A programmed labour protocol for optimizing labour and delivery

Background: Objectives: 1) To evaluate the effect of programmed labor on duration of labor 2) To assess efficiency of analgesics in reducing severity of labor pains and 3) To find out any maternal and fetal/neonatal complications.Methods: 100 primigravida pregnant women meeting inclusion criteria admitted in labor room 50 were randomly enrolled in study group and 50 in control group.Results: Significant reduction in duration of active phase of labor and 43 (86%) cases had pain relief. Out of them 20 (40%) cases experienced excellent pain relief while in controls, only 22% had pain relief.Conclusions: Labour analgesia ensures pain relief, avoid maternal hyperventilation controls alteration of placental circulation thereby safe guarding the fetus against hypoxia. Thus programmed labor is easy, simple and effective method for painless deliver

Visual inspection with Acetic Acid (VIA) as an Alternative to Colposcopy in Detection of Cervical Carcinoma in low recourses setting

Objective: To evaluate visual inspection with acetic acid ( VIA ) as an alternative to colposcopy in detection of cervical carcinoma in low resource setting. Introduction: Cervical cancer is a major public health problem in developing countries, with India itself accounting for one-fifth of the global burden of the disease. In low resource settings, screening of CIN and carcinoma cervix by colposcopy can be replaced by cheaper and easily available visual methods like VIA, which has the high sensitivity to detect any grade of dysplasia. Method: VIA was performed in two hundred symptomatic women as a pre colposcopy attending the gynaecology department at National Institute of Medical Science ( NIMS ) Hospital Jaipur. Sensitivity of VIA was calculated. Result: Out of 200 patients VIA was positive in 48 (24%) cases. In VIA positive cases, Colposcopy was abnormal in 30 ( 62.5%). In VIA negative cases colposcopy was abnormal in only in 2 (1.3%) cases. 32 cases with abnormal colposcopic finding were subjected to biopsy. Conclusion: The high Sensitivity of 86.6% of VIA shows that most of the preinvasive and invasive lesion were picked up by VIA. Thus VIA could be valuable in detection of precancerous lesion of the cervix in low resource setting

Incidence of Gestational Diabetes Mellitus in Pregnant women from Rural Background Attending Antenatal Care Clinic

Objective: To assess the incidence of Gestational Diabetes Mellitus in pregnant women from rural background attending antenatal care clinic. Introduction: Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. Incidence of GDM is increasing worldwide for recent trends in obesity and advancing maternal age, with huge healthcare and economic costs. Depending on the population studied and the diagnostic test employed, prevalence may range from 2.4 to 21 per cent of all pregnancies. Method: 75 gm OGTT was performed on pregnant women attending antenatal clinic in NIMS Medical College and Hospital, Jaipur, Rajasthan, incidence then calculated. Result: Out of 511 patients studied, maximum percentage of patients with GDM (42.85%) were seen in age group of >/= 36 years, followed by 31-35 years (9.84%). Incidence of GDM in rural area of Jaipur in our study was 03.32%. Conclusion: Of total 511 patients 17 patients were diagnosed to have Gestational Diabetes Mellitus thus incidence came out to be 3.32%. Out of these 17 GDM patients, 3 (17.64%) patients were diagnosed in first trimester and thus diagnosing pregnant patients with high risk factors in first trimester, proved to be beneficial as early diagnosis and treatment reduces maternal and fetal complications. Association of presence of risk factors and GDM was not statistically significant and would have missed 13 (76.47%) patients