Microsoft excel. Primary analysis was conducted by using Epi Info statistical software. Results: The mean age of the women was 25.43±4.72 years. The gestational age according to the LMP was calculated and it was observed that majority of the patients were of 35 weeks gestation (14%) followed by 30 weeks (12%). The mean gestational age was 33.53±3.368 weeks. The gestational age was also calculated by using Femur length on ultrasonoghraphy and it was seen that majority of the women were of 38 weeks of gestational age (16%) followed by 32 weeks of gestation with mean gestational age of 34.15±3.40 weeks. The gestational age calculated by LMP and FL showed no statistically significant difference. Thus the gestational age calculated from femur length was comparable with the gestational age calculated by LMP. The correlation coefficient between GA by LMP and GA by FL was 0.9603with P-Value <0.05 thus there was significant correlation between GA by LMP and FL. Conclusion: The gestational age estimated from femur length was correlated with the gestational age calculated from the LMP with Correlation coefficient of 0.9603 with P-Value <0.05. Thus we conclude that the foetal femur length can be useful in evaluation of Assessment of Gestational Age in Third Trimester and the findings.

Keywords: Fetal Femur Length; Gestational Age; Ultrasonographic Age Estimation.

Approximately 10-15% of couples suffer from infertility all over the world and male factor is responsible in 45%of cases. Determining the possible etiology of male infertility is very important. The aim of this study was to analyze the seminal fluid parameters of the male partner of infertile couples and to try to identify the abnormalities present and to determine the possible contribution of male factors. A total of 406 consenting male partners of women attending the infertility clinics were recruited and their semen analysis was performed for volume, pH, liquefaction, viscosity, sperm concentration, motility and morphology. Maximum numbers of patients (34.5%) were in the age group 30-35 years, 15.8% had hypospermia while 84.2% had normal semen volume. 8.4% had motile sperms, 36% had motility less than 50% and 55.7 % had motility more than 50%.In our study 7.9% had azoospermia, 37.5% had count less than 20 million /ml and 54.7% had count more than 20 million/ml. 11.8% had abnormal morphology and 88.2% had normal morphology. Semen analysis is the cornerstone of the laboratory evaluation of the infertile male and helps us to define the severity of the male factor. It is very important to recognize the contribution of the male partner to infertility and to reduce the stigma attached to the female partner alone.

Keywords: Male Infertility; Semen Analysis; Semen Parameters. 

Background: Cervical cancer is the second most common cancer of women in age group 15-44 years. Worldwide. Approximate 3/4th of patients are diagnosed in advanced stages leading to poor long term survival and cure rates.3 the effectiveness of the pap smear, VIA & VIA guided biopsy as screening methods are easily available in a rural set up of India. Aim: To screen all the women between the age of 18- 65 years attending Gynaecology OPD irrespective of their complaints, by Pap Smear and Visual inspection after applying acetic acid (VIA) followed by VIA guided cervical biopsy and to study incidence of positive findings & effectiveness of pap smear, VIA test and VIA guided cervical biopsy to screen cervical cancer and finally to study the incidence of premalignant lesions of the cervix in a rural setup. Material and Methods: In 2146 total women (18- 65years) attending Gynecology OPD between February 2016 to July 2016 (6 months) & 828 consecutive women were examined after fulfilling the selection criteria and proper consent. Results: Out of total 828 women 3.38% women were positive for abnormal cytology, 35.26% women were VIA test positive. Out of total 828 VIA test done, 19.08% underwent VIA guided cervical biopsy & 5.43% women had positive HPE report. Out of 28 abnormal cytology 19 were ASCUS positive, 06 were LSIL & 03 were HSIL. Out of 45 abnormal biopsies 28 were CIN I (3.38 %%), 10 were CIN II (1.21%) & 07 were CIN III (0.84%). Incidence of premalignant cervical lesions is 8.81%

Keywords: Premalignant Cervical Lesions; Cytology; Biopsies. 

Introduction: Medical termination of pregnancy has been legalized in India for over four decades since the MTP Act was passed in Indian parliament in1971 to safe guard the health of the mother yet unsafe abortion continues to be responsible for 13% of maternal mortality. Medical abortion is the method to terminate pregnancy by using mifepristone and misoprostol tablets by giving them at 48 hours interval. As per WHO it a safe and effective method upto 9 weeks (63 days) of gestation. Awareness and attitude about medical abortion amongst the general population are not documented extensively. This study was carried out to gauze the knowledge, attitude and practice of medical abortion and also the sociodemographic profile of women seeking abortion in a teaching institute in the north eastern part of India. Materials and Method: This prospective study included 220 women who opted for medical abortion from September 2015 to February 2017. All the information regarding age, religion, residence, income, socioeconomic status, education of both partners, occupation, parity, history of previous MTP (medical or surgical), awareness and utilisation of routine and emergency contraception, awareness about medical abortion, gestational age at present pregnancy, indication of MTP, person taking decision for MTP, was taken on a pre-structured format. Result: During the study period 220 women opted for medical abortion. Majority of the women (66.8%) were between 25-34 years age group. Mean age in years was 28.1 ± 4.76 and mean parity was 1.8 ±1.28. Previous history of abortion was present in 45%. Only 20.4 %( 45) women were aware about medical abortion. Most common indication of MTP was completed family (30%) and spacing (23.2%). Pre and post procedure contraceptive uses were 39% and 45%. Majority of women were Hindu (68.2%), married (84.1%), housewives (72.7%), residing in urban area(61.4%), less educated and belonging to a lower socioeconomic status (70.3%). Conclusion: According to the present study, women in younger age group, Hindu by religion, married, housewives, residing in urban area, less educated and belonging to a lower socioeconomic status are more likely to seek for abortion. In our study women who were initially unaware of medical abortion opted for medical abortion after proper counseling and had high success rate. Increasing the Knowledge of the safety and effectiveness of medical abortion in general population with special attention targeting this vulnerable population would be a major step towards our goal of population control and ensuring safe abortion.

Keywords: Medical Abortion; First Trimester; Mifepristone; Misoprostol; Demographic.