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Background: Preterm premature rupture of membrane (PPROM) is among the most important cause of the perinatal morbidity and mortality. We sought to determine whether cervical length and amniotic fluid index individually or in combination can predict the pregnancy outcome in cases of PPROM.Methods: The prospective observational study was done on 170 women complicated by PPROM with gestational age between 24-36+6 weeks. They were categorized into three groups Group I.24-28 weeks, Group II.28+1 to 32 weeks and Group III. 32+1 to 36+6 weeks. Cervical length and amniotic fluid index were measured using trans abdominal ultrasound within 24 hr of admission. Maternal outcomes were recorded in terms of latency period, chorioamnionitis, and abruption , and neonatal outcomes were recorded in terms of birth weight, first minute APGAR score <7, NICU admission and early neonatal death. Qualitative variables were correlated using Chi-Square test /Fisher’s exact test. Univariate logistic regression was used to assess cervical length and AFI as a predictor of complication. A p value of <0.05 was considered statistically significant.Results: Out of 170, majority (95) belonged to 28+1 to 32 weeks group. Latency was inversely related to period of gestation (p<0.0001). A long cervical length correlated with increased latency, increased risk of chorioamnionitis and increased neonatal complications in all three groups. Also, women with PPROM having AFI >5 cm had a greater mean latency period (8.32±1.25 days) which increased their risk of developing chorioamnionitis as compared to women with PPROM having AFI ≤5 cm, who had a shorter mean latency period (7.63±1.07 days) and a lower risk of developing chorioamnionitis (p value <0.0001).Conclusions: Latency is inversely related to period of gestation. A long cervical length and increased amount of AFI correlates with increased latency, increased risk of chorioamnionitis and increased neonatal complications.

Background: In this study, we aimed to find diagnostic accuracy of neutrophil to lymphocyte ratio in comparison with liver function tests for the diagnosis of intrahepatic cholestasis of pregnancy and adverse fetal-maternal outcomes.Methods: NLR and aminotransferase (AST/ALT) levels in the blood samples of pregnant women with complaint of pruritus. 90 women with elevated transaminase were taken as cases and same number of women with normal aminotransferase levels taken as control. All were examined in this prospective case-control study.Results: Not only was the mean NLR elevated in the pregnant women with cholestasis when compared to the controls, but it also predicted the severity of the cholestasis. The correlation between transaminase levels and NLR was significant.Conclusions: Although TBA is still the diagnostic standard, NLR can be used as an initial screening tool due to its high specificity.

Background: Study was done to assess the efficacy, safety and continuation rate of Centchroman and IUCD administered in immediate postpartum period (within 48 hours).Methods: An interventional study was conducted in Obstetrics and Gynecology department of Safdarjung Hospital, New Delhi, at a tertiary care hospital after approval from ethical committee. 280 women were enrolled in the study and divided into 2 groups centchroman group and PPIUCD group, 140 in each group after excluding the exclusion criteria and satisfying inclusion criteria. These women were followed up at 6 week, 3 month and 6 months to study efficacy, safety and continuation rate.Results: Centchroman as contraception is safe with fewer side effects, better satisfaction rate and better continuation rate in comparison to PPIUCD.Conclusions: Centchroman is a newer contraceptive which is recently added in basket of family planning in our country to give wider choices to women. It is an indigenous product developed by central drug research institute (CDRI), Lucknow available free of cost in government hospitals. Centchroman needs more popularity and education for its widespread use.

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