Objectives:To evaluate the effect of Mifepristone (25 mg) on symptomatic myoma in perimenopausal women.Study Design:Open label clinical trial.Materials and Methods:Ninety three perimenopausal women of age 35-50 years having symptomatic myoma were selected from Gynecology OPD and given 25 mg Mifepristone once daily continuously for three months. Variables as; baseline uterine size, uterine volume, myoma size, volume, their number, position, characteristics, hemoglobin and blood parameters, were taken and followed monthly for six months. Bleeding and pain scores were checked on monthly visits. Changes in above parameters were tabulated during the first three months treatment phase and then next three post-treatment phase for analysis.Statistical Analysis:Was done by calculating mean, standard deviation, standard error and percentage distribution of variables.Results:Menorrhagia was the most common symptom which led patients to report to hospital. Mean uterine volume reduced to 63.69% of baseline, Mean dominant Myoma volume reduced to 53.62% and hemoglobin level raised to 137% after complete three months of treatment. Changes persisted in next three months post-treatment follow-up, while hysterectomy was required in 10 (12.2%) cases.Conclusion:Three months treatment of 25 mg Mifepristone effectively controls bleeding, reduces the uterine and myoma volume and thus can avoid blood transfusion and hysterectomy in a lot of symptomatic myoma cases.

BackgroundSince 1985, the international healthcare community has considered the ideal rate for cesarean section (CS) to be between 10% and 15%. However, CS has been increasing both in developed and developing countries. The aim of the present study was to audit CS using Robson's Ten Group Classification System (TGCS).

Background: Obstetric emergencies can occur suddenly and unexpectedly. Obstetrics is unique in that there are two patients to consider and care for, a mother and a baby or fetus. Identification and referral of high risk pregnancies are an integral part of maternal and child health services. Timeliness and appropriateness can reduce the incidence of obstetric emergencies. Present study was carried out to know the incidence, nature and outcome of obstetric emergencies.Methods: Retrospective study of obstetric emergencies admitted to Obstetrics and Gynaecology department of Indira Gandhi Institute of Medical science, Patna from March 2015 to September 2017.Results: The common clinical presentation was Ectopic Pregnancy (19.64%), Heart Disease (16.64%), Abortion (13.69%), Severe Anaemia (16.66%), Purpureal Sepsis (9.52%), Sever pregnancy induced hypertension (3.57%), Eclampsia/ HELLP Syndrome (2.38%), Multiple Pregnancy (1.19%) Malignancy Disorder with Pregnancy (2.97%) and HIV in pregnancy (0.59%). Intervention done include Dilation and evacuation (13.69%), Caesarean section (28.57%), Vaginal delivery (22.62%), Caesarean Hysterectomy (2.38%), Exploratory Laparotomy (20.83%) and conservative management in (11.90%) of patients. Maternal outcome include shock due to rupture ectopic and post-partum (16.68%), Blood Transfusion done in (27.99%), Septicaemia (15.48%), ICU admission (8.92%), HDU (12.5%), Pulmonary oedema (6.54%), DIC (4.16%), CCF (3.57%), Ventilatory Support (1.78%) and Maternal Mortality (2.38%). Fatal outcome includes live birth (58.8%), NICU Admission (27.45%), Ventilatory Support (7.84%) and Neonatal mortality (5.88%).Conclusions: High risk pregnancy identification and proper antenatal, intranatal and postnatal care will reduce the incidence of obstetrical emergencies. Peripheral health care system need to be strengthen and early referral need to be implemented for better maternal and fetal outcome.

Introduction: Pregnancy-related acute kidney injury (AKI) is a common occurrence and is associated with substantial maternal morbidity and mortality in developing countries. It may comprise up to 25% of the referrals to dialysis centers in developing countries. Acute kidney injury in pregnancy bears a high risk of bilateral renal cortical necrosis and consequently chronic renal failure. Study aimed to evaluate the contributing factors responsible for pregnancy-related Acute kidney injury and to assess the outcome of patients with pregnancy-related Acute kidney injury. Material and methods: The present study is a prospective study of patients with obstetric complications leading to Acute kidney injury admitted in Obs and Gynae Deptt and nephrology deptt of IGIMS for a period of one year. Pregnant women who are included in the study are those who were healthy previously and had developed Acute kidney injury-oliguria (Urine output <400 ml/d) and azotemia (Serum creatinine >2 mg%) due to pregnancy related complications. Results: Pregnancy related complications was present in 38 patients admitted in our hospital with acute kidney injury in one year period. Out of these 37% (14) of patients were in early stage of pregnancy while 63% (24) were in later stage of pregnancy and puerperium. Causes of AKI was post abortal sepsis in 23.6%, puerperal sepsis in 26.3%, haemorrhagic shock in 23.6%, eclampsia/pre-eclampsia/HELLP syndrome in 21%, IUD in 2 nd trimester with sepsis in 2.6% and acute fatty liver of pregnancy in 2.6% of cases. Sepsis was the major cause accounting upto 52.6% of cases. Approximately 52.6% (20) of patients improved on treatment and dialysis, 21% did not improve (8), 13.15% (5) died and 13.15% (5) left against medical advice. Cause of death in 80% (4 out of 5) of patients was sepsis. Renal biopsy was performed on 62.5% of patients who did not improve (5 out of 8 patients). Renal transplant was done in 1 patients. Conclusion: Obstetric AKI is still a critical situation in developing countries and rare entity in developed countries. Maternal mortality has decreased but sepsis still accounts for majority of cases. Therefore early diagnosis and treatment is the need of the hour.

(1) PAP test and visual techniques are complementary. (2) p(16INK4A) expression was seen in majority of CIN 2 lesions suggesting a higher grade lesion.

Uterine fibroids are the most common uterine neoplasm of uterus and the female pelvis and the most common indication for hysterectomy worldwide. When the fibroid is large and fills the whole pelvis or is pedunculated, it becomes difficult to differentiate from ovarian mass clinically. Cervical fibroids pose enormous surgical difficulty by virtue of their relative inaccessibility and proximity to the anterior bladder, posterior rectum, and distorting the normal anatomical relationship of pelvic structures. A cervical fibroid especially with degenerative changes mimics an ovarian tumor and poses a clinical dilemma. This case is also exemplified for its rarity and diagnostic difficulty.

BackgroundAbortion is the most common entity in the practice of obstetrics and gynaecology. Different methods and modes have been opted for until now to find an effective regimen with the least complications. We have tried the minimal dose (100 mg) of Mifepristone (PO) instead of the presently recommended 200 mg for medical abortion in early first trimester cases.ObjectivesThe objective of the study was to determine the efficacy of low dose (100 mg) Mifepristone for medical termination of early pregnancy with oral Misoprostol 800 μg, 24 hours later.DesignA prospective analytical study was conducted on a population of 82 early-pregnant patients who have requested medical abortions.MethodPregnant women of less than 56 days gestation age from their last menstrual period, requesting medical abortion were selected over a period of 14 months from January 2007 to March 2008. They were given 100 mg Mifepristone orally on Day-1, followed by 800 μg Misoprostol orally 24 hours later on Day-2, keeping the patient in the ward for at least 6 hours.Abortion interval, success rate, post-abortion bleeding and side-effects were noted. Success was defined as complete uterine evacuation without the need for surgical intervention.ResultsThe total success rate of this minimal dose Mifepristone regimen was 96.25%. Pain and nausea were the predominant side-effects noted. In total 72 (90%) women had completely aborted within 5 hours of taking Misoprostol. Three (3.75%) women only required suction aspiration, hence termed as failed medical abortion. The abortion interval increased with the gestation age. All three failures were of the more-than-42-day gestational age group. The overall mean abortion interval was 4.68 ± 5.32 hours.ConclusionMifepristone 100 mg, followed 24 hours later by Misoprostol 800 μg orally, is a safe and effective regimen for medical abortion.

The pandemic of coronavirus disease (COVID-19) has caused serious adverse effects on the human race. There are limited data on maternal and neonatal outcomes of pregnant women with COVID-19.An observational descriptive study was conducted in the department of obstetrics & gynaecology at SMSR and Sharda hospital located in Greater Noida, Uttar Pradesh. This medical college drains patients from entire Greater Noida and as well as from far-away places as referrals. All pregnant patients were included that came to this hospital from 1 April to 31 May 2021. These were the two dreadful months for the entire country in which so many lives were lost. All pregnant patients were labelled COVID-19 positive after undergoing either Rapid antigen test/RTPCR test taken from nasopharyngeal and oral swab.: This included assessment of the maternal morbidity and mortality, comorbidities & worsening of outcome due to COVID-19 infection in pregnant patients as well assessment of the effect of COVID-19 infection on fetus and newborn.