Background: Emergency peripartum hysterectomy (EPH) is a rare but a lifesaving procedure done as a last resort to save life of mother. We conducted this study to know the incidence, leading causes, risk factors and complications of EPH. Methods: We conducted a retrospective analysis of all the patients who underwent EPH from January 2008 to December 2015 at SDMCM and H. All patients who underwent EPH from 22 weeks of gestation to 6 weeks postpartum were included in the study. Results: There were 21 emergency peripartum hysterectomies, with deliveries during the same period being 27271 and the rate of EPH was 0.7 per 1000 deliveries. Most common indication for EPH was uterine atony (38%), followed by uterine rupture (23.8%) and morbidly adherent placenta (19%). Most of the patients (47.6%) had previous cesarean deliveries. EPH was done following cesarean in 66.6%. Subtotal hysterectomy was done in 61.9%. Intra-operative urinary bladder injury was seen in 14.2% of the patients. Conclusions: Uterine atony and uterine rupture continues to be the most common causes for EPH in our population. Multiparity is an important risk factor among patients with rupture uterus. Cesarean delivery and repeat cesarean deliveries are the likely risk factors for EPH.

A 22-year-old primigravida came for a routine antenatal check up at 27 weeks of gestation. There was no history of a consanguineous marriage. There was no family history of any hereditary disease or delivery of a malformed foetus in the family. On examination, the fundal height corresponded to that seen at 30 weeks of gestation. Her obstetrics ultrasonography revealed the presence of a single live foetus with large, multicystic, multiseptate, variable sized anechoic areas in an echogenic background, which were found to involve one entire lower limb, which extended upto the ipsilateral pelvic region and were partly seen on the abdomen, on the ipsilateral side [Table/ Fig-1,2]. Colour Doppler showed no blood flow within the lesion. The other extremity appeared to be normal. No other structural anomalies were noted. Liquor was excessive. Parameters corresponded to those seen at 27 weeks of gestation. Patient went in to preterm labour at 30 weeks of gestation and delivered a baby with ambiguous genitalia. Baby showed massive oedema with congestion of right side of abdominal wall, back and whole of right lower limb, with involvement upto the toes. No other gross external malformations were noted. On autopsy, multiple sections taken from skin, which were studied, showed a cavernous lymphangioma which involved the right side of abdomen, back and right lower limb. Abdominal organs and the bones of the affected limb were normal. The foetal karyotype showed 46 XX chromosomes.

Background: Cervical cancer is the second leading cause of death in india. it is also one of the few malignancies where an infectious etiological agent human papilloma virus (HPV) has been identified. With the advent of HPV vaccination, it is possible to reduce the morbidity and mortality associated with carcinoma cervix. But biggest hurdle to achieve this is the lack of awareness about the availability and use of HPV vaccine. This study was conducted to know knowledge and awareness of HPV infection and vaccination among medical and paramedical students. We also evaluated the acceptability and coverage of HPV vaccine among these students.Methods: This study was conducted among a total of 520 female students of the Sri Dharmasthala Manjunatheshwara University with the help of a questionnaire. The study group included 207 MBBS students, 167 BDS students, 89 nursing students and 57 physiotherapy students.Results: Most of the students were in 18-20 years’ age group. Nearly 40.57% of the students knew that HPV is sexually transmitted and 29.80% were aware that this infection can be prevented. Availability of HPV vaccine was known to 75% of the students and the main source of their information was through their college teachings. Nearly 43.75% of the students knew HPV vaccine protects against cervical cancer and 26.73% of the students were vaccinated. Overall knowledge and awareness were better among medical students.Conclusions: A lot of work needs to be done so as to make the target population accept HPV vaccine. There is a great difference between awareness of availability of the vaccine and its use. This emphasizes the need for health care professionals to take special interest in promoting this vaccine in the general population.

Background: Hysterectomy is one of the most common gynecological surgeries performed around the world. This study was done to review the data of all patients who underwent TLH. With this study a uniform method of performing TLH by a single surgeon was assessed.Methods: A 5 years retrospective study was performed at Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital Dharwad, Karnataka India. Demographic data, pre-operative findings, indication for surgery, intra-operative and post-operative complications, duration of surgery were recorded and analyzed.Results: A total of 118 women were included in the study. Mean age of the patients wasMost common indication for the surgery was leiomyoma. Mean operating time was 162.18 minutes. Mean weight of the post-operative specimen was 208.45 grams. Intra-operative urinary bladder injury was seen in 1 patient. Conversion to laparotomy was needed in 2 patients.Conclusions: With improving experience TLH can be performed safely without complications. As number of surgeries done increases duration of TLH reduces. TLH can be effectively used to avoid laparotomy.

Background: The present study was conducted to study the knowledge, attitude and practice of emergency contraception (EC) among the practicing gynecologists. Methods: A cross-sectional study was carried out with the help of predesigned questionnaire among the members of local obstetrics and gynecological society. The questionnaire included questions regarding basic knowledge, misconception and attitude towards use of emergency contraception. Results: Results were analyzed using 124 fully completed questionnaires. Majority of them were female gynecologists (72%). About 84% were not offering EC routinely nor did they advice the same to their clients. All the participants were aware of levonorgestrel (LNG) being used for EC. Only about 64% of them answered correctly about the dosage and timing of initiation of EC. About 12% of the participant gynecologists believed that EC is a form of abortion. Fifty eight percent of the respondents believed that it promotes the irresponsible and promiscuous behavior in the clients and 60% felt that it is targeted mainly at unmarried adolescents and may undermine the parental authority and community morals, which show a strong misconception even among the gynecologists. About 54% believed that women/couples may stop using the regular contraception if it is easily available. About 10% felt that it is not safe to use EC. Conclusions: There is a great paucity of knowledge regarding the use of EC not only among the general public and clients, but also among the service providers and health professionals. This study concluded that there is lack of awareness and certain misconceptions about the use of EC even among the gynecologists, which has resulted in underutilization of EC. There is an urgent need for sensitizing all sections of people about EC through appropriate programs for curbing the population.