INTRODUCTIONCervical cancer is one of the most common malignancy among females, worldwide.1 Every year, more than 493,000 individuals are diagnosed with and 274,000 die from cervical cancer. The majority of these cases (80%) are experienced in developing countries.2 PAP smear is the most sensitive and specific screening test for cervical cancer in reducing mortality and morbidity of women. However, high incidence and mortality rates continue in developing countries due to the lack of screening programmes. 4 In India it is an important public health problem for women leading to annual mortality of ABSTRACT Background: Carcinoma cervix is the second most common gynaecological cancer causing deaths among women. PAP smear being most sensitive and specific screening test reducing mortality and morbidity, can be used to identify early changes in cervix during pregnancy. The aim of the study was to offer cervical cancer screening for pregnant women and motivate them into the mainstream of screening subsequently and evaluate their acceptance. Also to identify reproductive tract infections, associated pregnancy changes and their effect on pregnancy outcome. This prospective study enrolled 200 normal pregnant patients admitted at Sri Rama Krishna Hospital from September 2012 to January 2014. Methods: All the patients selected for this study underwent history taking and examination .Pap smear was taken with patient in dorsal position. Among 200 cases, 196 (98%) were adequate smears and only 4 (2%) were inadequate. Adequate smears which were grouped as per Bethesda system, majority (97.5%) fell in Group I and were found to be normal or inflammatory smear, while only one showed ASCUS. Of the cases in Group I, 114 cases (57%) showed inflammation while 81 cases (40.5%) were normal. Statistical analysis used was SPSS 11.5. Results: Majority of the patients involved in study were in the age group of 20-35years with only 3.5% below 19yrs and 2% above 35years with mean age of 26.9years. Most of the patients were married at 20-30yrs of age while only 4.5% were married after 30 with mean age of marriage 23.4yrs. Importantly 15% had an early marriage between 15-19yrs. Most of patients who consented for study belonged to third trimester (91.5%) followed second trimester (17%) with average of 32.7wks. About 80% had knowledge regarding screening for cervical cancer. Statistical analysis used was SPSS 11.5. Conclusions: PAP smear being a cost effective, easy to perform test, can be carried out even in pregnant woman. It does not interfere with the natural course of pregnancy and hence safety is ensured. Pregnancy is a potential opportunity to counsel and educate them regarding the significance of screening.

In routine gynecological practice, benign tumor mimicking malignancies are rarely thought of as differential diagnosis. It is always mandatory to consider malignancy as the first diagnosis so that the clinician`s approach will be with a bird`s eye view. The diagnosis of malignancy will have a pronounced bearing mentally for the affected women. We confronted one such interesting case in our institution. The patient had undergone prior surgeries and recovered from serious postoperative complications. In addition, she poses a higher risk for anesthesia. Above all, to counsel the patient and the family about the impact of the current problem is a Herculean task. The scenario takes a different upturn with the histopathology report. The effort by the multidisciplinary team proves fruitful.

Background: Infertility remains a global problem since ages and lot of stigma in society even in the modern era. The burden of psychosocial stress in primary infertility is overwhelming, still there is limited literature regarding this.Methods: We conducted a prospective study on 300 primary infertile women to determine the prevalence of psychosocial stress and the contributing factors. Data was collected using a semi structured questionnaire through a one-one interview, after narrating the purpose analysed the relationship of various psychosocial factors to infertility related stress.Results: In the present study, female factor 41%, 25% had male factor, 9% couple with combined factor and 25% with unexplained infertility. Polycystic ovarian syndrome was the most common, 25.6%, and tubal factor 13.3%. The sperm abnormalities and oligozoospermia in 20.3%. Earlier 52% had undergone ovulation induction, 38% had intrauterine insemination and only 10% undergone in vitro fertilization. 23% women and 4% men suffered psychological trauma in the past, 4% women had already been treated for psychiatric problem. We found higher scores for failed period, mind distraction, avoiding social gatherings. Parenthood desire seen in 82%, 8% for continuation of progeny, 7.6% for future security and 2.3% for social obligation. 53% were willing to adopt on failure of treatment. The prevalence of psychosocial stress was 70% in present study.Conclusions: Understanding the psycho social factors associated with stress helps to alleviate and improve the quality of life. Public health awareness programs and coping strategies are the need of the hour. Encouraging adoption will solve the twin problems of infertility and abandoned kids.