Indian Journal of Obstetrics and Gynecology

Twin pregnancy has been a fascinating subject and has generated a lot of interest in obstetrics, many religions, communities, and cultures. Multiple gestation still pose challenging problems for modern medicine. Almost every maternal and neonatal problem is increased in multiple gestations justifying their high-risk status and need for specialized management. Awareness of multiple birth is vital amongst patients, families, community, society, health care professionals and national health policy makers. They should have awareness about diagnosis, complications, management, socio-economic impact of multiple birth.

Background: Ectopic pregnancy is a catastrophic and life-threatening condition and one of the commonest acute abdominal emergencies in day to day practice. The objectives of this present study were to know the incidence of ectopic pregnancy at the tertiary care center, evaluate age group, parity, and risk factors of ectopic pregnancy, and analyse clinical presentation, outcome, management, and associated morbidity and mortality with ectopic pregnancy. Methods: It was a retrospective study done at GSL Medical College and General Hospital, Rajahmundry from 1stAugust 2019 to 31st July 2020. A total of 58 patients with ectopic pregnancy were analysed on clinical presentation, clinicalfindings, investigations, operative findings and outcome. Results: A majority of women were in the age group of 22-32 years and most of them were multigravida. Commonest risk factors were previous history of abortion, tubal ligation and pelvic inflammatory disease. Amenorrhea and pain abdomen were the most common presenting symptoms. Ampulla of the fallopian tube was the commonest site for ectopic pregnancy. There were no maternal deaths and majority were discharged within seven days without serious morbidity. Conclusion: Ectopic pregnancy still remains one of the major causes of maternal morbidity and mortality. With the use of better diagnostic modalities, ectopic pregnancies can be detected early, and referral in hemodynamically stable condition along with use of minimal access surgery or medical management not only reduces maternal morbidity but also preserves future fertility.

Context: Preterm delivery is one of the most important causes of perinatal morbidity and mortality. Early detection of infection is most important during the conservative management of patients with preterm labor. CRP is one of the sensitive markers of systemic inflammation and hence, a suitable marker for predicting risk of preterm delivery. This study was thus planned with an aim to establish the association between maternal plasma CRP levels in pregnancy and risk of preterm delivery. Aims: To study the association between the level of CRP and preterm labor and PPROM. Methods and Materials: The study included 150 women with singleton pregnancy with gestational age between 28-36+6 weeks who experienced PTL and PPROM. The study was conducted over a period of 24 months from November 2018 – October 2020. Venous blood samples were drawn from these patients and Serum CRP level was estimated. Results: 103 (68.7%) out of 150 patients enrolled in the study had elevated levels of Serum CRP >/=7 mg/L thus showing a significant statistical relation between S.CRP and PTL, PPROM. The mean S.CRP value being 12.0 ± 5.9 mg/L. The relation between S.CRP and its variation with gestational age was also found to be highly significant, showing the mean value of S.CRP to be highest among gestational age between 28-30 weeks and lowest among 35-36 weeks. Conclusions: CRP can thus be established as a biochemical marker for prediction of PTL and can be used as a non-invasive screening tool to detect cases that are at risk of PTL and PPROM.

Aims and Objectives: • To study factors associated with intra-partum meconium stained liquor &feto maternal outcome. • To compare the fetal outcome in relation to MSAF and clear amniotic fluid also in thick v/s thin meconium. Material and methods: This study prospective of 100 subjects was done in a tertiary care hospital over six months. Fifty with MSAF detected at any time during the course of labour or prior to it were enrolled in the study group. The inclusion criteria were, a singleton, cephalic, term pregnancy without anomalies. For control, the next woman giving birth following the index patient who satisfied similar inclusion criteria and had clear amniotic fluid was selected. Result: Among risk factors, preeclampsia p=0.04, fetal growth restriction p=0.05, fetal distress p=0.0002 and labour dystocia p=0.0009 were found to be statically significant. Caesarean section was considerably higher in patients with MSAF, p=<0.001. 66% patients with MSAF had FHR abnormalities as compared to 2% controls. 47.6% babies with thin MSAF and 75.8% of babies with thick MSAF had nonreassuring CTG. 42% patients had thin meconium and 58% patient had thick meconium. Conclusion: Women with prelabour or early labour rupture of membranes were noted to have a higher association with MSAF. Presence of thick MSAF, necessitates intensive monitoring of labour including surveillance of fetal wellbeing to optimise the neonatal outcome. Vigilance during labour and timely referral to higher centre/ availability of trained staff for neonatal resuscitation and management is the key to reducing neonatal morbidity and mortality associated with MSAF.

Background: In an effort to curb the spread of COVID 19 outbreak, Government of India have imposed aseries of preventive measures along with the media campaigns, disseminate information to the general public during the pandemic. Adherence to these measures is important to combat this pandemic when there is no definitive treatment available. However the level of knowledge and practice of these preventive measures among pregnant women who constitute a vulnerable group is yet to be evaluated. Aims and Objectives: To assess the knowledge. attitude and practice towards COVID 19 outbreak among pregnant women and descibe the association of various demographic characters with KAP. Materials and methods: A cross sectional study was conducted for pregnant women attending antenatal OPD at Government Medical College and Hospital, Nagpur. We have interviewed 497 pregnant women attending our antenatal OPD with a questionnaire of 14 questions.The response rates were scored and also association of different demographic score with KAP score was analysed. Median and standard deviation (SD) were calculated for KAP score and Chi square test and Annova test were used to analyse the association of demographic variables with KAP. Results: In our study scores of good knowledge, positive attitude and good practice were 81%, 90.54% and 86.12% respectively. Education, socioeconomic status and parity had significant association with KAP score. Conclusion: Majority of the pregnant women attending our OPD had good knowledge, practices and positive attitude toward COVID 19. The results of our study may help health authorities in managing these vulnerable population and implementing educational programmes since awareness and prevention is the only way to curb the spread of this novel disease.