INTRODUCTIONPremature rupture of membranes at term (PROM) is defined as a spontaneous rupture of membranes after 37 completed weeks of gestation and before the onset of regular painful uterine contractions.1 PROM occurs in 5-10% of all pregnancies of which approximately 80% occur at term. 2 The aetiology of PROM is multifactorial. 2At term, PROM can be physiological variation rather than a pathological event. PROM occurs when intrauterine pressure overcomes membrane resistance.This happens due to weakening of membranes either congenital or acquired (smoking and vitamin C deficiency), or because of damaging factors either mechanical during amniocentesis or damage by infection (Trichomonas infection, group B streptococci, bacterial vaginosis). Failure of mechanical support such as cervical dilatation can lead to premature rupture of membrane. 3Other etiological factors are overdistended uterus, big baby, polyhydramnios and multiple pregnancy. Methods:The present study was a prospective randomised controlled trial, conducted on 100 term antenatal women with PROM in the Department of Obstetrics and Gynaecology, UPUMS, Saifai from January 2016 to June 2017. 50 antenatal women received immediate induction with oral misoprostol while another 50 antenatal women were expectantly managed for 24 hours. The latency period, PROM delivery interval, maternal and neonatal outcome were compared and subjected to statistical analysis. Results: 42% of active management group and 30% of expectant management group had a latency period of 12-20 hours and results were found to be statistically significant (p value = 0.005). There was no statistically significant difference in the rate of caesarean section, maternal and neonatal morbidity in both the groups. Conclusions: Immediate labour induction in patients with term PROM resulted in significant shortening of latent period and PROM to delivery interval without any increase in caesarean section rate as compared to expectant management group.

Background: Cervical cancer is the second most common cancer among women worldwide.  The knowledge and attitude of nursing personnel towards cervical cancer screening can grossly influence the community. As the doctor to patient ratio is low in India, staff nurses if trained can act both as health educators and service providers. Objectives of the study were to determine the baseline information about the knowledge of cervical cancer and explore attitude and practice of Pap smear screening among staff nurses.Methods: In this cross-sectional study sample of 100 nurses was selected randomly out of the total 445 nurses employed in the hospital at a rural tertiary care centre from August 2016 to October 2016. A self-administered, structured, open ended and pretested questionnaire comprising of questions on the general characteristics, awareness, perceptions and actual practices of nursing personnel was used to gather information about cervical screening.Results: In this study, 82% knew that Pap smear can detect cancer. About 48% knew that it can present as post-menopausal bleeding and 32% of the respondents knew that HPV is a risk factor for cancer cervix, but only 30% knew about HPV vaccine and only 35% have ever been screened.Conclusions: The study showed that, knowledge about cancer cervix, screening and practice of Pap smear is low among nursing staff. There is an urgent need for integration of cervical cancer prevention issues in the nurses existing training curriculum.

Background: Well-being of child is directly related to the nutritional status of the baby. Malnutrition rate increases between 6 and 18 months- the period of complementary feeding. Complementary feeding is the introduction of semisolid or solid food in infant who is on breast feeding, when mother’s milk is no longer enough to meet the nutritional needs. Understanding the social beliefs, knowledge, attitude and practices about complementary feeding among mothers is an important step prior to designing an intervention strategy to prevent malnutrition in children. Aim of the study was to assess the knowledge, attitude and practices regarding complementary feeding among mothers.Methods: Prospective study including 200 mothers with children between 6 to 24 months of age in GMC Haldwani, from December 2017 to May 2018.Results: Present study shows 60.5% mothers initiate their breast milk soon after delivery. The initiation of complementary food at the age of 8 months, 6 month and 4-5 months were 64 (32%), 104(52%) and 32 (16%) respectively. 68% mothers did not properly clean their children hands and utensils before feeding Use of janam ghutti 64% and dilution of cow milk 79% was the major part of complementary feeding.Conclusions: Mother’s knowledge regarding timing of complementary feeding is inadequate and practices are inappropriate. Majority of them are not aware of the current recommendations. It is essential to give accurate information and education about complementary feeding to prevent malnutrition and improve the health status of children.

Background: Chronic pelvic pain is a major cause of morbidity among the reproductive age group women. The study on patients of chronic pelvic pain aimed to compare the diagnostic accuracy of ultrasonography and laparoscopy in these patients Methods: The study was conducted on 100 patients of chronic pelvic pain attending the gynaecology outdoor and were subjected to thorough clinical examination followed by ultrasonography and laparoscopic examination. Results: Maximum number of cases of chronic pelvic pain belonged to 25-30 years, were parous with mean duration of pain of 15.2 months. The most common complaint was vaginal discharge (70%) followed by menstrual irregularity. On clinical examination, pelvic tenderness was observed in majority (60%) of cases. USG examination showed chronic pelvic inflammatory disease in 43% cases followed by myoma (8%), ovarian cyst (5%), endometriosis (6%), pelvic congestion (5%) and no abnormal pathology in 25% cases. On laparoscopic examination, chronic pelvic inflammatory disease was present in 47% cases followed by endometriosis (11%), pelvic congestion (8%), myoma (8%), adhesions (7%) while 13% cases showed normal findings. Conclusions: Laparoscopy is more effective than ultrasonography as a diagnostic tool in patients of chronic pelvic pain.

Background: Objective of the study was to assess the awareness and acceptance for contraceptive practices amongst the women attending the routine antenatal outpatient services at our tertiary rural institute.Methods: It was a cross sectional study done in UP University of Medical Sciences (UPUMS) Saifai. Three hundred fifty (350) patients aged between 18 -40 years were enrolled in the study after written informed consent. A self structured pre formed questionnaire was provided regarding demographic profile, obstetric profile, contraceptive practices and reasons for not using any contraception. Then data were analysed statistically.Results: Majority of the women were between the age group of 30-35 years and had basic level of education. In our study 90% women were aware of one or more methods of contraception. 86.5% accepted the contraceptive practices and 81.43% followed the contraception. 81.43% used temporary methods of which OCPs, IUCDs, and Condoms were common.Conclusions: Majority of the women were between 30-35 years of age. 90% women knew about some method of contraception. 81.4% women followed the temporary method of contraception. Among non users the main reason for not using contraceptive method were mainly lack of knowledge and they wanted more children.

BackgroundThe risks of adverse maternal and perinatal outcomes are not very clear in coronavirus disease 2019 (COVID-19)-positive pregnant women. Therefore, this study aimed to determine the maternal and fetal outcomes in COVID-19-positive pregnancies. MethodologyThis prospective, cohort study was conducted in a tertiary care center over the period of one year. The study group comprised pregnant patients who presented with COVID-19 in the first and second waves of the pandemic. Maternal symptoms due to COVID-19 infection, comorbidities, number of admissions to the intensive care unit (ICU), and maternal mortality were noted for every patient. Perinatal outcomes were recorded in the form of intrauterine growth retardation (IUGR), mode of delivery, preterm deliveries, birth weight of newborns, neonatal intensive care unit (NICU) admissions, and neonatal mortality. Data analysis was done in the form of a variable percentage and mean ± standard deviation (SD). ResultsCOVID-19-positive pregnant patients were mostly asymptomatic (48.07%). Term deliveries (37-40 weeks) were seen in 44 (89.8%) patients. The percentage of normal vaginal delivery was 74% and cesarean section was 24%. Out of 52 patients, two (3.8%) patients were admitted to the high dependency unit (HDU), one (1.9%) patient was admitted to the ICU, and 49 (94.3%) patients were in the isolation ward. Of the 49 live births, four (8.16%) newborns were admitted to the NICU. No neonatal death was recorded. ConclusionsIn this study, COVID-19-pregnant women were mostly asymptomatic. Neonates of COVID-19-infected women also mostly tested COVID-19 negative. More studies are needed with larger sample sizes to determine the effect of COVID-19 infection in pregnant women and neonates.

Objectives: The aim of this study was to compare operative data and postoperative complications among nondescent vaginal hysterectomy (NDVH), laparoscopy-assisted vaginal hysterectomy (LAVH), and total laparoscopic hysterectomy (TLH) at a rural tertiary care center. Materials and Methods: This is a prospective analytical study, of 145 hysterectomies for benign conditions with or without salpingo-oophorectomy in women from 30 to 60 years, over 3 years from January 2016 to December 2019, with 60 cases of NDVH, 46 cases of LAVH, and 39 cases of TLH. The three groups were compared intraoperatively in terms of blood loss, operating time, and intraoperative complications and postoperative complications and postoperative duration of hospital stay. Results: There was no significant difference between the three groups in terms of age, parity, body mass index, and indications for hysterectomies. The mean operative time was significantly shorter ( P = 0.000) in the NDVH group (54.67 ± 15.67 min) as compared to the LAVH (102.45 ± 10.53 min) and TLH (126.79 ± 8.7 min) groups. Intraoperative blood loss was greater ( P = 0.000) in the TLH group (111.025 mL ± 20.8) as compared to the NDVH (59.50 mL ± 16.7) and LAVH (91.85 mL ± 10.66) groups. The intraoperative complications and postoperative complications were higher in the TLH group as compared to the LAVH and NDVH groups. The duration of hospital stay was almost similar in all the groups. Conclusion: NDVH may be the preferred approach for experienced surgeons, as it is less time-consuming, has a small amount of blood loss, and is a scarless surgery, whereas LAVH and TLH may be the preferred approaches in the cases of presence of adnexal masses and adhesions or whenever salpingo-oophorectomy is indicated.

Introduction Maternal near-miss and maternal mortality cases have common characters, especially in terms of risk factors. Both of them are indicators of the quality of health care services provided to pregnant women. Our center is a tertiary care center in a rural area of western Uttar Pradesh (U.P.) so we get a large number of referred cases from most of the rural areas of western U.P. and the adjoining areas of other states too, which sometimes end up in mortality. Thus this study was planned to find out the incidence of maternal near-miss events and compare the nature of near-miss events with maternal mortality. Goal and objectives The main objectives of the study were to determine the frequency of maternal near-miss events, observe the trend of near-miss events, and compare the nature of near-miss events with maternal mortality.