Background: Critically ill obstetric patients pose challenges to the intensive care unit team due to their altered physiology as well as due the presence of the foetus and safety of both the mother and the foetus is of paramount importance.Methods: All antenatal and postnatal cases within 42days of delivery requiring ICU admission from October 2014 to September 2016. Detailed history taken and outcome noted. Results were subjected to statistical evaluation using SSP software.Results: (n=75): obstetric reasons (n=51, 68%) of which 21(28%) had PPH and 17(22.6) had hypertensive disorders of pregnancy. Non-obstetric reasons (n=24, 32%) of which 7(9.3%) cases had jaundice and 4(5.3%) had malaria. Mechanical ventilation was needed in the majority of cases (n=44, 58.7%) followed by inotropic support (n=30, 40%).Maternal mortality was 16%. Mortality was higher (n=8, 66.6%) among patients admitted for obstetric reasons as opposed to non-obstetric indications (n=4, 33.3%).Conclusions: Early detection and prompt referral to the tertiary centre with intensive care facilities should be promoted among the medical fraternity to reduce the incidence of ICU admissions and maternal mortality. All residents of obstetrics and gynaecology should have short mandatory training phase in critical care. Multicentre randomised studies are required for formulating evidence-based national guidelines.

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Pregnancy with renal disease is associated with high risk for both mother and fetus with adverse outcomes. Criteria for considering pregnancy in renal transplanted patients include good post-transplant health for 2 years, stable allograft function with a serum creatinine <1.5 mg/dl, absence of rejection, control of blood pressure, absence of proteinuria. Authors report a case of 26-year-old, primigravida had renal transplantation done in NRI Medical College and treated with immunosuppressive therapy with tablets Tacrolimus 1mg twice daily, Azathioprine 50mg twice daily, Prednisolone 10mg once daily and continued till delivery. Developed gestational hypertension treated with tablet Amlodipine 5mg once daily. Elective caesarean section done for contracted pelvis. Post-natal period was uneventful and discharged on immunosuppressive therapy and contraceptive advice. Post-renal transplantation pregnancy should have multidisciplinary approach for. With close medical and obstetric follow up, successful outcome for both mother and infant is possible.

BACKGROUND Abnormal uterine bleeding (AUB) is a common problem mainly seen in peri-menopausal and post-menopausal women. AUB has a negative impact on quality of life and in turn affects the efficiency of women. Hysteroscopy in this new era is increasingly becoming the investigation of choice for the evaluation of AUB, owing to the direct visualization of the uterine cavity, and its ability to pinpoint the aetiology in most of the cases. METHODS This is a prospective study. 100 cases with abnormal uterine bleeding (AUB) underwent hysteroscopy and biopsy was taken from suspected area. They then underwent dilatation and curettage and tissue samples were sent for histopathological examination. The findings on hysteroscopy and histopathological examination were correlated. Data obtained was subjected to statistical analysis and results derived was analysed in terms of sensitivity, specificity, positive predictive value and negative predictive value. RESULTS 42 (42%) cases with AUB were seen in the age group of 40-49. Most common symptom was menorrhagia 70 (70%) seen in the age group 40-49 years. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of hysteroscopy was 97.18%, 96.55%, 98.57% and 93.33% and that of histopathology was 89.13%, 96.29%, 95.34% and 91.22% respectively. All 5 cases of carcinoma diagnosed on hysteroscopy were confirmed by histopathology. CONCLUSIONS Hysteroscopy should be considered as the gold standard for diagnosis of intrauterine pathologies and it should be included in the management of AUB.

Background: Smooth muscle tumor of uncertain malignant potential (STUMP) of uterus indicates a group of uterine smooth muscle tumors that are not diagnosed unequivocally as either benign or malignant. It is a rare tumor in young women. It is considered as a "transition" tumor between leiomyoma and leiomyosarcoma or possibly undiagnosed leiomyosarcoma. Case description: We herein report a case of uterine STUMP in a 28-year young nulliparous woman who presented with a symptom of continuous dull aching lower abdomen pain. MRI pelvis shows large transmural vascular mass. Underwent radical hysterectomy, histopathology report, and immunohistochemistry showed STUMP with ki67 <10%. Conclusion: STUMP is a rare tumor with inconsistent diagnostic criteria and has no definitive treatment protocols especially in young women who desire for fertility.

Introduction: Thrombocytopaenia occurs in 7-12% of pregnancies at the time of delivery. Knowledge, regarding the causes and effects of thrombocytopaenia on mother and newborn, facilitates proper diagnosis and management of thrombocytopaenia in pregnant women for better maternal and foetal outcomes. Aim: To determine the incidence, causes and outcome of pregnancy with Thrombocytopaenia. Materials and Methods: A prospective observational study was conducted among women attending Outpatient Department for an antenatal checkup at NRI Medical College and General Hospital, Chinnakakani, Guntur, Andhra Pradesh, India, from October 2017 to October 2019. A total of 44 antenatal women with platelet count less than 1,50,000/cumm were included in the study. They were followed-up throughout the antenatal period until delivery to record any complications that developed due to low platelet counts in the mother and neonate. A neonatal platelet count was done on day one of life. Data was subjected to statistical analysis using Statistical Package for Social Sciences (SPSS) version 22.0, all qualitative variables were expressed in terms of proportion. Results: A total of 500 cases were studied of which 50 cases had Thrombocytopaenia with an incidence of 10%. Out of 50 cases, six were lost for follow-up and the remaining 44 cases were included in the study. Out of 44 patients, 52.27% (n=23) had mild thrombocytopaenia, 27.27% (n=12) had moderate and 20.46% (n=9) had severe thrombocytopaenia at the time of diagnosis. Common causes seen were Gestational Thrombocytopaenia (GT) 38.6% (n=17), Preeclampsia (PE) 18.18% (n=8), Gestational hypertension 9.09% (n=4). A total of 11.36% (n=5) required intensive care unit care, 6.81% (n=3) had multiorgan dysfunction syndrome (MODS), 4.54% (n=2) underwent hysterectomy, 4.54% (n=2) had postpartum haemorrhage (PPH), 4.54% (n=2) had secondary suturing done for wound infection, 2.27% (1 patient) underwent laparotomy (for rectus sheath hematoma), and mortality was seen in two cases. A total of 31.8% (14 cases) required blood and blood product transfusions. eight neonates were admitted to the neonatal intensive care unit. There was no case of neonatal thrombocytopaenia. Conclusion: Thrombocytopaenia is a significant problem in pregnancy; hence, the routine antenatal platelet count should be done for a timely diagnosis of thrombocytopenia.