Incidence of adherent placenta is on the rise nowadays due to various reasons. Placenta percreta is seen in 5-7% of cases with adherent placenta, patients with morbidly adherent placenta are at increased risk for major obstetric hemorrhage, usually in the third trimester. Here we present an unusual case of placenta percreta presenting with obstetric emergency after trauma to abdomen in the second trimester. Emergency exploratory laparotomy was done for abruptio placentae with scar dehiscence at 20 weeks period of gestation. Consent for obstetric hysterectomy, if needed, was also taken. Intraoperatively, the placenta was found to be adherent to posterior wall of bladder. Emergency obstetric hysterectomy with bilateral internal iliac ligation with cystoscopy with detrusorrhaphy was done. Patient had an uneventful recovery. Multidisciplinary management with obstetricians, urologists and intensivist is presented hereed.

Background: The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has exposed vulnerable populations to a health crisis. Since the beginning of the severe acute respiratory syndrome (SARS-CoV-2) or COVID-19 outbreak, it has been argued whether pregnant women are at increased risk of severe infection.1 The objective of this study was to summarize the effect of COVID-19 on maternal near miss cases.Methods: This single-centre prospective observational study, included all consecutive pregnant women with COVID-19 infection admitted to Lokmanya Tilak Municipal Medical College and General Hospital (Mumbai, India), a tertiary referral hospital, from 1 April 2020, to 20 December 2020. In this study, a total of 46 patients were included in near miss cases, who required ICU admission with severe morbidity. Of these, 8 patients were COVID-19 positive and remaining 38 patients were included in control group (COVID-19 negative). The course of each of their stay in ward was noted and findings were compared in both the groups. Results: During their course in ICU it was found that 6 COVID-19 patients had maternal death representing 75% and 12 non-COVID-19 patients had maternal death representing 31.57%.  Conclusions: The mortality rate from the above results concludes that in this study mortality appeared to be higher in COVID-19 infection. Multi-centre retrospective analysis with larger population size is required in order for this to be statistically significant.

Introduction Stillbirth is a global health problem having many emotional, social and economic consequences. India has the largest number of stillbirths per year in the world. Objective The objective of this study is to review the causes of stillbirth and classify the causes into maternal, foetal and placental causes and further classify causes by relevant condition at death (ReCoDe) classification. We intend to observe the causes of and demographic factors contributing to the burden of stillbirths. Using this data, the areas of action can be identified and measures can be formulated to reduce a significant number of perinatal mortalities. Methodology This is an observational study of data collected over one year (January 2019-December 2019) from a tertiary care centre in Mumbai, India. The maternal demographic characteristics and causes of stillbirth were studied. The causes of stillbirths were classified into maternal, foetal and placental causes and relevant condition at death (ReCoDe) classification [1]. Results A total of 9074 babies were delivered during this period. There were 275 stillbirths in this year (SBR 30.3 per 1000 total births). Majority of the mothers were in the age group of 26-30 years (32.7%). Almost all the mothers (98.5%) were from urban areas. As per the modified Kuppuswamy classification for urban India, 195 (71.79%) belonged to the upper lower class. 31.2% were primigravidae, and 54.8% had 3 or more antenatal visits. Maternal conditions (pre-eclampsia, diabetes, pre-existing medical disorders) as a group were the cause of maximum number (42%) of stillbirths either directly or as a contributory risk factor. 78% of the stillbirths occurred in the antepartum period. Ours being a referral centre, 65% subjects in the study were referred to us from other peripheral hospitals. 53.8% of the stillborn babies were male. 58.9% were

Background: Approximately 72,000 pregnant women all over the world die every year due to direct or indirect complications related to eclampsia and severe preeclampsia. Incidence of hypertensive disorders in pregnancy in India is found to be 10.08% as per the data collected by the National Eclampsia Registry (NER). Here we present the results of a survey conducted among obstetricians in India to know the common practices in the management of pre-eclampsia followed in our country.Methods: Observational study of survey which was conducted for the period of 1 month from 22nd May 2020 to 22nd April 2020. Questionnaire was prepared on surveyheart.com and sent to obstetricians via Social media platforms to the members of FOGSI. all answers 'collected' and results were prepared from given answers. The survey was answered online by 289 obstetricians.Results: For mild to moderate pre-eclampsia Labetalol is still first line antihypertensive agent being used by many of the obstetricians. In our study also we found out Tab Labetalol 100mg BD is the most preferred type (278, 96.19%) of first line anti-hypertensive in cases of pre-eclampsia followed by Cap Nifedipine 5mg QID and Tab Amlodipine 5mg OD respectively.Conclusions: Comprehensive educational efforts and skill building modules are need of hour to keep every practicing obstetrician regarding recent advances in standard practice protocols.With close monitoring of all cases and well selected anti-hypertensive treatment, it is possible to achieve favourable outcomes for the mother and the baby.