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Background: Premature Rupture of Membranes (PROM) is a significant obstetric problem. Evaluation of neutorphil-lymphocyte ratio (NLR) is expected to throw light on the potential scope of early prediction of PPROM. With this background, the present study was carried out to compare the NLR among preterm PROM and healthy controls to evaluate the predictive role of NLR and platelet-lymphocyte ratio (PLR).Methods: This case control study was carried out among 101 pregnant women 44 pregnant women diagnosed with Preterm PROM and 55 term gestation matched healthy controls. Laboratory parameters (including complete blood count were measured. PLR was calculated as the number of platelets divided by the lymphocyte count, and NLR was calculated by dividing the neutrophil Count by the lymphocyte count, both of which were obtained from the same blood samples.Results: All the inflammatory markers including total count, neutrophil count, NLR and PLR ratios were elevated among PPROM group compared to the controls. The observed differences in the mean levels of these parameters were statistically significant (p<0.05).Conclusions: It may be considered that monitoring of NLR during second and early third trimesters as a routine practice among high risk mothers can significantly help in early prediction of PPROM and help in minimizing adverse maternal and neonatal outcomes.

Background: Childbirth has a profound influence in a women’s life. One factor that has been more consistently identified as influencing the women’s physical and psychological symptoms following childbirth is the mode of birth.  This study aims at figuring out on women’s satisfaction with their mode of delivery and what difficulties they faced in the immediate postnatal period accordingly.Methods: All women who delivered between the period 1st July 2019 to 1st August 2019 were interviewed with a pretested semi structured questionnaire on postnatal day two. Patient was asked how much they were satisfied with their mode of delivery, immediate postnatal adjustments like ambulation, holding the baby first time, initiation of breastfeeding and pain score following different modes of delivery. The data was analysed to find out which mode of delivery made women more comfortable in the immediate postnatal period.Results: A total 97.1% women were satisfied with the support they got from health care professionals during labour. But when compared, spontaneous vaginal delivery group were satisfied with their mode of delivery (P-value-0.0005 highly significant) than the rest. Women who had vaginal delivery were ahead of caesarean group in terms of ambulation, holding the baby, initiation of breastfeeding and were well adjusted in their postnatal period.Conclusions: Authors conclude that women in our study were more satisfied with spontaneous vaginal delivery than caesarean section which was reflected in their immediate postnatal adjustments. As obstetricians’ authors need to understand the empowering effects of the psychological experience of vaginal delivery. The benefits of this process can be maximized through good communication skills and emotional support for women, enhancing their confidence to deliver normally so that caesarean section is done only when really indicated.

Background: Hypertensive disorders complicate 5-10% of all the pregnancies and preeclampsia is identified in 3.9%.Preeclampsia is a pregnancy specific syndrome characterized by the development of hypertension and proteinuria in the second trimester of the pregnancy. Microalbuminuria and elevated spot protein creatinine ratio are commonly found in preeclampsia. The aim of this study was to determine microalbuminuria and spot creatinine ratio in early pregnancy as predictors of pre-eclampsia.Methods: The study was conducted among 102 pregnant women by detecting the levels of albuminuria and spot protein creatinine ratio at 10-14 weeks period of gestation. Random urine sample of about 5 ml was taken to analyse the samples for microalbuminuria and spot protein creatinine ratio. All the women included in the study were followed up till delivery to rule out the possibility of developing preeclampsia depending on their microalbumin and spot protein creatinine ratio values.Results: Pregnant women who developed preeclampsia or eclampsia had significantly higher levels of microalbumin and spot protein creatinine ratio.Conclusions: A detailed study among a larger group of population is required to determine that microalbuminuria and spot protein creatinine ratio in early pregnancy are definitive predictors of preeclampsia.

Background: Fetal growth restriction (FGR) affects up to 5-10% of pregnancies. It is associated with increased perinatal mortality and morbidity. Doppler studies identify at risk fetuses and help in timing interventions and prognosticate outcomes. The ability of Doppler studies to predict neonatal outcome is studied here.Methods: Prospective study of seventy-two women with singleton pregnancies with gestational age above 28 week and detected to have FGR was done. The patients were subjected to Doppler analysis. Abnormal Doppler indices were compared with neonatal outcomes such as NICU admission, ventilator or CPAP support, sepsis, phototherapy and perinatal mortality.Results: Elevated umbilical artery PI, reduced middle cerebral artery PI and low CP ratio were found in 14, 18 and 36 fetuses. The sensitivity and specificity in predicting neonatal outcome was 25% & 75%, 58.1% and 62% and 17.9% and 75% for umbilical artery PI, MCA PI and CP ratio respectively. None of the Doppler indices showed significant p value. On testing, gestational age at delivery and length of NICU stay, gestational age was a significant determining factor with ‘p’ value of 0.003.Conclusions: Antenatal Doppler analysis of UA and MCA can predict neonatal outcome in FGR fetuses. Though the ‘p’ value was not significant in this study, the sensitivity, specificity, positive predictive value and negative predictive value are comparable to other studies. Gestational age at delivery significantly influences neonatal outcome.