Background: Cervical cancer is the second most common cancer among women worldwide.  The knowledge and attitude of nursing personnel towards cervical cancer screening can grossly influence the community. As the doctor to patient ratio is low in India, staff nurses if trained can act both as health educators and service providers. Objectives of the study were to determine the baseline information about the knowledge of cervical cancer and explore attitude and practice of Pap smear screening among staff nurses.Methods: In this cross-sectional study sample of 100 nurses was selected randomly out of the total 445 nurses employed in the hospital at a rural tertiary care centre from August 2016 to October 2016. A self-administered, structured, open ended and pretested questionnaire comprising of questions on the general characteristics, awareness, perceptions and actual practices of nursing personnel was used to gather information about cervical screening.Results: In this study, 82% knew that Pap smear can detect cancer. About 48% knew that it can present as post-menopausal bleeding and 32% of the respondents knew that HPV is a risk factor for cancer cervix, but only 30% knew about HPV vaccine and only 35% have ever been screened.Conclusions: The study showed that, knowledge about cancer cervix, screening and practice of Pap smear is low among nursing staff. There is an urgent need for integration of cervical cancer prevention issues in the nurses existing training curriculum.

Background:The term delivery is defined as that occurring between 259 and 294 days of pregnancy from the last menstrual period. If the pregnancy exceeds this period, it is called as post term pregnancy. Our center is in rural area where most of the patients are unbooked or even booked patients are also loss of follow up. So, this study was done to know the incidence of prolonged pregnancy and maternal and fetal outcome in case of prolonged pregnancy in our rural population. Methods: This study was a retrospective observational study for 1 year, to analyze the maternal and fetal outcome of post term pregnancies. Data was collected from hospital record and analysed. Results: Out of 5210 total deliveries 1.49 % were beyond 42 wks. 57.69 % patients delivered vaginally whereas 42.3 % patients needed cesarean section. 6.41 % neonates developed meconium aspiration syndrome and 15.38 % of neonates needed NICU admission for different indications. Conclusions: This study concluded that prolonged pregnancy is associated with adverse outcomes like fetal distress, meconium aspiration syndrome and more neonatal ICU admissions. The outcome of prolonged pregnancy can be improved by proper counselling for follow up during pregnancy and proper monitoring and appropriate management during labour.

BackgroundThe risks of adverse maternal and perinatal outcomes are not very clear in coronavirus disease 2019 (COVID-19)-positive pregnant women. Therefore, this study aimed to determine the maternal and fetal outcomes in COVID-19-positive pregnancies. MethodologyThis prospective, cohort study was conducted in a tertiary care center over the period of one year. The study group comprised pregnant patients who presented with COVID-19 in the first and second waves of the pandemic. Maternal symptoms due to COVID-19 infection, comorbidities, number of admissions to the intensive care unit (ICU), and maternal mortality were noted for every patient. Perinatal outcomes were recorded in the form of intrauterine growth retardation (IUGR), mode of delivery, preterm deliveries, birth weight of newborns, neonatal intensive care unit (NICU) admissions, and neonatal mortality. Data analysis was done in the form of a variable percentage and mean ± standard deviation (SD). ResultsCOVID-19-positive pregnant patients were mostly asymptomatic (48.07%). Term deliveries (37-40 weeks) were seen in 44 (89.8%) patients. The percentage of normal vaginal delivery was 74% and cesarean section was 24%. Out of 52 patients, two (3.8%) patients were admitted to the high dependency unit (HDU), one (1.9%) patient was admitted to the ICU, and 49 (94.3%) patients were in the isolation ward. Of the 49 live births, four (8.16%) newborns were admitted to the NICU. No neonatal death was recorded. ConclusionsIn this study, COVID-19-pregnant women were mostly asymptomatic. Neonates of COVID-19-infected women also mostly tested COVID-19 negative. More studies are needed with larger sample sizes to determine the effect of COVID-19 infection in pregnant women and neonates.

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Introduction Maternal near-miss and maternal mortality cases have common characters, especially in terms of risk factors. Both of them are indicators of the quality of health care services provided to pregnant women. Our center is a tertiary care center in a rural area of western Uttar Pradesh (U.P.) so we get a large number of referred cases from most of the rural areas of western U.P. and the adjoining areas of other states too, which sometimes end up in mortality. Thus this study was planned to find out the incidence of maternal near-miss events and compare the nature of near-miss events with maternal mortality. Goal and objectives The main objectives of the study were to determine the frequency of maternal near-miss events, observe the trend of near-miss events, and compare the nature of near-miss events with maternal mortality.

Objective: To compare the efficacy of intracervical dinoprostone gel and hyaluronidase injection for induction of labour in term primigravida. Materials and methods: This is a hospital based analytical prospective interventional study conducted in a rural tertiary care centre over a period of 18 months.  A total of 70 patients who required induction of labour for one or another reason with Bishop score of less than 6 were included in the study. All the cases were randomly divided into two groups, Group A received dinoprostone gel and Group B received hyaluronidase injection. Chi square test & unpaired T test were applied for statistical analysis. Results: Time interval from induction to active phase of labour was comparatively shorter in group A than in group B (10.74 ± 6.17 vs 15.94 ± 7.1) and the difference was significant (p= 0.001). Time interval from induction to delivery time was comparatively shorter in group A than group B (14.84 ± 8.86 vs 21.33 ± 7.86) and difference was significant (P= 0.009). Maternal complications were more common in group A as compared to group B. Conclusion: This study showed that labour could be accelerated significantly by intracervical injection of hyaluronidase. Hyaluronidase injection has less maternal and fetal side-effects as compared to dinoprostone gel and can be a good choice for induction of labour.

Introduction: The rate of Caesarean Section (CS) either primary or repeat has significantly increased worldwide over the time. Trial of Labour After Caesarean (TOLAC) is an important strategy to limit the number of repeat CS. TOLAC either spontaneous or induced offers both benefits and risks to the mother and neonate. Aim: To determine the risks and benefits of inducing labour with Prostaglandin Gel (PGE2) in women with previous one CS and to compare it with patients who developed spontaneous labour in terms of fetal and maternal outcome. Materials and Methods: A prospective interventional study was conducted over a period of one year from June 2017 to May 2018. A total of 322 pregnant patients with previous one CS who fulfill the eligibility criteria for TOLAC were enrolled and divided into two groups. Of these 74 patients were induced with PGE2 gel (study group) and 248 experienced spontaneous labour. Data were analysed via Chi-square test and unpaired t-test using analytical tool pack of Microsoft excel (version-10.0)-2010 home edition. Results: In study group and control group, 51 (68.9%) and 191 (77.01%) women respectively delivered vaginally either spontaneous or assisted, but the difference was not statistically significant. Two cases in the study group had laparotomy for uterine rupture with favourable feto-maternal outcome. Vaginal Birth After Caesarean (VBAC) rate was significantly more in women who had history of prior vaginal delivery (p=0.0024). TOLAC was successful in 242 women while CS was done in 80 women. Mean BMI in women with successful TOLAC was significantly lower than in women with unsuccessful TOLAC (23.42±2.07 versus 26.08±3.07, p=0.0001). With an inter-pregnancy interval of 25-36 months, 45.1% in study group and 47.6% in control group delivered vaginally. Conclusion: For women with previous one CS, TOLAC is a reasonable option as compared to planned repeat Caesarean. In these women with continuous supervision, PGE2 is as safe and effective as spontaneous labour in achieving vaginal birth after Caesarean.

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