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Thirty-two patients were treated with placebo tablets or indomethacin (25 mg three times daily) in a six-month, double-blind, cross-over trial. During indomethacin therapy, 75 per cent of patients experienced significant pain relief while associated vomiting and diarrhoea were relieved in 44 per cent and 64 per cent of patients respectively. The efficacy of indomethacin was comparable to that of other prostaglandin synthetase inhibitors.

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Background: Maternal death has a serious implication on the family, society and nation. The preventable and avoidable factors have been noted in most of the maternal deaths and these can be reduced by effective and affordable actions. The objective of present study was to evaluate the causes of maternal mortality in a tertiary care hospital, assess its epidemiological aspects and suggest remedial measures to reduce the same.Methods: A retrospective study of all hospital records and death summaries of all maternal deaths over a period of 16 months from April 2015 to July 2016 was carried out and epidemiological factors and causes affecting maternal mortality were assessed.Results: A total of 100 maternal deaths occurred over a period of 15 months out of which unbooked and late referrals constituted 75.55 % of maternal deaths. Most maternal deaths occurred in the age group of 20–30 years, multiparous women (73%) and women from rural areas (71.%). Direct obstetric causes were responsible for 91 maternal deaths whereas 50 maternal deaths were due to indirect causes. Most common cause of death (41) was hemorrhage, followed by pregnancy-induced hypertension including eclampsia (15) and sepsis (21).Conclusions: Hemorrhage, sepsis and hypertension including eclampsia were seen as the direct major causes of death. There is a wide scope of improvement because a large proportion of the observed deaths are preventable.

Background: Referral services for identification and referral of high risk pregnancies are an integral part of maternal and child health services. The aim of this study was to review the pattern of obstetric cases referred to tertiary care center, to identify their clinical course, mode of delivery, maternal and perinatal outcomes.Methods: It is a prospective observational study carried out from January 2017 to July 2017. Study population was all Obstetrics patients referred to Department of Obstetrics and Gynecology of B.J Medical College, Ahmedabad, Gujarat, India a tertiary care center during the study period.Results: The total number of referred cases in above study period was 100. Mode of transport used by the referred patients was by 108 ambulances (75%) and private vehicles (25%). Most common diagnosis at the time of referral was hypertensive disorders of pregnancy (31%). Out of the total referred cases, 57% had vaginal delivery, 42% had caesarean section. Hypertensive disorders of pregnancy constitute the leading cause of maternal deaths amongst the referred cases.Conclusions: The present study has shown that inadequate antenatal and intra-natal care at the periphery level is responsible for increased maternal and perinatal morbidity and mortality. Even today, hypertensive disorders of pregnancy are the leading cause of maternal mortality. Health education to the community will definitely reduce maternal and perinatal morbidity and mortality.