A 25-year-old female second gravida with one live deliver with previous one lower segment caesarean section at 36 weeks six days pregnancy reported to the emergency with chief complaint of decreased foetal movements for the past two weeks. Patient perceived 3-4 foetal movements per day in last two weeks.On examination her vitals were normal. Her systemic examination revealed no positive abnormal finding. On per abdominal examination uterine height was corresponding to term pregnancy and foetal heart rate was regular, cardiotocography was done which showed accelerations of foetal heart rate coinciding with foetal movements, indicating healthy foetus with normally functioning autonomic nervous system. However, patient was not able to feel any movement during the cardiotocography. In view of this and to rule out additional risk factor, ultrasonography was undertaken. Ultrasonography revealed amniotic fluid volume of 15, expected baby weight of 3.1 kilogram and manning score of 10/10.Patient was unsatisfied after sonographic confirmation of foetal well being saying that the movements are not good enough as earlier. This was followed by repeated admissions for the same complaint three times a week.Similar complaint of decreased foetal movement was also present in her previous pregnancy. At that time she was induced with three doses of dinoprostone gel 0.5 mg which was followed by syntocinon augmentation. However, she had undergone lower segment caesarean section due to foetal distress but she was not informed about the uterine anomaly at that time.Keeping a track of foetal movement and responding to change in movement as first line of defence against still birth and perinatal hypoxia, decision was taken to induce the patient with dinoprost gel at 37 weeks four days after well informed patient consent. After receiving two doses at eight hour interval, patient was taken up for lower segment caesarean section in view of non reassuring cardiotocography. Peroperative findings revealed partial uterine septum. Birth weight of the foetus was 3.1 kg with APGAR score of 6,8,10 at 0, 1, and 5 minute respectively. Both mother and baby were healthy in post operative period. DISCUSSIONIncidence of mullerian duct anomaly is 1-3% in women.[1] Literature have reported septate uterus as one of the most common types of mullerian anomaly [1]. Uterine septum may be incomplete in which wedge-like partition may involve only the superior part of the cavity. Less frequently, it may involve the whole length of the uterine cavity (complete septum) or even cervix leading to morphologically double cervix. This septation may also continue into the vagina resulting in a double vagina. Serosal surface of the uterus is usually normal but less commonly may have a groove or indurations.[1] Congenital uterine anomaly has been well established as cause of infertility and recurrent pregnancy loss [2]. However, only few studies [2,3] have reported the adverse pregnancy outcome of mullerian anomaly in third trimester which include pre term labour, pre ter...

Pregnancy implanted in the rudimentary horn of unicornuate uterus is very rare with an incidence of 1 in 75,000 to 1 in 150,000 pregnancies. Half of them rupture, and 80% of the rupture occurs in first and second trimesters. Atrocious outcomes are reported. Horn pregnancy rarely reaches third trimester and when it does the diagnosis becomes more challenging. Ectopic in unicornuate rudimentary horn of uterus is difficult to diagnose even with best facilities available. Consequences are grave with slightest error of radiological and clinical judgment. Here we present case series of women who had rudimentary horn pregnancy and presented with varied clinical presentation, however they went undiagnosed even after radiological assessment and it lead to exaggerated maternal morbidity. The purpose is to spread awareness of all such rare cases where maternal and fetal wellbeing is jeopardized, and accentuates the significance of high index of suspicion in all such cases

Objectives:To determine the correlation of subclinical hypothyroidism (SCH) with polycystic ovarian syndrome (PCOS) and to assess its impact on the clinical, biochemical and hormonal features in polycystic ovarian syndrome. Background:PCOS is one of the most common endocrinopathies seen in women of the reproductive age group with a prevalence ranging from 2.2% to 26% globally (Joshi et al., 2014) and 3.7% to 22.5% (Malik et al., 2014) in the Indian population. Thyroid disorders are quite commonly seen in PCOS patients, SCH are seen in up to 5-10% of this population (de Medeiros et al., 2018). Its association with PCOS has been insufficiently explored and therefore this study was designed to better understand the correlation. Methodology:This was a cross-sectional study conducted from November 2019 to 2021 in the Department of Obstetrics and Gynecology of Jawaharlal Nehru Medical College and Hospital, Aligarh, India, on 150 PCOS women in the age bracket of 18–35 years. They were divided in two groups: one with normal thyroid levels and the other with SCH. Measurement of clinical, anthropometrical, biochemical and hormonal profile was made in both groups and comparison was made using appropriately matched tests of significance and coefficient of correlations. Results:Notable findings included a positive and statistically significant correlation between SCH and menstrual cycle irregularities ([Formula: see text] = 0.167, [Formula: see text] < 0.05), infertility ([Formula: see text] = 0.299, [Formula: see text] < 0.05), body mass index ([Formula: see text] = 0.172, [Formula: see text] < 0.05), waist to hip ratio ([Formula: see text] value = −2.952, [Formula: see text] < 0.01), testosterone( [Formula: see text] = 0.246, [Formula: see text] < 0.01), total cholesterol ([Formula: see text] = 0.205, [Formula: see text] < 0.05), triglyceride values ([Formula: see text] = 0.305, [Formula: see text] < 0.01), fasting insulin ([Formula: see text] = 0.219, [Formula: see text] < 0.01) and HOMA-IR ([Formula: see text] = 0.221, [Formula: see text] < 0.01). A positive but statistically insignificant correlation was found with hirsutism ([Formula: see text] = 0.116, [Formula: see text] > 0.05), luteinizing hormone ([Formula: see text] = 0.122, [Formula: see text] > 0.05), follicle-stimulating hormone ([Formula: see text] = 0.113, [Formula: see text] > 0.05), prolactin levels ([Formula: see text] = 0.109, [Formula: see text] > 0.05), high-density lipoprotein ([Formula: see text] = 0.050, [Formula: see text] > 0.05), low-density lipoprotein ([Formula: see text] = 0.136, [Formula: see text] > 0.05) and fasting blood sugar values ([Formula: see text] = 0.046, [Formula: see text] > 0.05). No statistical significance with systolic blood pressure ([Formula: see text] value = −0.502, [Formula: see text] > 0.05) and diastolic blood pressure ([Formula: see text] value = −1.643, [Formula: see text] > 0.05) was found. Conclusion:The study showed a significant correlation between SCH and multiple variables in PCOS and thereby necessitating thyroid screen in PCOS population.

Uterine rupture is a rare but life threatening emergency and its immediate diagnosis and treatment is of prime importance as it could lead to mortality of both mother and the baby especially in developing countries where birth is attended by untrained professionals. Rupture uterus can present atypically and this might pose a challenge in making of diagnosis, as in our case where a young primipara with no previous surgical scar, presented with abdominal pain post normal vaginal delivery and it took 6 hours to diagnose the case as our patient had no risk factors. She was operated and a rent of 7x8 cm was found on anterior uterine segment which was repaired. Thus in absence of typical signs a postpartum patient with abdominal pain should always be evaluated very carefully.

Objective: To find correlation of 25-hydroxy vitamin D (25OHD) levels with various clinical biochemicals, anthropometric parameters in patients of PCOS. Study design: Cross-sectional observational study. Materials and Methods: The study was conducted at Obstetrics and Gynaecological dept. of Jawaharlal Lal Nehru medical college, AMU, Aligarh, for a period of 2 years, 2018-2020. A total number of 100 PCOS patients satisfying inclusion criteria were enrolled for the study. Frequency of Vit-D deficiency in study group was estimated. Correlation of Vit-D levels with various clinical, anthropometrical, biochemical parameters was evaluated. Based on Vit –D levels the study population was divided in to Vit-D deficient and non-deficient individuals and Paired sample t-test was used to assess changes in quantitative variables. Pearson product moment co-relation analysis was used to see correlation among different variables. Qualitative variables were interpreted using Chi square test. Statistical analysis was performed using computer program SPSS version 25.0. Observations and Results: The results of 100 PCOS patients were analysed. Vit-D deficiency was found in 74% of PCOS population. Vitamin D correlated inversely with LH, FSH Prolactin and Testosteron levels (r=-0.213, p<0.05,r=-0.176;p>0.05,r=-0.101;p>0.05; r = 0.246, p<0.01).)Though significant correlation was found with LH and testosteron only.

Contraception means interference in the process of ovulation, fertilization or implantation. This is an old practice and dates back to ancient times and continues to modify and remodify itself according to the social customs and demands of the society. This chapter discusses various forms and methods of contraception, their efficacy, advantages and disadvantages of their use, their importance in present scenario and their impact on the society. Unwanted pregnancies and their termination attempt can be hazardous if not dealt in proper way, so avoidance of pregnancy is considered the best way out for physical and mental health of the patient and thereby focuses the importance of contraception practice and health education.

Introduction: Non Stress Test serves an important function in assessment of fetal wellbeing, but false positive results limit its role. Light stimulation stimulates the fetus, speeds up the test and catalyses its rate limiting step. This study has compared simple Non Stress Test and Light stimulation test and there correlation with various fetal outcomes. This study helps us to assess whether light stimulation be used as a better alternative or an adjunct to traditional Nonstress test. Material and Methods: A total of 220 patients above 34 weeks of pregnancy were taken.110 pts underwent 20 minutes of Nonstress test and 110 underwent Halogen light stimulation which was given transabdominally for 10 seconds and it was repeated every 10 minutes for a maximum up to three times. This allocation was done randomly. Non reactive Nonstress test were then stimulated with Halogen light. Results: The test showed that sensitivity of Nonstress test is greater than Light stimulation test, but specificity, positive predictive value, and negative predictive value is lesser than Light stimulation test .Out of 36 Non reactive NSTs after stimulation with light 18 became reactive. Conclusion Nonstress test is considered as a screening test and Light stimulation test can be used as an adjunct to Nonstress test as it decreases the number of false positive results and increases the specificity of the test. Clinical outcomes are more closely related with LST, but more studies are required to arrive at the final conclusions.

Introduction: Caesarean section (CS) is one of the commonest surgical procedures performed in obstetrics. Postoperative infectious complications including surgical site infections (SSI) are a cause of significant morbidity after CS as compared to vaginal delivery. Aim: To assess the role of application of surgical bundle and vaginal cleaning before caesarean section in preventing postoperative infectious complications. Design: Prospective randomised interventional study. Place and duration of study: Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College and hospital,Aligarh from November 2016 to October 2018. Methodology: Total of 216 patients undergoing emergency CS in the hospital was enrolled in the study. Patients were kept in 2 groups. In group 1, women undergoing emergency C-Section whom conventional preoperative preparation was done using savlon-povidone iodine as skin antiseptic and a 7 day postop prophylactic antibiotic regime was administered.In group 2,surgical bundle and vaginal cleaning was done but postop prophylactic antibiotic regime was reduced to 3 day Results:Overall,SSIs were most common infectious morbidity in both groups with highest incidence in group 1(14.7%) and lower in group 2(7.01%), and the difference was statistically significant. Rates of endometritis, UTI and URTI were similar among 2 groups.Duration of hospital stay was lower for group 2 (6.43+_3.29days).No Significant association was noted between haemoglobin levels <8g/dl and number of >4 vaginal examinations with risk of development of SSI (p<0.05). Conclusion:Bundled approach including vaginal cleaning has decreased the incidence of SSIs after emergency CS but larger clinical studies are needed to prove the definite role