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: India is the second-most populous country in the world. Appropriate knowledge and usage of contraception are important. Objective: This cross-sectional observational study was done to assess the awareness and usage of different methods of contraception among women of reproductive age group. Material and methods: Six hundred women between age groups of 18-45 years, attending Gynae OPD at SIMS, Hapur were interviewed with the help of a predesigned questionnaire from May 2019 to January 2020. Women having medical disorders were excluded. Results: Among 600 women, 52.5% were between 21 to 30 years of age. 81.2% had parity equal to or more than two. 86% of women were of rural origin & 66.5% belonged to the Muslim community. 85.3% women were aware of barrier contraception, 81% were aware of natural methods, 47.7% knew about IUCD & 57.5% were aware of OCP’s. 78.2% were aware of permanent methods of family planning. 96.3% of women were aware of at least one method of contraception. Only 37.4% of women were using contraception. There was a statistical difference among the rural and urban populations for awareness and usage of contraception. Conclusion: Despite awareness of contraception, in our study population, the acceptance of contraception was low, in comparison to many studies. Fear of side effects is the most common reason for less usage.

This study is an analysis of five cases of orbital trauma causing proptosis, paralysis of extraocular muscles with or without associated visual failure. All the cases were treated by a ENT and Neurosurgical team. Either a frontal craniotomy or a lateral orbitotomy was performed. Plain X-rays of the skull and Computerised Tomography (C.T. Scanning) were the main investigations. Results were encouraging both functionally and cosmetically. Early diagnosis and an aggressive approach to orbital decompression can achieve good results.

Introduction: The umbilical cord is the vital extension of the fetal circulatory system which regulates blood flow in both directions, thus allowing mother-child communications viz., immunological, oxygenation, fetal nutrition, cardiac function. Umbilical cord abnormalities are associated with the adverse maternal and perinatal outcome.. Aim: To assess prevalence of various umbilical cord abnormalities and its association with maternal complications and perinatal outcome. Materials and Methods: This prospective observational study was conducted at Saraswathi Institute of Medical Sciences Pilkhuwa, Hapur, Uttar Pradesh, India from June 2019 till March 2020. The approval for the study was taken from the Institutional Ethical Committee. Total number of deliveries during this period were 1284. After satisfying exclusion criteria, total 600 deliveries of more than 37 weeks of gestation were included in the study at random. Examination of cord was done during delivery for presence of loops of cord around the neck or body, any knots, true or false. After the delivery, the cord was clamped 5 cm from the fetal end and the total length was measured from the cut end till the placental insertion site, and 5 cm added therein. Umbilical cord was examined for any abnormalities and numbers of coils recorded and Umbilical Coiling Index (UCI) measured. Apgar score and NICU admissions noted. Results: Out of 600 patients, umbilical cord abnormalities were seen in 194 (32.33%) patients, while in 406 (67.67%) no abnormality was detected. The mode of delivery was vaginal in 441 cases (73.5%) while 159 (26.5%) had Lower Segment Cesarian Section (LSCS). Out of 194 cases with umbilical cord abnormality, 89 (45.87%) had LSCS and out of 406 cases with no cord abnormality, only 70 cases (17.24%) had LSCS (p-value<0.0001). Mean UCI was 0.25±0.09. Total 269(44.83%) had maternal complications and 143 cases (53.16%) had umbilical cord abnormalities. While 126 (46.84%) cases with maternal complications did not show any cord abnormality. Apgar score of <7 at one minute was seen in 43 cases (22.16%) and 23 (11.86%) were admitted in Neonatal Intensive Care Unit (NICU) with umbilical cord abnormality. Conclusion: The umbilical cord abnormalities were associated with the adverse maternal and perinatal outcome and increased rate of LSCS (p-value <0.0001). The study shows the importance of knowledge of cord abnormalities. The cord abnormality should be looked for after each delivery, with the aim to reduce perinatal morbidity.

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