Background: High-risk pregnancy refers to any condition in pregnancy that increases risk for morbidity or mortality in mother, fetus and neonate. Globally, nearly 5,29,000 women die due to pregnancy related complications. In India, 20-30% of the pregnant patients contribute to high risk group. This study was conducted to determine different high-risk factors prevalent in antenatal women in Haryana. Objective of this study was to find out prevalence of different high-risk factors in antenatal women.Methods: Data of all antenatal high-risk patients attending OPD during one year was taken from hospital record registers. Maternal characteristics such as age, gravida/parity, gestational age, and gestational age at the time of first visit were noted. High risk factors identified were noted.Results: The records of total 10073 antenatal women were analyzed, 1283 were included in the high-risk group. Most prevalent high-risk factors found were previous cesarean section (31.04%), anaemia (31.02%), malpresentation (12.93%) and thyroid disorders (13.09%).Conclusions: Antenatal surveillance for the high-risk factors complicating pregnancy may prevent or treat most of the complications. Authors should develop strategies for early screening of high-risk pregnancy cases to prevent maternal and perinatal mortality and to improve the maternal and perinatal outcome.

The aim of this study was to evaluate the demographic profile, risk factors, management strategies in women with placenta accrete spectrum and also to see the feto-maternal outcome of these women. Study design-Prospective AnalysisMethods: This study was conducted in the Department of Obstetrics and Gynaecology, PGIMS, Rohtak, Haryana from January 2017 to December 2018. All the women who were diagnosed as placenta accrete spectrum (PAS) either on ultrasonography, magnetic resonance imaging or intra-operatively were included in the study. Results: During the two year study period, there were 22745 deliveries, out of which 22 patients were diagnosed to have placenta accrete spectrum, therefore, the incidence was 0.09%. The majority (41%) of the women in study belonged to the age group of 30-35 years. Most of the women (77%) were unbooked and 80% were from rural background. None of the women in our study were primiparous. The risk factors for PAS in our study included history of one caesarean section in 11(50%) patients, two caesarean section in 4 (18%) patients and history of three caesarean section in 2 (9%) patients. Co-existing placenta previa was present in 17 (77%) of the women with placenta accrete spectrum. Eight women (36%) had placenta accrete, one (5%) had placenta increta and rest of the 59% were diagnosed as placenta percreta. The maternal complications encountered in the study were post-partum haemorrhage (95%), bladder injury (59%), DIC (9%) and sepsis (5%). Maternal mortality rate was 9%. The most common neonatal complication was prematurity and low birth weight. Conclusion:The rising rates of caesarean sections is an important factor behind increase in incidence of placenta accrete spectrum. Early diagnosis in antenatal period, timely intervention, multi-disciplinary team approach and adequate arrangement of blood and blood products is a key for successful management of PAS, thereby, reducing maternal and neonatal morbidity and mortality.

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The main objective was to evaluate the effectiveness of Neuromuscular exercises (NEMEX) on pain and function in patients with knee osteoarthritis. Pubmed, Cochrane and Pedro and Google Scholar were accessed with eligibility criteria Randomized controlled trials, single blinded controlled trial and Controlled before and after study comparing and assessing the effectiveness of NEMEX in knee osteoarthritis, articles published in English language till 2020 with NEMEX either alone or in conjunction with other interventions (drugs, educational packages) in patients with Knee osteoarthritis. Outcome measures used for meta-analysis were visual analog scale (VAS) for pain and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for function and the other measures Knee injury osteoarthritis outcome score (KOOS), Knee Index and Knee Adduction Moment (KAM) and Hip Disability and osteoarthritis outcome score (HOOS). The result of the metaanalysis for the included two studies showed statistically significant reduction in pain (VAS) in the NEMEX group as compared to the other group Z = 0.64, p = 0.03, I2 = 79% and no significant reduction in WOMAC scores Z = 0.70, P = 0.64.The study concludes that there was statistically significant improvement in pain (VAS) but no functional improvement (WOMAC) with the NEMEX whether used in isolation or in conjunction with other interventions was seen in the patients with knee OA. However, large numbers of studies are required to generalize the effectiveness of NEMEX in knee osteoarthritis. Implications of the study includes NEMEX can be used as a potential intervention in reducing pain, improving strength and function in knee osteoarthritis patients.

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Background: Women with previous LSCS often have to make a decision about mode of delivery of their second baby. As the rate of caesarean section is continuously increasing, vaginal birth after caesarean section (VBAC) is a good strategy to decrease caesarean rate. The present study was planned to assess the fetomaternal outcome in pregnancies with previous lower segment caesarean section undergoing trial of scar and to identify the factors, which can influence the outcome of trial of scar.Methods: This was a prospective observational study on 100 patients at a tertiary care institute. Pregnant women with previous LSCS were selected randomly for the study on the basis of the inclusion and exclusion criteria. Each labor monitored closely using a partogram. Decision for repeat emergency caesarean was taken by consultant. All women included in the study were followed through delivery and till discharge.Results: Out of 100 pregnant women 49 % cases had successful VBAC, 50% had emergency caesarean and one patient had laparotomy for rupture uterus. In women, who also had a prior vaginal delivery, 72% delivered vaginally, as compared to 40% of the women who did not undergo prior vaginal delivery (p value=0.003). Women who were in spontaneous labor, 59.21% delivered vaginally, whereas women who were induced, 16.6% delivered vaginally. The rate of perinatal complication was more in the patients who required an emergency CS after a failed trial. Conclusions: Our findings may encourage obstetricians to encourage VBAC in the properly screened ANC patients and decrease the rate of recommending caesarean section.

Introduction: Polycystic ovarian syndrome is the most common endocrinopathy affecting approximately 5 to 21% of reproductive age women. Although the exact aetiology of PCOS is unknown, recent reports have indicated the association between PCOS and disturbance in trace elements (e.g. zinc, copper and magnesium) levels and oxidative stress. Aim and Objective: To compare serum levels of essential trace elements Zinc (Zn), Copper (Cu) and Magnesium (Mg) among patients with PCOS and healthy controls of age group (15-35 years) from same socio economic status. Material and Methods: Present study was carried out in 240 patients (120 cases and 120 healthy controls) of age group (15-35 years) and serum levels of Zinc, Copper and magnesium were compared in PCOS women and healthy controls by using colorimetric method Results: High baseline serum concentration of zinc, copper and magnesium were found in both i.e. women with PCOS and the healthy controls and it may be attributed to the socio-cultural and environmental characteristics of this population. Serum zinc and magnesium levels were found to be significantly higher while serum copper levels were significantly lower in women with PCOS in comparison to healthy controls in present study. Conclusion:The results of the present study provide clues to explore the role of trace elements in pathogenesis of PCOS and provide an area of interest for further clinical trials in PCOS.

Background: The objective of the study was to study the sociodemographic, obstetrics profile and folic acid intake in women seeking medical termination of pregnancy for gross congenital malformed fetus (GCMF)and to study pattern of GCMF.Methods: A cross sectional study was conducted among women who underwent medical termination of pregnancy for congenital malformation in fetus in tertiary referral hospital of north India. The details regarding their sociodemographic profile, previous obstetrics history, pattern of GCMF, history of folic acid intake and method of termination were taken.Results: 61% of women seeking medical termination of pregnancy for GCMF were of age group 20-25 years.  75 women were from rural area which is 83.3 % in present study. Only 13.3 % of women in present study were illiterate. Most of the women 66.6 % belongs to middle class of society in present study.  40 % women seeking medical termination of pregnancy for congenital anomaly were primigravida. 96.6 % of patient’s congenital anomaly was detected in second trimester. 74.4 % of patient had central nervous system (CNS) congenital anomaly, most common was anencephaly in 34 patients followed by meningocele/myelomeningoceles in 9 fetuses.   Only 27 % women had history of folic acid intake and 55 patients were given mifepristone 200 mg with 400 mcg misoprostol while 32 patients who had previous history of cesarean section were given lower doses.Conclusions: Anencephaly was the most common congenital anomaly detected. The high reporting of anencephaly suggests the need for a fortification of folic acid in food. Dismal rate of cardiac malformation suggests there is need of inclusion of cardiac echo in level II anomaly scan. Prolonged induction to abortion time in present study shows need of further studies for simultaneous or 24-hour regimen of mifepristone and misoprostol and higher doses of misoprostol.