Indian Journal of Obstetrics and Gynecology

Bladder perforation during laparoscopy is a seldom recognized, uncommon complication. We present a case of distended urosac bag secondary to bladder injury. Repair was done laparoscopically in two layers, Catheter was kept for 3 weeks. Patient had no complaints later on.

Chorioangioma is a placental hemangioma is a common, non-trophoblastic benign vascular placental tumour of primitive chorionic mesenchyme. The size of the tumour is important. Smaller tumours are clinically insignificant. Giant chorioangioma more than 4 cm has higher risk of maternal and foetal complications. Early diagnosis is done by imaging techniques. Placental lesions detected on sonography necessitate close surveillance of these pregnancies because of the poor outcome ofpregnancy. We present a 32-year primigravida with placental chorioangioma who went in spontaneous labour and delivered a male baby. The baby was referred to higher centre for further evaluation and revealed mild cardiomegaly. The histopathological examination of placenta helped in the diagnosis of placental chorioangioma.

The yolk sac and the allantois give rise to and are preserved in the umbilical cord. By the fifth week of development, it has formed and is the embryo's new source of nutrition, taking the place of the yolk sac. The cord joins the placenta, which transports substances to and from the mother's blood without allowing them to directly mix, rather than being directly attached to the mother's circulatory system. The umbilical cord can be clamped at various times, although postponing it until at least one minute after delivery improves results, provided that the minor risk of jaundice can be treated if it does occur. Clamping is followed by a painless cord cutting procedure because there are no nerves present. Out of those 20 studies, only 5 studies discuss the risk associated with delayed cord clamping, 2 studies discuss the benefit associated with good nutritional status, 2 studies discuss the benefit associated with good neurodevelopment, and the remaining studies discuss the increase in hemoglobin due to delayed cord clamping.

Aims and objectives:
• To use Robson’s Ten Group Classification System to evaluate caesarean sections in present institution.
• To understand the reasons behind the CS rates for different groups of Ten Group Classification System specific to present institution.

Study Design and Settings: The prospective observational study conducted for a period of one year from 15th July 2020 to 15th July 2021 which included all women admitted in the labour room of GMERS medical college and general hospital, Gotri, Vadodara, Gujarat for delivery over in the analysis.

Methods and Material: The data compilation and statistical analysis was performed according to Robson’s Ten Group Classification using Microsoft excel version 2011 and Med Calc software. For each group, we have calculated the caesarean section rate within the group and its absolute and relative contribution to the overall caes arean rate.

Results: A total 1768 patients delivered in the present institute and out of which 1069 were vaginal deliveries and 699 were caesarean section over this study period of one year. The overall caesarean section rate (CSR) was 39.54%, maximum contribution to total CS was from group 5, followed by group 1, group 2, group 10, and group 3. Less contribution from group 4, group 7, group 6, group 8 and least from group 9. Group 1, 2, 3 & 4 were low risk group.

Background: Early identification of sepsis is essential as the mother has a risk of chorioamnionitis. C-reactive protein levels are done along with placental histopathology to detect chorioamnionitis. It is one of the most significant causes of high perinatal morbidity and mortality.

Aim and Objective: To determine c-reactive protein levels and placental histopathology in premature rupture of membranes for maternal chorioamnionitis.

Methodology: A prospective study was conducted in a tertiary care university medical college hospital and research center in western Maharashtra. A total of 250 pregnant women were reported per vaginal leak during the study period and CRP levels were sent along with urine culture sensitivity and high vaginal swab, post-delivery the placenta was sent for histopathology and were included in the study analysis.

Results: The histopathology was done in all 250 pregnant women, and chorioamnionitis was evident in 46 pregnant women. This gives the incidence of 18.4% of chorioamnionitis in the study population. The sensitivity for CRP was calculated to be 15.22%, with a specificity of 99.02%, positive and negative predictive values of 77.78% and 83.82%, respectively, with an accuracy of 83.60%.

Conclusion: Normal CRP level has good predictive values to rule out maternal chorioamnionitis. A raised single CRP level has low sensitivity to predict histological chorioamnionitis prior to its clinical expression.