Background: As per NFHS III, 4.5% of the teen aged women of Tripura were pregnant, 18.5% have begun childbearing, and 14% have given live births. Objectives: To estimate the prevalence of teenage pregnancies among tribal and nontribal population of West and South districts of Tripura, to study the social practice of care during these pregnancies, and to assess the utilization of RCH services by them. Methods: A community-based mixed method study was conducted from 5 th September 2014 to 4 th September 2015 among 2108 tribal and nontribal women aged 15 to ≤18 years residing in the undivided West and South districts of Tripura chosen by multistage sampling. Result: Among the study women, 93.5% were married, 6.3% were unmarried, and 0.2% was either divorced or widowed. Out of total, 21.35% were pregnant and 57.92% had already delivered. ASHA services were received by 59.73% and 72.13% in West and South districts and by 68.09% and 63.69% of the tribal and nontribal, respectively. JSY registration was 53.99% and 83.43% in West and South districts and 71.56% and 66.91% among tribal and nontribal, respectively. Antenatal check-up was received by 96.26% and 90.79% in West and South districts and 89.39% and 97.66% among tribal and nontribal ever pregnant women, respectively. Home deliveries were higher among tribal and they had inadequate postnatal check-up. Practice of isolated confinement following childbirth was fewer and these rooms were unclean and ill-ventilated though normal clothing was used. Qualitative component revealed that underutilization of RCH services was mainly due to poor quality of services, ignorance, and economic constraints to reach health facility. Conclusion: Teenage pregnancy is prevalent in Tripura and more among tribal. Ignorance of the women and poor quality of RCH services at primary health care level are responsible for its underutilization.

Background: The objective of present study was to assess the proportion of maternal near miss and maternal death and the causes involved among patients attending obstetrics and gynaecology department of Agartala Govt. Medical College of North Eastern India.Methods: Potentially life-threatening conditions were diagnosed, and those cases which met WHO 2009 criteria for near miss were selected. Maternal mortality during the same period was also analyzed. Patient characteristics including age, parity, gestational age at admission, booked, mode of delivery, ICU admission, duration of ICU stay, total hospital stay and surgical intervention to save the life of mother were considered. Patients were categorized by final diagnosis with respect to hemorrhage, hypertension, sepsis, dystocia (direct causes) anemia, thrombocytopenia, and other medical disorders were considered as indirect causes contributing to maternal near miss and deaths.Results: The total number of live births during the study period (January 2017 to June, 2018) was 9378 and total maternal deaths were 37 with a maternal mortality ratio of 394.5/1 lakh live births. Total near miss cases were 96 with a maternal near miss ratio of 10.24/1000 live births. Maternal near miss to mortality ratio was 2.6. Of the 96 maternal near miss cases - importantly 20.8% were due to haemorrhage, 19.8% were due to hypertension, 13.5% were due to sepsis, and 11.5% were due to ruptured uterus. In maternal death group (n-37), most important causes were hypertensive (40.5%) followed by septicemia (21.6%), haemorrhage (10.8).Conclusions: Haemorrhage, hypertensive disorders and sepsis were the leading causes of near miss events as well as maternal deaths.

ABSTRACT:Gestational trophoblastic disease is a broad disorder of abnormal fertilization of ovum. Early detection and treatment is the best approach to prevent mortality and morbidity of patients of gestational trophoblastic tumors. All trophoblastic cells produce hcg (human chorionic gonoadotropin) and can easily be detected in urine of pregnant ladies. When urine pregnancy test become negative in a highly suspected patient, the management becomes difficult. In this case, though the urine pregnancy tests were negative on several occasions, serum β hcg level was very high > 1500000 mIU/ml (positive) and patient was cured by chemotherapy.

No abstract

Two patients of 30-35 years of age presented in Gynecological emergency of Agartala Government Medical College at unstable condition with the diagnosis of ruptured ectopic pregnancy. Both the cases were taken for emergency laparotomy after initial resuscitation, investigations & arrangement of blood products. In both the cases rupture were found in right side and hence right sided salpingectomy done in both the cases. Both the tubes (affected) after laparotomy were sent for histopathological examination where both the reports came to be partial mole. Ectopic hydatiform mole (either complete or partial) are rare events, among these Ectopic partial moles are rarer. Both the cases were in regular follow up & ß-HCG levels came to the base level within 6-7 wks. The 1st case became pregnant after 9 months of laparotomy.

BACKGROUND Lancefield Group-B Streptococcus (GBS) emerged as a significant neonatal pathogen with mortality rates of 15 - 50 % in western countries during 1970s. In India, incidence of invasive neonatal GBS diseases is around 0.17 per 1000 live birth and probably is underestimated. Hence, the study was undertaken to evaluate the vaginal GBS colonization in pregnant women along with the neonatal outcome. METHODS The study was single centered, hospital based observational cross-sectional study done in the dept. of Obstetrics & Gynaecology at Agartala Government Medical College (AGMC), and GBP Hospital for one & half years (Jan’ 16 - June’ 17). 250 Pregnant mothers with 31 to 40 weeks of gestation with singleton pregnancy, delivering either by Caesarean section & Vaginal delivery, were included in this study. They were recruited from obstetrics OPD and casualty of AGMC & GBP Hospital. During 1 st pelvic examination, two low vaginal swabs were taken for Gram Staining, and for determination of ß-hemolytic colony in blood agar. After identification of GBS from genitalia, outcome of neonates in these positive cases were evaluated for up to 28 days after delivery. RESULTS GBS was found in 8.8 % of total women recruited and was more common in multi-gravida. GBS vaginal colonization was significantly associated with low birth weight, and preterm delivery (p value 0.01) which is significant. CONCLUSIONS Prevalence of vaginal GBS colonization is more in pregnant mothers, more in multigravidas & is associated with low-birth-weight neonates and preterm delivery. So, there is a need to formulate guidelines for incorporation of detection of vaginal colonization in multi gravidas to determine its prevalence. KEYWORDS Group-B Streptococcus (GBS), Multigravidas, Colonization, Neonates, Pregnant Women

A 14 years old girl presented to the gynecology OPD with pain abdomen and huge abdominal lump since 2 months. On clinical examination, a large mass of 20x15 cm size was found extended upto the xiphoid process. Serum studies showed rise of CA-125 up to 406.9U/mL and LDH up to 310U/L. USG shows right ovarian cyst of 14.8x14.1x12.8 cm with internal calcification. MRI revealed a well encapsulated mass of 21x19x17cm with solid and cystic mass and upward peritoneal extension. Exploratory laparotomy was performed with right sided salpingo- ophorectomy with infracolic omentectomy, as the omentum appeared granular. She had an uneventful post-operative recovery. Subsequently HPE showed immature teratoma NORRIS grade 3 with co-existent peritoneal gliomatosis (grade 0). She is under regular follow-up and decided to give six cycles of combination chemotherapy with BEP at regional cancer hospital.

No abstract