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Background: Intrahepatic cholestasis of pregnancy is one kind of the hepatic disorder which is unique to pregnancy. It is associated with many adverse pregnancy outcomes if doesn’t intervened at right time. It requires adequate clinico-biochemical correlation during management.Methods: A prospective observational study was conducted at multispecialty government zonal hospital. Total 137 IHCP patients were managed during the study period from 01 Jan 2017 to 30 Jun 2019. Incidence and pregnancy outcome in form of several maternal and fetal factors were analysed by appropriate statistical test using spps software version 20.0.Results: During the study period total 4872 patients were undergoing delivery and 137 patients were diagnosed with IHCP. The incidence of IHCP was 2.81%. Majority of cases 75 out 137 (54.74%) were nulligravida. Total 29.92% (41/137) cases were underwent LSCS delivery and of this 21.17% (29/137) were primary caesarean delivery. There were three still birth noted in IHCP study population. Total 28 cases (20.44%) of IHCP were presented with preterm labour. And NICU admissions of the study population were 32 new born babies (23.36%). 2.18% case of still birth was noted among study population.Conclusions: IHCP causes significant maternal and neonatal morbidity and is major contributor of preterm delivery, caesarean delivery, meconium stained liquor and NICU admission.

Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiological syndrome. Patients usually present with seizures, visual disturbances, headache, and altered mental state. Most accepted pathophysiology is vasogenic edema. Imaging predominantly shows parieto-occipital white matter changes. We report a 22-year-old G2P1L1 lady who presented at 23 weeks 2 days period of gestation (POG) with high blood pressure (160 /104 mm of Hg) and headache and later on developed diminished vision too. There was no sensory motor deficit. After evaluation a plan of termination of pregnancy was made, in consultation with the patient and her husband. She was put on prophylactic dose of Inj. MgSO4 and anti-hypertensives and termination of pregnancy was done with intracervical application of PGE2 gel followed by vaginal PGE1 tablet (Misoprost) application. Her vision and headache however, didn’t improve even though she was put on Inj. MgSO4 and BP was controlled with antihypertensive. She delivered within 10 hours. In view of persistence of her symptoms, a MRI brain was done in consultation with a neurophysician, two hours after the delivery that suggested edema in occipital and temporal lobe suggestive of posterior reversible encephalopathy syndrome. Approximately 6-8 hours after delivery, gradual clinical improvement in visual acuity and headache was noted. Her vision completely recovered in 6 days. This case highlights the importance of keeping this entity in mind for the prompt diagnosis and early management, thus preventing short and long-term neurological deficits in this reversible condition popularly known as PRES.

Background: Implication of fibroid uterus on infertility is still debateable. Co-existence of infertility and fibroid uterus has been observed many times in clinical practice. This study is conducted to ascertain the frequency of primary infertility in women suffering from fibroid.Methods: A prospective observational study was conducted at Altnagelvin hospital, Northern Ireland from July 2019 to December 2019. Total 100 patients were participated in the study. All data were collected and analysed using SPPS ver 20 software.Results: During the study period, a total of one hundred women presented with fibroid uterus were observed. All the cases were within the reproductive age group ranging from 20-43 years of age. 40% for cases were between 20-27 years, 49% cases were between 28-35 years and 11% belonged to 36-43 years of age. Considering the symptoms, infertility was 14%. According to the number of fibroids, in 22% of cases, there were multiple fibroids. The single uterine fibroid was seen in 78% of cases.Conclusions: Fibroid is relatively common in patients of reproductive age and was associated with infertility in 14% of cases.

Hepatitis E is water born disease and transmitted by feco-oral route and it is an emerging infectious agent causing acute viral hepatitis all over the world. During pregnancy, especially in the third trimester, hepatitis E infection is characterized by a more severe infection with many fold increase in hepatic enzyme levels that sometimes results in fulminant hepatitisleading to increasing maternal and fetal morbidity and mortality. We are presenting an atypical case of hepatitis E in pregnancy which showed mild increase in enzyme levels with very high bilirubin levels.

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Background: ASHA (accredited social health activist) are the grass root level workers. Hence it is essential to study if they have adequate knowledge for delivering maternal health care services to community. The aim was to evaluate the knowledge of postnatal care among ASHA workers in North Indian rural area.Methods: This study was conducted at Basohli block of Kathua district from December 2019 to December 2020. Information was collected from ASHAs by interview technique.Results: 83.70% of ASHAs believed that colostrum should be given to newborn. 88.04% agreed for exclusive breast feeding for 6 months. 61.96% were in favor of more than 3 postnatal visits within 42 days of delivery. Many of them were aware of dangerous sign of postnatal mother and newborn. They were ignorant of postnatal exercises. All the ASHA were aware of purpose of immunization but only 21 knew the immunization schedule completely. All were aware of most of the available family planning methods that can be used by postnatal women.Conclusions: It is evident from the present study that ASHA workers have good knowledge of maximum aspects of postnatal care. Further training of the ASHA should be skill based and efforts should be made to remove the obstacles they are facing.