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Introduction: Puerperal sepsis is one of the leading causes of preventable maternal mortality and morbidity. Various factors predispose to the infections. The objective of the study was to evaluate factors related to labor in the women with puerperal sepsis. This was an observational study. Study population was all postpartum women with puerperal sepsis admitted in a tertiary care hospital from April 2016-March 2017. The women were carefully evaluated, data collected and analyzed. There were 60 women with puerperal sepsis. Thirty three percent cases were less than 34 weeks gestational age. 81.7% of the women had institutional deliveries. Fifty three percent women delivered by spontaneous vaginal delivery. Prolonged labor (> 24 hours) was present in 73% of cases. Prolonged rupture of membranes was found in 70% cases. Grade III and IV sepsis was more in women who had prolonged labour and rupture of membranes >24 hours. (p<.05). Conclusion:Puerperal sepsis was observed more in preterm births and complicated institutional deliveries, while severity was more in women with prolonged labor and prolonged rupture of membrane. Antimicrobial sensitivity should be done of all women with prolonged labor or prolonged rupture of membranes.

Aim: Caesarean section is the commonest obstetric surgery. Any change in the operative technique however small, affects the postoperative outcome.Effect of nonclosure of peritoneum on postoperative outcome was evaluated. Method:This was an interventional study. Postoperative condition of the women was assessed after caesarean section. Peritoneum was either closed or left open and outcome was compared.Statistical analysis was done.Results: Most women in the nonclosure group had earlier ambulation and return of bowel activity and breastfed early in comparison to the closure group. More postoperative pain, nausea and vomiting was observed when peritoneum was closed. Since the stay in hospital was less in women with peritoneal nonclosure and because of use of lesser suture material, this was more cost effective too. Conclusion:Leaving the peritoneal open was a better method than closing it because patient was more comfortable, there was lesser morbidity and shorter hospital stay and cost effectiveness. Clinical significance:The policy of peritoneal nonclosure will help in decreasing maternal discomfort, shorter hospital stay and overall economical.

Background: Caesarean section is the most commonly performed obstetric surgery. A change in the operative technique affects the postoperative outcome. The study was undertaken to study the postoperative outcome of the patient who underwent caesarean section by Pfannensteil Kerr and Misgav Ladach method of lower segment caesarean section. Methods: It was a hospital based interventional study done in a tertiary care hospital over one year. Postoperative condition of the women was assessed after caesarean section in women with Pfannensteil Kerr and Misgav Ladach method and compared. Results: Most cases in the Misgav Ladach method had breast fed early, had quicker return of bowel activity and earlier ambulation in comparison to the Pfannensteil Kerr method. This difference was statistically significant. Women with the Pfannensteil Kerr method had more postoperative pain, nausea and vomiting. The duration of hospital stay was less in Misgav technique. Conclusions: Since Misgav Ladach method was a better technique than Pfannensteil Kerr, adopting it routinely would result in considerable reduction in maternal morbidity, decreased hospital stay, better patient satisfaction level and more cost effective.