This prospective observational study compared the effects of general and spinal anesthesia in 173 severe preeclamptic women undergoing emergency cesarean section. 146 (84.5%) patients underwent spinal anesthesia (SA) and 27 (15.5%) patients had general anesthesia (GA). Most of the patients were primigravid and nulliparous. Intraoperatively SA group required more intravenous fluid and vasopressor support, while GA group required more preoperative labetalol injection for blood pressure control. Overall 13.3% of patients required critical care, particularly GA group (44.4% versus 7.5%; P < 0.001). Patients receiving GA had a higher mortality (25.9% versus 1.4%; P < 0.001). The length of hospital stay was comparable. Significantly more neonates of patients receiving GA were found to be preterm (77.8% versus 44.5%; P < 0.01) and required advanced resuscitation. GA group also had higher neonatal mortality (29.6% versus 11%; P < 0.05). To conclude, severe preeclamptic mothers receiving general anesthesia and their babies required more critical care support. Maternal as well as neonatal mortality was significantly higher with general anesthesia.

To conclude, prophylactic therapy with palonosetron is more effective than prophylactic therapy with ramosetron for the long-term prevention of PONV after cesarean section.

Background: Hysterectomy is the most common performed major gynaecological surgery and the decision depends on indications for operation, surgeon’s training and preference, uterine size, adnexal pathologies and patient choice. To avoid laparotomy either total laparoscopic hysterectomy (TLH) or non-descent vaginal hysterectomy (NDVH) is the recently practised option. Objectives of the present study are to compare duration of operation, blood loss, ambulation time, post-operative pain and complications between TLH and NDVH.Methods: Patients undergoing above operation during January 2014 to December 2014 at N.R.S. Medical College, Kolkata, were included under the study. All patients were thoroughly examined and investigated and malignancies were excluded by Pap smear and or D&C. All patients were observed minutely during pre-operative, intra operative and post-operative period for any complications.Results: NDVH requires less operative time than TLH but intra operative blood loss, post-operative pain and ambulation time are slightly more.Conclusions: TLH requires infrastructural set up, greater surgical expertise, longer operative time and major intraopertive complications as compared to NDVH. In our low resource government hospital NDVH is better choice for removal of uterus in uncomplicated benign conditions.

Background: Infectious maternal and perinatal morbidities are 5 to 20 times more in caesarean section when compared to vaginal births. Objective of present study was to assess the rates of maternal and neonatal infectious morbidities following administration of antibiotic before skin incision compared to given after umbilical cord clamping during caesarean delivery.Methods: 185 pregnant women with gestational periods more than 34 weeks who were prepared for caesarean delivery, randomized to single dose antibiotic given either before skin incision (study group) or after umbilical cord clamping (control group). Primary outcome measures: maternal postoperative infections morbidities. Secondary outcome measures: neonatal infections morbidities with Sick Newborn Care Unit (SNCU) admissions and postoperative hospital stay of mother.Results: Surgical Site Infections (SSI) and postoperative fever were significantly less in the study group than the control group so also the lesser incidences of endometritis but no statistically significant difference in the incidence of peritonitis and wound dehiscence were observed in both groups. No significant differences were seen in neonatal infectious morbidities and SNCU admission when compared in both groups. There was significantly less mean postoperative hospital stay of mothers in the group who received prophylactic antibiotic pre-incision.Conclusions: Antibiotic given 30-60 minutes before skin incision significantly decreases maternal postoperative infectious morbidities barring neonate.

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