Background: Semen analysis is an indispensable diagnostic tool in the evaluation of the male partners of infertile couples. Methods: Semen samples were analysed by manual method. Analyses were for volume, viscosity, sperm concentration, motility, and morphology, according to WHO guidelines on semen analysis Results: This study, done at a rural setup, at Acharya Vinoba Bhave Rural Hospital has demonstrated that abnormal semen quality is a major factor in our rural setup with 52% of male partners of infertile couples having abnormal semen parameters. Conclusion: Male contribution towards infertility is yet to be studied and requires more elaborate research. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000): 161-164

Background: Gestational diabetes mellitus (GDM) is characterised by carbohydrate intolerance of varying severity with onset or first recognition during pregnancy. GDM is an important public health problem in India. Method: The present study was carried out in 300 antenatal women. Fasting blood glucose was measured after which they were given 75 g oral glucose and plasma glucose was estimated at 2 h. Patients with plasma glucose >140 mg/dl were labelled as GDM. Thus WHO criteria were used for diagnosing GDM. Data was collected from all subjects on demographic characteristics, socioeconomic status, education level, parity, family history of diabetes and/or hypertension, BMI, etc. and pregnancy outcome was studied. Results: Prevalence of GDM was found to be 8.33%. Gestational diabetes mellitus was found to be significantly associated with age, parity, BMI, socioeconomic status, education level and was also found to be associated with adverse pregnancy outcomes. Conclusion: GDM adversely affects maternal and fetal outcomes and its prevalence is steadily rising. Appropriate interventions are required for its control.

Acute Respiratory Distress Syndrome is characterised by acute onset dyspnoea, hypoxemia, and diffuse pulmonary infiltrates. Many physiological changes occurring in pregnancy predispose to its occurrence. Maternal and perinatal mortality is high with significant morbidity in residual cases. Management strategies in obstetric population have been derived from general non-obstetric cases. Mechanical ventilation, both invasive and non-invasive, play a key role in treatment. In our case series, late identification of infection and postponement in referral were important factors contributing to maternal mortality. Many factors like pre-eclampsia, viral pneumonia, bacterial pneumonia, UTI lead to development of ARDS in pregnancy. ARDS leading to Multi-Organ Dysfunction Syndrome is an important cause of Maternal Mortality. Early detection of ARDS helps in improving both maternal and neonatal outcome. ARDS management depends on identifying the underlying cause and treating it along with maintaining the oxygen saturation. Mechanical Ventilation plays an important role in ARDS management. Multidisciplinary team approach by obstetricians, pulmonologists, intensive care providers is required. With the decrease in other causes of maternal death, mortality in obstetric patients due to ARDS is increasing significantly and needs to be addressed. It is a morbid condition, aetiology being inflammatory disease of lung that causes acute onset hypoxia due to noncardiogenic pulmonary oedema leading to respiratory failure. Bernard et al. and the American-European Consensus Conference proposed the present definition of ARDS. The criteria are-1) acute onset 2) a PaO2/FiO2 ratio, or hypoxia score of ≤ 200, irrespective of positive end expiratory pressure 3) bilateral infiltrates on chest X-ray and 4) a pulmonary artery occlusion pressure of ≤18 mmHg or the absence of clinical evidence of left atrial hypertension. (1) Normal physiological changes occurring during pregnancy like increased vulnerability to infection, high chance of aspiration, reduced chest compliance, reduced functional residual capacity, mucosal oedema, reduced arterial PaCO2 predispose to ARDS and also make it difficult to manage. (2) Here we present cases of pregnant women in their peripartum period with sudden onset breathlessness and hypoxia caused by obstetric and non-obstetric causes with their clinical course, management and outcome. The women were treated at a rural tertiary care centre in Central India.

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