Background:Prevalence of subclinical hypothyroidism (SCH) in pregnancy varies widely in different parts of our country, but it has multiple adverse outcomes in both the mother and fetus.Objectives:This study was conducted to evaluate the prevalence of SCH in pregnant women during the first trimester and to identify the prevalence of thyroid autoimmunity in pregnant women.Materials and Methods:This cross-sectional study (March 2014 to February 2015) was conducted among the pregnant women attending antenatal clinic in their first trimester at a tertiary care center. Morning samples of study participants were analyzed for free thyroxin (FT4), thyroid stimulating hormone (TSH), and thyroid peroxidase antibody (TPO Ab). Data expressed as mean ± standard deviation and percentage (%) as applicable.Results:Of the 510 subjects, 168 had TSH value >2.5 μIU/ml (32.94%) with normal FT4 and they were diagnosed as SCH. TSH level >4.5 μIU/ml was estimated in 13.92% (71) of the subjects. TPO Ab was positive in 57 (33.93%) of subclinical hypothyroid and 5 (1.47%) of normal subjects. 70.42% (50) of the subjects with TSH >4.5 μIU/ml had positive TPO Ab.Conclusions:Prevalence of SCH is high in South Bengal and routine thyroid screening at the first antenatal visit should be done to reduce the social and financial burden caused by SCH.

Women with cardiovascular diseases may present for cesarean delivery. We present a case of anesthetic management for cesarean section in a patient with uncorrected tetralogy of Fallot complicated with preeclampsia. No definite guideline or information is available in the textbook or literature about the management of such a case. A 21 year primigravida was admitted in our institute with breathlessness on normal day to day life activity. Her blood pressure was 160/100 mmHg, oxygen saturation 85-86% in room air and she had ejection systolic murmur of grade three intensity along the left sternal border. Her echocardiography which was done in the first trimester revealed tetralogy of Fallot with moderate to severe right ventricular outlet obstruction with hypoplastic pulmonary artery and pulmonary valve. Proteinurea was detected on bedside urine examination. The patient was posted for emergency cesarean section due to non-reassuring fetal heart rate associated with preeclamsia. Magnesium sulfate 10 gm intramuscularly was given for seizure prophylaxis and general anesthesia was administered using etomidate as induction agent. The objective of anesthetic management mainly depends on maintaining of systemic vascular resistance and decreasing pulmonary vascular resistance. In preeclampsia systemic vascular resistance is already elevated. Thus treatment of preeclampsia may worsen cyanosis, so we avoided labetalol to reduce blood pressure. Intra-operative and post-operative periods were uneventful and baby had good apgar scores. So we can conclude that cesarean section in patient with both tetralogy of Fallot and preeclampsia can be managed successfully with general anesthesia using techniques which maintain systemic vascular resistance.

Background: Threatened abortion is till most common cause of early trimester bleeding PV and can be diagnosed and managed by early USG diagnosis. Materials and methods: This was a prospective observational study. Place of the study was Department of Obstetrics and Gynaecology and Department of Radiodiagnosis, Midnapore Medical College and Hospital from January 2019 to June 2020. Eighteen months. Result: When the clinical method to diagnose threatened miscarriage was compared to the sonographic method, it was evident that sonographic method was reliable than the clinical method and the difference was statistically significant. Conclusion: In case of missed miscarriage and complete miscarriage, although the percentage of discrepancy was 100%, on further statistical analysis, the discrepancy was not statistically significant. And the cause behind this was probably inadequate sampling.

BACKGROUND Self-medication or medication by untrained person for termination of unwanted pregnancy is commonly practiced among women of child bearing age group. This study was undertaken to observe the consequences of self-medication of abortifacient agent on women's health reporting to a Government Medical College. MATERIALS AND METHODS This is an observational study conducted at Midnapore Medical College from January 2016 to June 2017. After applying inclusion and exclusion criteria, 102 women were selected with respect to age, parity, period of gestation, clinical features at presentation, ultrasonography findings, complications and management they received. Analysis was also done with respect to surgical interventions, need for blood transfusion and maternal mortality. RESULTS In this study, 77 cases (75.4%) were diagnosed as incomplete abortion (8 cases clinically and 69 cases ultrasonographically). 15 cases (14.7%) of complete abortion, 5 cases (4.9%) of missed abortion, 3 cases (2.9%) of live gestation and 2 cases (1.9%) of ruptured ectopic pregnancy were recorded. 15 cases (14.7%) received blood transfusion and 2 cases (2%) required intensive care unit (ICU) admission. Fortunately, no maternal death was reported in the study group. CONCLUSION Reproductive health protection and care is every woman's right. Awareness on contraception is must for all. This study shows urgent need for legislation and restriction of drugs used for medical termination of pregnancy. Availability of abortifacient drugs directly from hospital/ practitioners who are qualified under Medical Termination of Pregnancy (MTP) Acts may reduce complication of these drugs.