Background: Demise of a fetus is not only a cause of distress to the parents but also leaves the obstetrician with little choice. Managing such a pregnancy and counselling of the patient becomes a difficult task for us. Early assessment and timely intervention are the key approaches for reducing the incidence of still births globally. By such a strategy, peripartum complications can also be reduced. The current study was undertaken with an aim to assess the incidence of IUFD, causes and peripartum complications associated, in order to formulate a management protocol at our centre.Methods: This is a retrospective study done over a period extending from September 2014 to October 2015. IUFD was taken as absent fetal heart sounds beyond 20 weeks gestation which was confirmed by sonography. Maternal and fetal records were analysed for studying demographic profile, obstetric details including present and past complications, along with evaluation of fetal parameters.Results: Total number of deliveries over this period was 995 and cases of IUFD reported were 56. Hence calculated proportion was 5.62%. Majority of the cases were unbooked (66%) and presented to obstetric casualty. Maximum cases were found in primi gravida patients, i.e., 35.7% and most of the cases were identified at a gestational age of 20-24 weeks, 32.1%. Hypertensive disorders of pregnancy, 41% and Anaemia, 25% were found to be the leading maternal causes at our centre. Whereas congenital anomalies 23.2% and Antepartum haemorrhage 30.3% were the commonest causes in fetal and placental factors studied. Prolonged labor was observed in 33.9% and Atonic PPH was present in 21.4% patients. ARF was present in 3.5% and DIC was also found in 3.5% of the cases. However, no explainable cause could be found in 12.5% of the patients.Conclusions: Barring the unexplained fetal losses, most of the causes that were ascertained in present study were avoidable. This highlights the importance of our need to understand the avoidable causes of IUFD and to enforce the need of adequate antenatal care so as to timely identify the risk factors. In addition, the necessity of pre-conceptional counselling in order to avoid complications and recurrence must also be emphasized.

One hundred four histologically proven malignant tumors of the eye and orbit in children seen in Guinness Eye Clinic, Kaduna, Nigeria between 1975 and 1982 are presented. Retinoblastoma and Burkitt's lymphoma account for the majority of the tumors. The data are compared with those from Ibadan, Nigeria. Burkitt's lymphoma occurs less frequently in Kaduna, whereas the incidence of retinoblastoma is almost the same. Chloroma, which was not seen in Ibadan, accounted for 2.9% of the current series. Factors that may be contributory to the observed differences are discussed.

Background: COVID 19 is a new pandemic affecting human life globally. Complexity in management is because little is known about effect of COVID 19, particularly its effect on pregnant women and infants. Pregnant women with comorbidities are more vulnerable to severe effects of COVID 19 infection. The aim of this retrospective study is to review the perinatal outcome in pregnant women affected by COVID 19. Materials and Methods: This was a single centre retrospective comparative study performed at COVID referral centre. The study was conducted in 4 months duration in patients diagnosed COVID 19 positive and were compared with all pregnant women who were tested COVID negative and delivered during the same time frame. Data collected from individual case records included age, parity and complications in the antenatal, intrapartum and postpartum periods and also neonatal outcome. Results: Out of 28 patients there were 6 (21.4%) patients who presented with fever, 4 (14.3%) patients presented with cough, 2 (7.14%) patients presented with shortness of breath, 14 (50%) were asymptomatic who were incidentally diagnosed on COVID testing based on routine hospital testing policy. Mean age was 25.35 ± 3.31 years in COVID positive patients and was comparable to COVID negative patients who had mean age of 26.16 ± 3.32 years. Parity was comparable in two groups. 8 (28.5%) out of 28 had preterm delivery as compared to 13 (11.6%) out of 112 in COVID negative group, p value was significant (p=0.0245. In COVID positive group 18 (64.3%) out of 28 had c-section, whereas 40 (35.7%) out of 112 underwent cesarean section (p=0.006). Conclusion:There has been increase in preterm delivery in COVID positive pregnant women. This study emphasize on the need for regular antenatal and medical follow up and good perinatal care for COVID positive mothers.

Background: The aim of this study is to evaluate the maternal and perinatal outcome in term primigravida with isolated oligohydramnios.Methods: A retrospective, case–control study was carried out in the department of OBG, School of Medical Sciences and Research, Sharda Hospital, Greater Noida from November 2014 to October 2017. The study population comprised of low-risk primigravida with singleton, term pregnancy, with vertex presentation and intact membranes.  After meeting the inclusion and exclusion criterion, the study population was divided into cases (n = 51) and control group (176) and the results were analyzed in reference to rate of induction of labour, C. Section rate and the perinatal outcome.Results: Isolated oligohydramnios is associated with increased rate of induction of labour and increased operative interference, but perinatal outcome in terms of mean birth weight, Apgar score at 5 min and NICU admissions for over 24 hours, are not statistically significant in comparison with control group.Conclusions: Isolated oligohydramnios is not an indicator of adverse perinatal outcome.

Background: In modern era of conservative therapies and minimal invasive surgeries, imaging plays an important role in diagnosis, treatment and determination of prognosis of a disease. Role of ultrasonography (USG) in female subfertility has been documented in World Medical literature. Hence, in this study, we aim to determine the accuracy of USG in determining variety of causes of female subfertility using hysterolaparoscopy as a gold standard in our conditions. Subjects and Methods: One hundred and thirty females in reproductive agegroup presenting with primary and secondary subfertility were included in the study. Females with primary amenorrhea were excluded from the study. All patients underwent endovaginal USG (EVS) while Color Doppler Flow Imaging (CDFI) was used whenever indicated. Imaging was done after 8th-10th day of menstrual cycle and a minimum of 3-4 days after complete cessation of menstrual blood flow. Results: USG is very accurate in detecting polycystic ovaries, leiomyoma / adenomyoma, etc with nearly 100% accuracy while has considerable limitations in tubal disease and in cases of pelvic inflammatory disease (PID) where the accuracy may fall up to 50%. Conclusion: USG should be first investigation of choice in all patients presenting with subfertility as it is highly accurate in detecting polycystic ovaries, leiomyoma, endometriosis / adenomyosis, endometrial thickening and uterine and ovarian anomalies. Further imaging, should be used reserved tool in patients with complex clinical disease showing unremarkable or non-characteristic USG.

Aims and objectives:To compare the efficacy of VIA and Pap smear for detection of premalignant and malignant lesions of cervix. Materials and methods:Two hundred and forty women atten ding outpatient department of obstetrics and gynecology were subjected to detailed history taking, clinical examination, Pap smear and VIA, and biopsies were indicated.Results: Of 240 patients, 27 patients (11.3%) were Pap posi tive and 28 patients (11.7%) were VIA positive. A total of 39 patients in whom either test was positive, had undergone cervical biopsy. Sensitivity of VIA and Pap smear was 92 and 84% respectively and specificity of VIA and Pap smear was 64.3 and 57% respectively. Conclusion:The study concluded that sensitivity of VIA is comparable to Pap. Therefore, VIA is an efficacious and cost effective method to screen premalignant and malignant lesions of cervix, especially in developing countries like ours.

Background: Reduction in the maternal morbidity has been the key strategy towards achievement of Millennium Development Goal. Despite exhaustive measures at all levels, the decline has been slow. WHO in 2007 established a technical working group to identify cases of severe acute maternal morbidity. It served dual goals to identify the causes and pointing out delays leading to SAMM. SAMM is now an established superior indicator of surviving women’s health and allows uniform comparisons. The present study was conducted with an aim to identify cases of SAMM at our centre. The objective is to determine the frequency of maternal near miss and conduct an epidemiological survey.Methods: This retrospective study was conducted in the department of Obstetrics and Gynecology and ICU of School of Medical Sciences and Research, Greater Noida, from November 2014 to October 2017. All the cases identified as SAMM, as per WHO 2009 criteria (modified according to the local protocol), were included in the study.  Results: During the study period there were a total of 2252 delivery, out of which 2051 were live births. There were 123 SAMM cases and 47 were excluded out of study. So, study was done on 76 cases of SAMM, and on 11 maternal deaths in the study period. Calculated MNM incidence ratio was 37.05 per 1000 live births. A mortality index of 12.64% was calculated. MNM to maternal death ratio was 6.9:1. Major identifiable cause for SAMM was hypertension (35.5%)), followed by haemorrhage (18.4%). Haematologic system was the commonest organ system involved. 67.8% of the admissions were done in critical condition.Conclusions: Maternal mortality and SAMM cases shared characteristics, and study of SAMM cases can provide an insight into the causative etiology and give time for early intervention.

AIMS & OBJECTIVES:The aim of study was to compare the efficacy, safety and compliance of intravenous iron sucrose complex with oral Iron therapy in treatment of postpartum anemia. MATERIAL AND METHODS: 60 postpartum women who had delivered within 24 -48 hours and having hemoglobin <9.0 gm./dl and serum ferritin < 15 μg/L were studied prospectively. They were randomized into two groups. In Group A 30 women received 200 mg of iron sucrose on every alternate day for 3 days and in group B 30 women received oral iron ferrous sulphate tablets twice daily for 30 days. Hemoglobin and serum ferritin were measured on day 7, and day 30. The side effects in both groups were noted. RESULTS: There was a significant rise in mean hemoglobin on day 7 in intravenous iron group (7.23 ± SD 0.57 gm./dl to 9.24 ± SD 0.57 gm./dl) in comparison to oral iron (7.33 ± SD 0.41 gm./dl to 7.42 ± SD 0.39.) difference was statistically significant (p value < 0.01) Mean Hemoglobin on day 30 was higher in Intravenous iron group than oral iron although the difference was not significant. Mean serum ferritin levels showed rise from 11.40 ± SD 0.94 μg/L to 40.42 ± 7.76 μg/L in Intravenous iron group on 7th day and it was 49.21 ± 3.33 μg/L on day 30.Level of rise on day 30 of serum ferritin in intravenous was significant (p < 0.001) whereas in oral iron group on day 30 mean Serum ferritin was 15.86 ± 2.28 μg/l level of rise was not significant (p value > 0.05). Intravenous iron sucrose did not result in any serious adverse reactions. CONCLUSION: Intravenous iron sucrose is more effective, rapid and safe in increasing hemoglobin level in women with postpartum anemia in comparison with oral iron therapy. It also replenishes iron stores more rapidly without any serious adverse effects.