Puerperal uterine inversion is a complication of third stage of labour, which can lead to maternal morbidity and mortality due to haemorrhage shock and infection. Early cases can be managed by manual reposition of uterus but neglected or late cases of uterine inversion are managed by Haultain`s repair. Here we are presenting a case of subacute uterine inversion referred from peripheral hospital managed by Haultain’s technique.

Background: Prenatal estimation of birth-weight is of utmost importance to predict the mode of delivery. This is also an important parameter of antenatal care. This study was conducted to evaluate the accuracy of estimated fetal weight by ultrasound, compared with actual birth weight.Methods: This was a prospective and comparative study comprising 110 pregnant women at term. Patients who had their sonography done within 7 days from date of delivery were included. Fetal weight was estimated by Hadlock 2 formula, the software of which was preinstalled in ultrasound-machine. The estimated fetal weight was compared to the post-delivery birth-weight. The Pearson's correlation coefficient was used and the accuracy of sonographic fetal weight estimation was evaluated using mean error, mean absolute error, mean percentage error, mean absolute percentage error and proportion of estimates within 10% of actual birth weight.Results: Mean estimated and actual birth weights were 3120.8±349.4 gm and 3088.2±404.5 g respectively. There was strong positive correlation between estimated fetal weight and actual birth weight (r = 0.58, p<0.001). The mean percentage error and mean absolute percentage error of ultrasound fetal weight estimations were 1.96±11.8% and 8.7±8.2% respectively. The percentage of estimates within ±10% of the actual birth weight was found to be 67.3%. In 23% of the cases, ultrasound overestimated the birth weight. In 13% of the cases, ultrasound underestimated the birth weight.Conclusions: There was strong positive correlation between actual and sonographically estimated fetal weight. So, ultrasonography can be considered as useful tool for estimating the fetal weight for improving the perinatal outcome.

Background: Worldwide there has been an increase in the rate of caesarean delivery due to multiple factors. Objective of the study was to assess the prevalence and different indications of caesarean section in this institute.Methods: The aim of the study is to analyse the rates and indications of lower segment caesarean section (LSCS) in our institution. We conducted a retrospective study over a period of six months; 1st September 2016 to 1st March 2017 at SLBSGMC Mandi at Nerchowk. Total number of patients who delivered in our hospital during the defined study period was recorded and a statistical analysis of various parameters was done.Results: The total number of women delivered over the study period was 2075, out of which caesarean sections (CS) were 473. The overall CS rate calculated was 22.8%. Previous LSCS was the leading indication to the CS rate.Conclusions: Routine obstetric audits should be done to analyse the various indications of emergency and elective caesarean sections so that protocols and guidelines can be implemented to curtail the increasing trend of caesarean delivery.

Introduction: Anemia among pregnant women is one of the major health concerns for healthcare workers. The management becomes a concern in the pregnancy where the question arises of which is better the intravenous iron sucrose or the oral ferrous sulfate tablets. To answer this, a randomized control trial comparing both the treatment options in a tertiary care government hospital was set up in the hilly terrains of India. This study discusses the effectiveness and practical aspect of using both, which seems to be the better out of both, and why.Methods: The study was conducted as a parallel-group, open-label randomized controlled trial (RCT) in the Department of Obstetrics and Gynecology of a tertiary care government hospital in India, with approximately 4,000 delivery loads annually. Ethical clearance was obtained from the institute's ethics committee (IEC), and the trial was registered with the Clinical Trial Registry of India (REF/2022/06/055013). Two hundred sixty-eight pregnant women between 18 and 45 years of age with moderate iron deficiency anemia (IDA) (hemoglobin (Hb) 7-9g/dl, microcytic-hypochromic, and serum ferritin <30ng/ml) were included in the study. Patients were randomly divided into two groups: group 1 with 134 patients to receive intravenous iron sucrose and group 2 with 134 patients to receive oral ferrous sulfate tablets.Results: The intravenous iron sucrose is superior in terms of tolerability and correction of iron deficiency anemia during pregnancy.Conclusion: It yields a quicker rise in Hb and serum ferritin with no major side effects. In the difficult terrain of Himachal Pradesh, this makes IV iron sucrose a better option for anemic pregnant women who do not have easy access to health facilities resulting in a large number of them reaching hospitals with moderate to severe anemia at a later gestation.

INTRODUCTIONThe childbirth experience has always represented as a very important event in women's lives, a unique and special moment, marked by the transformation of the woman in her new role, that of being a mother.1 In developed countries, women often opt for caesarean delivery because of their improved understanding of its role and safety and increasing importance given to the right to self-decision making, regarding mode of delivery.2 However in developing countries like India, women are reluctant to accept caesarean delivery because of their traditional beliefs and socio-cultural norms, hence they even try to avoid hospital delivery and engage in the services of untrained and unskilled care providers. These women usually report to hospital with life threatening complications and in such situations most of the caesareans are performed as an emergency procedure under suboptimal circumstances. 2 Main reason of choosing caesarean section by pregnant women is the fear and lack of sufficient knowledge about normal vaginal delivery. Although in specific situations caesarean section can prevent serious morbidity and mortality of the ABSTRACT Background: The rising rate of caesarean section is the subject of concern worldwide. The aim of our study was to know the knowledge, attitude and preferences of pregnant women towards the mode of delivery in a tertiary care centre and hence to see weather this is a contributing factor towards rinsing trend of caesarean delivery or not. Methods: This was a prospective questionnaire study conducted on 100 antenatal women in third trimester who attended the antenatal clinic in SLBS GMC Mandi at Nerchowk from 1 st June, 2017 to 1 st September 2017.The information regarding socio-demographic profile, obstetric history, knowledge and attitude statements towards vaginal delivery and caesarean section was collected and analysed. Results: Total of 100 women was interviewed in our study. Out of these, majority (85%) had received education up to High school and above. Majority of the women (90%) had the positive attitude towards vaginal delivery. The most frequently mentioned source of information about the mode of delivery was relatives and friends. Almost half of women agreed to the statement that vaginal delivery creates a more affectionate mother and baby relationship. Majority of women co-relate that caesarean section was associated with more complications and not good in long term outcome. Economic factors did not play an important role in deciding caesarean birth. Conclusions: Majority of pregnant women interviewed were interested to deliver vaginally, while some women were indecisive due to lack of knowledge and some due to apprehension of labor pains during vaginal delivery wanted to undergo a caesarean section. Appropriate counselling of pregnant women and their partners will help in changing their outlook and make them a better judge while choosing their preferences.