Background: Engagement of head is the most important event in labor which decides obstetric outcome. Floating head in primigravida at term is considered an important obstetric risk factor. Cephalopelvic disproportion, occipito-posterior position and deflexed head should be suspected in most cases of floating head. Present study was conducted to determine the outcome of labor in primigravida with floating head at term. The primary objectives of the study was to analyse the progress of labor, need of medical and surgical interventions and fetomaternal outcome. The secondary objective was to find out the rate of caesarean section for floating head in all situations whether elective or emergency in labor.Methods: This study was conducted in department of Obstetrics and Gynaecology SGRDIMS and R, Sri Amritsar on 100 primigravida subjects with floating head at term admitted through OPD admissions for induction of labor /spontaneous labor or referred from outside directly in early labor.Results: In present study the mean age was 24.95±3.01 years. The youngest case was 19 years old and eldest being 32 yrs old. The mean height was 151±3.41. At the time of admission 21% of cases had floating head, 55% cases were at -3 station, 17% of cases had -2 station, with only 7% of cases had -1 station.  56% of women delivered by caesarean section, 8% by forceps assisted vaginal delivery and 36% by normal vaginal delivery. The mean duration of labor was more in free floating and -3 stations in comparison to -2, or -1 stations. The need for augmentation was more in higher head stations.  Mean birth weight was 2.84±0.31, it was more in higher fetal stations in comparison to lower fetal stations. No significant maternal and fetal morbidity was seen. There was no significant difference in the Mean APGAR score of higher head stations in comparison to lower fetal stations.Conclusions: Primigravida with floating head at term and during labor should be managed cautiously. By proper monitoring and maintenance of partogram most of these cases deliver vaginally and without any maternal and fetal morbidity. The attitude of watchful expectancy and timely intervention will be used in all cases, especially in those appearing to be taking a protracted course.

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Our study generates data of HPV prevalence in patients with cervical lesions visiting tertiary care institute. The data generated will be useful for laying guidelines for mass screening of HPV detection, treatment, and prophylaxis.

Background: Cesarean section has become more prevalent over the years due to various factors and is exceeding the tolerable limit specified by WHO. The objective of this study was to analyze cesarean section rates in our department and to identify the factors that contributed to rising cesarean section rate considering both institutional aspects as well as socioeconomic causes. Methods: It was a retrospective study conducted between May 2015 to April 2016 and included all pregnant patients booked in antenatal clinic and unbooked patients admitted in early labour in whom cesarean section was conducted later along with cases coming in emergency for which cesarean section was indicated. Data was collected and categorized on the basis of age, parity, socioeconomic status, education and according to Robson's ten group classification. Results: The cesarean section rate was found to be 33.2% in our study. The most common indication was repeat cesarean section, fetal distress, and breech presentation. Robson's group1 had maximum cesarean rates followed by group 5, 6 and 3. Conclusions: Tertiary care centers cannot be expected to have a similar rate as primary and secondary ones due to high number of complex cases referred to them. Though effort should be made to keep the cesarean rate at a low level as suggested by WHO but denying it for an indicated case just to adhere to keep low rate jeopardizes maternal and fetal health. Hence no definitive guidelines can be followed and a very judicious approach is needed.

Background: The aim of the study was to find out pre-induction cervical length by TV Sonography, determine Bishops score and to co-relate the obstetric outcome with these two variables.Methods: A study was done on 100 women with singleton pregnancies at 37-42 weeks of gestation, admitted for induction of labour in the Department of Obstetrics and Gynaecology at SGRDIMSR, Vallah, Amritsar, Punjab, India. All women underwent cervical assessment by both transvaginal ultrasound and Bishop Score and the outcome of labour induction was determined.Results: Of the 100 women, 53 women had vaginal delivery and 47 landed into LSCS. Bishop score < 6 and cervical length > 3 cm are cut off values of cervical unfavourablity. Successful induction was achieved among 87.5% and 78% women with favorable cervix according to Bishop Score and Cervical length respectively .Among the 92 and 50 women with unfavourable cervix according to Bishop score and cervical length, 48 (52.17%) and 14 (28%) had vaginal delivery respectively.Conclusions: Hence, cervical length by transvaginal ultrasound is a better predictor for the success of induction of labour as compared with assessment by Bishop Score alone.