INTRODUCTIONIn 2012 the London Summit on Family Planning was held to bring back the focus on family planning globally. With 60% unmet need for FP in the postpartum period and JSY (conditional cash transfer scheme) bringing women to facilities, PPIUCD is a safe and effective reversible long term birth spacing method that should be available to women. IUCDs are used by only 2% of current users of contraception in India. According to the World Health Organization Medical Eligibility Criteria, an IUCD can be inserted in the 48 hours postpartum, referred to here as a postpartum IUCD (PPIUCD), or after four weeks following a birth. ABSTRACTBackground: PPIUCDs are the only method for couples requesting a highly effective and reversible, yet long acting, family planning method that can be initiated during the immediate postpartum phase. World Health Organization (WHO) medical eligibility criteria state that it is generally safe for postpartum lactating women to use a PPIUCD, with the advantages outweighing the disadvantages. PPIUCDs are cost-effective and they are low-cost intervention that reduces maternal, infant, and under-five Child mortality. Methods: After approval from the ethical committee and consent from the patients, the study was performed on 1000 postpartum women within 10 min. of delivery and up to 6 weeks of delivery at Labour Room of, M.Y. Hospital, Indore. Results: Majority of acceptor (72.5%) belong to age group of 18-25 years and 53% belonged to urban area. Acceptance was more in those who completed their secondary school level education (33%). Working women (55.5%) accepted PPIUCD more than the non-working. Out of 1000 women counselled only 10% agreed for PPIUVD insertion. During the study of 1 year duration (3.5%) of non-acceptors become pregnant and none of the acceptors conceived. Most common reason stated for accepting PPIUCD among acceptors, was that it is a reversible method (66%). Most common reason for not accepting PPIUCD among non-acceptors, because they are interested in Other Method of Family Planning (60%). Conclusions: Verbal acceptance is more than actual insertion of PPIUCD because of adoption of other method of family planning, family pressure, nonacceptance by partner, lack of awareness, fear of complication. Proper counselling can help to generate awareness and compliance for PPIUCD use in postpartum mother who have institutional delivery. Inserting CuT 380A within 10 min after placental delivery is safe and effective, has high retention rate. The expulsion rate was not high, and further can be reduced with practice could not be predicted.

Background: HIV virus infection was detected first time in India in Tamil Nadu in April 1986; India has the third largest HIV epidemic in the world. In 2013, HIV prevalence in India was an estimated 0.3 percent. The pregnant women and her unborn child who are HIV reactive are mostly innocent bearers of the brunt of the infection. Mother-to-child transmission of HIV is a major route of new infections in children. Without any intervention, the risk of transmission of HIV from infected pregnant women to her child is estimated to be around 20- 45%.Early diagnosis of children born to HIV positive mother using HIV DNA PCR and treating children who are diagnosed HIV-positive with antiretroviral drugs within their first 12 weeks of life reduces mortality by 75%.Methods: This retrospective data analytic study of HIV positive pregnant women who attended antenatal clinic and delivered at M.Y. Hospital, Indore from January 2011 to December 2013 .For screening of ANC patients ELISA method was used. For the children, HIV DNA was done by sending the dried blood smear on blot paper and was sent to the reference laboratory Kasturba Hospital, Mumbai and used for diagnosis at 6 week and 6 month.Results: Only 50% of HIV positive children were started on ART, 20% died, 20% loss to follow up and 10% were not willing for follow up. Also 30% mothers practiced mixed feeding. Neonatal mortality rate was 54.87 per thousand live births which is more than the seronegative mothers.Conclusions: First HIV DNA testing can be done at 72 hours to detect antenatal HIV transmission. Early testing can pick up these cases early and ensure treatment. Mixed feeding should be strongly discouraged by counseling and modern methods of communication.

Background: Accurate prediction of fetal growth retardation (FGR) is a long-sought goal of perinatology as it contributes significantly to perinatal mortality and morbidity. It generally manifest later in pregnancy, their underlying pathophysiology is largely established early in pregnancy. Early detection will help in decreasing the associated morbidity.Methods: The study was carried out on 100 pregnant women of 20-24 weeks gestation in the Department of Obstetrics and Gynecology, MGM Medical College and MY Hospital, Indore from March 2015 to February 2016.Presence of diastolic notch in uterine artery waveform was taken as screen positive.Results: Total Diastolic notch positive cases 20/100 out of which 60% developed FGR and 80/100 Diastolic notch negative cases out of which only 4 cases (5%) will developed FGR. The sensitivity of the test was 75% while the specificity was 90.47%. The positive predictive value was 60% while the negative predictive value was 89.74%. 50% of screen positive belonged to 30-39 year age group and 68.75% FGR was seen in primiparous.Conclusions: Study of uterine artery flow velocity waveform seems to be a modern technique which can be used for ruling out the probability of FGR. Presences of diastolic notch in uterine vessels in 2nd trimester are of prognostic value for maternal complications and fetal jeopardy and therefore need of further critical assessment and management.

Background: Jaundice in pregnancy has potentially serious consequences for maternal and fetal health. The cardinal features of hepatobiliary disease may include jaundice, pruritus, abdominal pain; nausea, vomiting, and a variety of liver biochemical test abnormalitiesChallenges involve making the diagnosis and the methods of treatment and their safety for both the mother and the baby.Methods: Based on inclusion criteria, 120 pregnant women were selected from Department of Obstetrics & Gynecology, MGMMC and MYH Indore from 1Aug 2014 to 1st August 2015.Patients were categorized according to serum bilirubin level. Basic investigations done and associated complications studied and correlated according to the severity and degree of jaundice.Results: 60% of the patients were aged between 20 and 30 years. 54% were primigravida. 83.3% lived in rural areas while 74.27% came in emergency. Maternal mortality was found highest in the third trimester and when the serum bilirubin crossed 5mg/dl. 43.34% patients with jaundice developed acute kidney injury with serum creatinine level above the cut-off. INR was deranged in 47.5% of the patients. The most common complication seen in our study group was that of HELLP closely followed by multi organ dysfunction and encephalopathy. 67% of the patients delivered vaginally, while 20% went under LSCS. Maternal mortality was 32.5% and perinatal outcome was poor with 50% mortality and 25% nursery admission. 62% of the patients who died were referred from a peripheral health centre.Conclusions: Liver disease can cause significant morbidity and mortality in both pregnant women and their infants. Better identification and treatment of mothers and fetuses at risk may have far-reaching implications for maternal and child health. Monitored intensive care gives a long term pay off in the maternal and fetal outcome.