Background: To identify the risk factors and to streamline preventive and management protocols for IUD. Methods: This was a retrospective study from January 2011 to December 2012 which was conducted at G.S.V.M. Medical College, Kanpur. IUD was defined as fetal death beyond 20 weeks of gestation and/or birth weight > 500g. Maternal and fetal records were analysed. Mode of delivery and associated complications were studied. Results: Total number of deliveries were 7310.Incidence of IUD at our centre was 40 per 1000. 55.73% were antepartum and 11.06% were intra partum. In 33.44% cases, no causes were identified. Among the identifiable causes, very severe anemia (16.55%) and hypertensive disorders (10.81%) were most common followed by placental causes (12.16%).Congenital malformations were responsible for 9.45% cases .Induction was done in 151 patients,111 patients had spontaneous onset of labour and caesarean section was done in 34 patients. The most devastating complication of IUD was DIC found in 14 patients (3.71%). Conclusions: The present study is an effort to compile a profile of maternal, fetal and placental causes culminating to IUD at our centre. This emphasizes the importance of proper antenatal care and identification of risk factors and its treatment. Institutional deliveries should be promoted to prevent intrapartum fetal deaths .A substantial number of IUD are still labeled as unexplained, hence cannot be prevented. Decrease in the incidence of IUD would significantly reduce the perinatal mortality. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000): 141-146

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Background: A decreased amniotic fluid volume is frequently one of the first clues to an underlying fetal abnormality or maternal diseased state. Isolated oligohydramnios may occur in late pregnancy in patients with no other high risk factors and diagnosed on routine ultrasound. This study was conducted to assess the effect of oligohydramnios on perinatal outcome at or beyond 34 weeks of gestation with amniotic fluid index (AFI) ≤ 5. Methods: 50 cases and equal controls were taken in the study which fulfilled the inclusion criteria. A written and informed consent was taken from all the subjects entering into the study. An ultrasound examination was performed on all the subjects entering the study. Phelan method was used for measurement of AFI. Measurement of the deepest pool in each quadrant was summated and AFI was recorded in centimeters. Results: Anthropometric variables were comparable in both the groups. The distribution of non-stress test (NST) and onset of labor was significantly different in both the groups. The presence of meconium stained liquor was non significantly same in both groups. Regarding neonatal outcome, birth weight less than 2.5 kg and APGAR score less than 7 was significantly higher in cases as compared to controls. Conclusions: Oligohydramnios (AFI< 5) was associated with more number of preterm deliveries, non-reactive NST, fetal distress and more NICU admissions. More studies are needed for defining threshold levels for measuring AFI.

Background: The objective of the present study was to compare the efficacy between sublingual 600 and 800 microgram Misoprostol after administration of Mifepristone up to 9 weeks gestation, to compare the incidence of side effects between the two doses. To compare the acceptability between the two doses.Methods: This study is a single-center, randomized study. The study is conducted at Fortis Escorts Hospital and Research Centre, Faridabad, during period of May 2014 to June 2015. 160 Pregnant women with singleton pregnancy up to 9 weeks gestation, visiting OPD of Obstetrics and Gynaecology, who wanted MTP by drug, after taking care of inclusion and exclusion criteria. An informed consent was taken from all the women.Results: In terms of efficacy, both the groups were comparable (p value 0.509). Blood loss was comparable in both the groups (p value 0.147). In terms of side effects, itching and rashes (p value 0.004) and abdominal cramps (p value 0.001) was found to be more in women taking 800ug Misoprostol. Also, need for analgesia (p value 0.001) was found to be more in women taking 800ug Misoprostol.Conclusions: Sublingual Misoprostol is comfortable and easier administration when compared to other routes and it has potential to be developed as a self-administered regimen. 600ug Sublingual Misoprostol is as efficacious as 800ug sublingual Misoprostol with significantly lesser side effects up to 7 weeks of gestation.

Background:The aim is to study the role of first trimester pregnancy associated plasma protein A (PAPP A) and second trimester uterine artery pulsatility index (PI) in prediction of pre-eclampsia in early pregnancy. Methods: This prospective study conducted at GSVM Medical College, Kanpur from May 2011 to May 2012 included 100 pregnant women. Serum PAPP-A level was determined in the first trimester (8-14 weeks) and uterine artery Doppler was done at 20-25 weeks of gestation. Results: Out of 100 patients 7 developed pre-eclampsia. Mean PAPP-A level in pre eclamptic and normotensive patients were 1.25±1.4 and 2.5±0.5ng/ml respectively. Mean PI level in pre eclamptic and normotensive patients were 1.77±0.28 and 0.96±0.25 respectively. The sensitivity and specificity of PAPP-A at cut off <1.7ng/ml was 71%, 71% respectively. The sensitivity and specificity of pulsatility index at cut off >1.4 was 100% ,94% respectively. Conclusions: Low level of maternal serum PAPP-A at 8-14weeks and high level of uterine artery PI at 22-25 weeks of pregnancy can predict subsequent development of pre-eclampsia.