Background: Experiencing labour pains and giving birth to infant is normal physiological process. Though it is a natural phenomenon, it produces severe pain which requires analgesia to relieve pain during labour. The objective of this study was to compare effects of low dose epidural analgesia verses no analgesia during labour on mother and fetus. Methods: Here in this study we have assessed effect of epidural analgesia on mother and fetus. Total we have taken 60 women in age group of 20-26 years with full term pregnancy (37-42 weeks). Those who have entered spontaneous labour with vertex presentation, without any previous uterine surgery, clinically adequate pelvis. We had divided these women in 2 groups, 30 were given epidural analgesia and 30 without any analgesia. Variables recorded were pain score during labour using VAS, duration of labour during each stage, mode of delivery, Apgar score of newborn at 1 minute and 5 minutes. Results: Present study shows that duration of first stage of labour in epidural and non-analgesia group are same. Second stage of labour is prolonged in epidural group than non-analgesia group. Both groups had normal APGAR score. Epidural analgesia is not associated with any change in mode of delivery. Visual analogue scale is good with epidural analgesia. Conclusions: There was no significant difference in first stage of labour in both group. Second stage of labour was slightly prolonged in EA group than control, but it was less than two hours. No harmful neonatal outcome in epidural analgesia.

AIM Ÿ To screen and diagnose bacterial vaginosis during rst two trimesters of pregnancy. Ÿ To give early treatment for bacterial vaginosis during rst two trimesters of pregnancy and prevent obstetric complications. METHODS – Pregnant women tting in the inclusion criteria are recruited and explained about the procedure. Informed consent and ethics committee clearance is obtained. Vaginal smear is sent for microscopy. Vaginal pH is detected. Amine (shy) odour in wet mount examination is identied. AMSELS score and NUGENTS criterion are applied. Positive specimens are sent for antibiotic culture and sensitivity and treatment is initiated accordingly. Afollow up is kept for all patients diagnosed as bacterial vaginosis to see the outcome of their pregnancy. CONCLUSION - Prevalence of Bacterial vaginosis in my study is 29.2%. BV in pregnancy is common among low socioeconomic status, multigravida, and less educated females. It is associated with signicant risk of miscarriages, preterm labour and PROM. Universal screening of all pregnant women at booking visit may be recommended to initiate treatment with metronidazole / clindamycin in those women at risk for preterm delivery, symptomatic women and before surgical abortions.

Pregnancy with hypertension, proteinuria, edema detected in third trimester is always preeclampsia unless proven otherwise 1 . We had a similar case with acute onset of hypertension, proteinuia, oedema, mild breathlessness along with frank hematuria at 32 weeks of gestation in a primigravida. She was initially diagnosed as preeclampsia with its complication either HELLP syndrome or DIC. Investigations showed sever anaemia, mild thrombocytopenia normal liver & kidney function normal coagulation studies without any evidence of sepsis. Surprisingly fetal parameters were absolulety normal. There was no evidence of Intrauterine Growth restriction, fetal, and uterine Doppler studies were normal. Renal Doppler showing paranchymal renal disease. Patient was stabilized in ICU with nasal Oxygen, diuretics, antihypertensive, antibiotics, steroids for fetal pulmonary maturity. In view of deteriorating maternal condition uncontrolled hypertension increasing hematuria urgent delivery by caesarian section done as bishops was very poor. Surgery went uneventful with outcome of male child of 1.7 kgs. Post surgery patient was hemodynamically stable hypertension well controlled but hematuria was persistent and fluctuant. Urine culture report was negative. Suspecting some renal pathology with nephritic syndrome like presentation, she was found to be ASO titer positive. Detailed history revealed pharyngitis 4-5 days before with altered voice since then. Repeat renal uitrasonography 15 days postdelivery showed same findings of altered corticomedullary differentiation, raised cortical echogenicity suggestive of medical renal disease with normal renal artery Doppler. Final diagnosis of nephritic syndrome was made and patient was discharged on day 16 with fluctuant hematuria. Hematuria completely cured over 3 months period. Case report26 years primigravida with 32 weeks of gestation presented to emergency department with sudden increasing edema over lower extrimities and vulval edema with hematuria and slight breathing difficulty. She was not a diagnosed case of hypertension or any other systemic disease. There was a history of fever with sore throat 4-5days back. On examination she was found to have tachycardia (pulse rate-139/min), severe hypertension (160/110 mm of hg ) with tachypnea (RR 30 /min), pallor, cardiovascular system was normal. On respiratory system examination fine basal crepts were noted. Obstetrics findings were corresponding to weeks of gestation. There was evidence of pitting type lower abdominal wall oedema, pedal oedema upto lower thighs, severe vulval oedema and frank hematuria. Considering provisional diagnosis of severe preeclampsia with its complications, she was treated with antihypertensives diuretics and steroids. As there were no premonitory signs or symptoms of eclampsia Inj. MgSO4 was withhold. Patient was kept in intensive care unit under strict monitoring.