Indications and foeto-maternal outcome of emergency cesarean sections in rural Mewar region

Background: In the 21st century caesarean section is the most common operation in modern obstetrics but its indications have been changed in elective and emergency cases. The aim of the present study was to find out the incidence, indication of caesarean, foeto-maternal outcome in patients who came in emergency from rural areas.Methods: This retrospective study was conducted at Pannadhai Mahila Hospital, R. N. T. Medical College, Udaipur from September 2017 to February 2018. All the women who were unbooked, belonged to rural Mewar region and underwent emergency caesarean section.Results: Total no. of deliveries conducted were 1560 in the emergency labour room out of which 462 were emergency caesarean sections. The mean age of the participants was 27 years. Foetal distress was the most common indication (17.75%) followed by prolonged labour/ failed induction 14.5%. Post-partum haemorrhage and adhesions were the commonly encountered complications.Conclusions: LSCS due to maternal and foetal indications is inevitable. Timely performed LSCS decreases the morbidity and mortality. The government of India has also taken initiative in making caesarean deliveries more acceptable, affordable to patients belonging to rural areas. The government is also enhancing primary and community health centers

The study of knowledge, attitude and practice about abortion and technology at the tertiary centre in the region of Mewar, Rajasthan, India

Background: Availability of safe, effective and acceptable abortion-care services is one of the most important aspects of women’s reproductive health. Unsafe abortion is one of the four main causes of maternal mortality and morbidity. To study knowledge, attitude, and practice (KAP) regarding abortion and methods used among/for women of child bearing age to formulate recommendation for improving the safe abortion servicesMethods: This prospective study was done among 100 cases who came for MTP at department of Obstetrics and Gynaecology, RNT medical college, Udaipur during November and December 2017. Data was collected using a self-semi structured questionnaire related to abortion technology.Results: 58% of women knew that there were provisions for abortion in public hospitals but only 38% of them knew that abortion should be performed/carried out by a trained doctor only. 70% of the women knew that there were medicines available for abortion (MMA) but only 20% of them knew how and from where to avail them. 69% knew about other methods and that D and E can be done in hospitals both at private and public sector, 25% knew the complications related to unsafe abortion. About the attitude almost all women wanted abortion should be done if needed only 10% knew that abortion is legal. 66% of women consider MMA to be safe and 27% of women consider contraception is necessary.Conclusions: Majority of women have positive attitude towards the abortion. The most prefer method chosen for abortion was medical method of abortion (MMA)

Association of colposcopy with pap smear in evaluation of unhealthy cervix- a prospective study

Background: Unhealthy cervix is a very common finding in our country due to poor genital hygiene, malnutrition and multiparity. The cervix is the commonest site for female genital cancer. Gynaecologists who work in tertiary care institutes in the developing countries to get referrals from practitioners and peripheral health centres for patients with a clinical diagnosis of an “unhealthy cervix. An “unhealthy cervix” or grossly abnormal cervix can harbour premalignant cervical lesions or invasive carcinoma. That’s why present study was planned to evaluate colposcopy role in relation to PAP smear in symptomatic patients. Methods: The present study was a prospective, analytical study. After institutional committee approval this study was conducted from January 2021 to January 2022 in department of obstetrics and gynecology at RNT Medical college, Udaipur. Total 140 women were assessed for this study. Results: Our study results based on combined cytology and colposcopy with histopathology- sensitivity =100%, specificity =87.03%, PPV=84.09%, NPV=100%, accuracy =92.30%. The result of current study supports that, PAP smear demonstrates premalignant and malignant lesions, whereas colposcopy shows the exact site for biopsy for histopathological diagnosis and for further management. Conclusions: Colposcopy and cytology are complementary to each other. Best result in early detection of pre-invasive carcinomas could be obtained by combined use of cytology, colposcopy and colposcopy guided biopsy. So, use of ‘single visit approach’ in which cytology, colposcopy and guided biopsy all are done in one setting and treated accordingly in resource poor countries will enable maximum utilization of scarce medical resources