European Journal of Molecular & Clinical Medicine

Background: While carrying twin pregnancy can be exciting for the family, the risk of illnesses increase manifold when compared to singleton pregnancies. This study was conducted to know about the factors that can be associated with the determination of mortality and morbidity revolving around the twin gestation.

Aim: To assess the maternal and fetal outcome of caesarean section in second stage of labour.
Methods: This prospective observational study was carried out in the department of Obstetrics and Gynecology at VIMS, Dahanu for the period of 2 years. Total 400 patients were included into the study. All caesarean sections performed at full cervical dilatation over the time period of Two years at a VIMS hospital Dahanu.
Results: During the Two years period, a total of 24600 women delivered by caesarean section, 16800 emergency and 7800 elective cases. Of these 400 (2.38%) were at full cervical dilatation, >37 weeks gestation with a singleton fetus in cephalic presentation. Among the 400 patient’s majority of them were in the age group of 20-30 years (72.5%). about 75.5% of the patients were primigravidae and only the remaining 24.5% were multigravida. The commonest indications for doing caesarean section in the second stage of labour were cephalo pelvic disproportion, fetal distress and obstructed labour. Incidence of PPH is 48 out of 400 cases (12%). Post-operative wound infection was seen in 23(5.75%) and Post-operative fever was seen in 70(17.5%) out of 400 cases. There were no cases of maternal deaths reported. The mean operative time was 52.9 min .The mean length of hospital stays was 6.6 days. Mean weight of the babies of the second stage caesarean section was 3.2 kg. 20 (5%) babies were admitted to the Neonatal Intensive Care Unit and 53 (13.25%) to neonatal nursery for management of respiratory distress, sepsis, jaundice and observation. 46 (11.5%) babies had Neonatal jaundice and there were 3 neonatal deaths reported.
Conclusion: Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and neonatal morbidity.

Background: In India 65% of women have unmet need for family planning during the first year post-partum, Insertion of PPIUCD appears appealing because, High unmet need for contraception during the first post-partum period, increasing rate of institutional delivery, Long term and reversible method, it requires only once motivation, Highly effective, Long-term benefits of reducing maternal mortality burden, hence in recent past PPIUCD as a method of contraception has evolved.
Objectives: To assess the safety and efficacy of PPIUCD.
Materials and methods: This is an observational study from June 2019 to May 2020, conducted in department of OBG, Kodagu Institute of Medical Sciences to assess the safety and efficacy of CuT380A when inserted within 10 mins of placental expulsion up to 48 hours after delivery. During this period total number of deliveries were 3293. Among them 833 women had PPIUCD insertion. Counselling of PPIUCD was done during their antenatal visit, early labour, immediate postpartum and while preparing for the scheduled caesarean delivery. Post-abortal and 6 weeks postpartum IUD insertion were excluded from study.
Results: Of 3293 total deliveries, women who had PPIUCD insertion were 833(25.9%). Among them Post placental 165(19.8%), Primary cesarean delivery 550(66%) and repeat cesarean delivery 24(2.88%). PPIUCD counselling were done during antenatal period in 211 (25.3%), during early labor in 528 (63.3%) and during postpartum period 94 (11.2%). Acceptance of PPIUCD insertion was found to be 526(63.14%) among women of age 20-25 years, primipara 651(67.34%), who had at least primary education 249(29.9%). 812 women attended follow up. 651(80.17%) had no complaints, continued counselling helped. Complications like string problem (5.91%), expulsion rate (2.83%), pain abdomen (6.4%), bleeding P/V (3.94%). PPIUCD was found to be safe as there was no evidence of perforation or failure rate. 10 women insisted for removal of PPIUCD, one of the main reasons was social factor.