Background: At or after 37 weeks of pregnancy, the decreased cerebroplacental ratio (CPR) denotes high risk of fetal complication. when low-risk foetuses with lower CPR have intrapartum distress within 72 hours after the start of labour, the prevalence of obstetric intervention is greater. This work aimed to assess CPR as evaluated during term pregnancy and before onset of the labor in normotensive and hypertensive pregnancies and its relationship with perinatal outcomes with reference to Intrauterine growth restriction (IUGR), fetal distress, APGAR score, birth weight and admission at Neonatal Intensive Care Unit (NICU). Methods: This prospective observational study was performed on 40 pregnant cases, their age ranging in years from 20 to 35, singleton living pregnancy, gestational age (37-40) weeks and before onset of labor and cephalic-presenting fetus. Participants were divided into two equal groups: normotensive cases and hypertensive cases. Results: Significant difference between two studied group regarding abdominal circumference (AC), Amniotic fluid index (AFI), estimated fetal weight (EFW), Umbilical Artery pulsatility index (UAPI), middle cerebral arterial pulsatility index (MCAPI), CPR, APGAR scores at one and five minutes were substantially reduced while rates of cesarean sections and NICU admissions were significantly higher in hypertensive compared with normotensive women. The cutoff value was 1.1 for CPR yielded a sensitivity of 90%, a specificity of 70%, a PPV of 75% and a NPV of 88% with 83% accuracy and with AUC of 0.955. Conclusions: CPR has high predictive value of perinatal outcome as Apgar score and rate of NICU admission in hypertensive pregnant women.

Background: Lactation is a natural defence against pregnancy. As long as a mother is nursing, she is delaying the return of fertility. This study aimed at evaluating the state of knowledge, among mothers of infants aged 0-6 months, on lactational amenorrhea as a contraceptive method, as well as these women's breastfeeding habitsMethods: In this study, a total of n=300 mothers were included. A questionnaire was used to interview one-on-one the mothers of infants aged 0-6 months, who had consented to such an interview. Results: Out of 300 total respondents, only 121(24%) of them had prior knowledge about LAM and 201 of them had prior knowledge about contraceptive methods. About 276(92.0%) were housewives by occupation and 24(8.0%) were working mothers. Primigravidas used contraception in the past and also had prior knowledge about LAM as compared to Multigravidas. Anganwadi workers provided knowledge to 17 of the totals, 40 of them got knowledge from relatives, Medical and paramedical workers educated 49 of them, 3 got it from the internet and 7 of them were self-acquired. Conclusion: This study although small in size localized in a particular geographical area and covering almost similar socioeconomic profile, has a strong message that if proper and sustained counselling is done the dual purpose of exclusive breastfeeding and a method of natural family planning can be achieved.

Aim: To assess the knowledge, attitude and practice about menstrual cup among health care professionals. Methods: A cross-sectional study was done using structured questionnaire method to collect data among health care professionals in Mangalore. Total sample size of 330 was taken. Results: Out of total 330 participants, 296 (91%) were aware of the menstrual cup and media was their main source of information. Maximum number of participants had a good knowledge about menstrual cups in terms of its various sizes, durability, mechanism of action, material used and mode of sterilization, cost of the cup. 87.6% participants are using sanitary pads currently. Discomfort (54.2%) was the major concern regarding menstrual cup use. A menstruation cup would be used by 137 (42.4%) of the participants if it was made available. Conclusion: Despite of good knowledge about the menstrual cup amongst the health care professionals in the study, practice was found to be poor. Healthcare professionals, who are more open to the idea of eco-friendly products, should be addressed in order to increase the adoption rate of menstruation cups. The government must implement an awareness campaign so that the dream of a

Background: Severe acute lung disease, known as coronavirus disease 2019 [COVID-19] had multifaced impacts on human lives especially in pregnant women. However, no clear-cut consensus have been made on the effect of COVID 19 on pregnancy and fetal effects due to limited data. Aim: To study pregnant women presenting to our department with missed miscarriages or early fetal demise in the COVID pandemic time for a period of 2 years (April 2020 to March 2022) and to assess the risk of early pregnancy loss due to COVID 19 infection if any. Materials and Methods: A Retrospective comparative study was carried out among pregnant women attending the department of Obstetrics & Gynaecology for MTP at SVS Medical College, Mahabubnagar in view of miscarriages both embryonic and anembryonic and early fetal demise till 20weeks Gestational age in the period April2020 to March 2021 and a control group of pregnant ladies who presented for MTPs before 20 weeks for miscarriages and early IUFDs till 20 weeks gestational age in the period of April 2019 to march 2020 were taken. Results: A total of 232 women were registered during pre-pandemic period and 180 women were registered during pandemic period for the study. The two groups were similar in demographic characteristics including the mean maternal age in both the groups which were 22+/-2 and 23+/-2yrs. Parity affected in both the study groups i.e, precovid which were 38.2% in primigravida and 61.7% in multigravida and the pregnancy loss during covid-there were 44.6% in primigravida and 55.3% in multigravida, showing no significant difference in pregnancy loss during and before covid. The percentages of missed miscarriages, early IUFDS less than 20 weeks Gestational age, MTPs done for various congenital anomalies also showed only marginal changes in both the groups. Conclusion: In our study, we did not find any significant difference between the early fetal demise, missed miscarriages, MTPs done for congenital anomalies during the pre-covid and COVID periods. Though some studies support early pregnancy loss due to COVID infection, because of our small sample size, we could not find attribute the marginal changes in the study group i.e, during COVID pandemic due to small sample size and also many studies reporting no significant difference, large multicentric studies are needed to evaluate any association between the COVID-19 SARS virus infection and its effect on fetal demise, any miscarriages or congenital anomalies.

Background: Polycystic ovary syndrome (PCOS) is defined using the Rotterdam criteria. PCOS affects 5%–15% of females of reproductive age and is the first cause of infertility due to anovulation. The aim of this work was to predict success of laparoscopic ovarian drilling (LOD) or redrilling in PCOS. Methods: This observational study was carried out on 50 female cases in childbearing with BMI range from 18-28Kg/m2, infertility > 3 years, irregular menstrual cycles and aged from 20-35 years old. All cases were subjected to pelvic examination except in virgins, ultrasound examination, determine baseline level of anti-Mullerian hormone (AMH) and 3-dimensional color Doppler. Results: AMH had a significant decline after first and second drilling as compared to before first and second drilling respectively (p <0.001). Follicle count in right ovary had a significant decline after first and second drilling as compared to before first and second drilling respectively (p <0.001). Ovarian volume in right ovary had a significant decline after first and second drilling as compared to before first and second drilling respectively (P = 0.002 and <0.001 respectively). Conclusions: In infertile females with PCOs, laparoscopic ovarian re-electro-cautery increased rate of spontaneous pregnancy and the majority of changes in ovarian reserve biomarkers reported following drilling may be viewed as normalisation of the function of the ovary instead of a decline in ovarian reserve.

Unicornuate uterus with rudimentary horn occurs due to failure of complete development of one of the Mullerian ducts and incomplete fusion with the contralateral side. It is associated with numerous obstetrics and gynecological problems such as Infertility, Endometriosis, Miscarriages, Malpresentations & Intrauterine growth restriction. Pregnancy in the non-communicating rudimentary horn is extremely rare and usually terminates in rupture during first or second trimester of pregnancy. Pregnancy occurs via transperitoneal migration of sperm or zygote. Variable thickness of rudimentary horn musculature, poor distensibility of myometrium lead to rupture. This complication is usually seen in 2nd trimester resulting in shock and haemoperitoneum. Diagnosis of rudimentary horn pregnancy is difficult and can be missed in ultrasound. It requires a high risk of suspicion. Materials and Methods: We report the case of 24yr primi gravida with 26 weeks of gestation presented with pain abdomen and sudden maternal collapse on arrival, suspected to be intra-abdominal pregnancy in ultrasound and on laparotomy found ruptured rudimentary horn of unicornuate uterus with fetus found intra-abdominally with massive hemoperitoneum. Conclusion: Pregnancies in rudimentary horn of unicornuate uterus are prone to intra uterine growth restriction and rupture in second trimester so a high index of suspicion is required to save this catastrophic event and associated maternal morbidity and mortality. In our opinion, routine excision of rudimentary horn should be undertaken during non-pregnant state laparoscopically. However, those women who refuse should be adequately counseled regarding potential complications and if pregnancy occurs in rudimentary horn, first trimester laparoscopic excision should be done.

Background: After the 20th week of pregnancy, preeclampsia is diagnosed when a woman develops new-onset hypertension (systolic blood pressure 140 mm Hg or higher, or diastolic blood pressure 90 mm Hg or higher) and proteinuria (300 mg or more in a 24-hour urine collection, or 1+ on dipstick testing). The aim of this work was to determine the sensitivity of placental volume (PV) in the first trimester at 11th week to 13th week+6 days in predicting preeclampsia. Methods: This prospective observational study was carried out on 250 women with any gravidity, singleton pregnancy between 11th to 13th week of gestation based on the last menstrual period or first-trimester ultrasound. All patients were subjected to laboratory investigations (CBC, Renal function tests, Random blood sugar and tests to detect proteinuria.) and imaging. Results: The sensitivity and specificity of PV in differentiating between preeclampsia and normotensive were 60.0%; 60.0% respectively. There was high significant difference in between preeclmpesia and normotensive cases regarding to PV. Conclusions: The PV was lower in cases with preeclampsia as compared to nonpreeclamptic women with highly significant statistical difference and that means 3D PV measurement at 11th to 13th week of pregnancy could increase the predictive accuracy for pre-eclampsia.

Background: Oxidized Regenerated Cellulose (ORC) is used in the treatment of Endometriosis to eliminate or postpone endometriomas’ recurrence and to preserve ovarian reserve subsequently increasing pregnancy rate. The aim of this research was to evaluate the benefit of ORC in surgical management of ovarian endometriomas to reduce the rate of recurrence while preserving ovarian reserve. Methods: This prospective randomized controlled research was carried out on 60 cases, divided into two groups: Group A (drainage and ablation): 30 cases had laparoscopic drainage of ovarian endometrioma with electrocautery of the endometriomal cyst wall. Group B (drainage and ORC): 30 cases had laparoscopic drainage of ovarian endometrioma with insertion of ORC inside the cyst cavity. Results: There was a statistically significant difference according to 3 and 6 months in anti-mullerian hormone (AMH) (ng/ml) and Antral Follicular Count (AFC) being higher in ORC group compared to ablation group while the reduction in AMH (change) was significantly lower in ORC group (P values< 0.001). The recurrence rate of ovarian endometrioma was comparable between both groups. AMH and AFC was significantly associated with the recurrence of ovarian endometrioma 3 and 6 months. Conclusions: ORC reduces effectively the recurrence risk of endometriomas following laparoscopic drainage.

Ill-treatment to a child under 18 years old is considered child abuse. Mohandas Karamchand Gandhi, the father of the nation, once said: “India will be free when the women feel safe to walk in the streets of India at midnight”. However, this endures to continue a fantacy yet to be executed and away from reality. Child sexual abuse is a grave issue in India. Children are the future of a nation and the leaders of tomorrow. They are succeeding in the architecture of society and civilization Child sexual abuse is actuality that is highly prevalent in India. Child abuse is in the form of physical, sexual, emotional and serious global problems. Sexual abuse goes unreported and children are not given the protective assistance they are left to suffer in silence. Child abuse is harmful for the children as well as for society. A welcome development has been the enactment of a special law-Protection of Children against Sexual Offences (POCSO) 2012-criminalising a range of acts including child rape, harassment, and exploitation for pornography. Child sexual abuse is a multidimensional problem having legal, social, medical and psychological implications.

Introduction: The World Health Organization (WHO) reports that in Iraq, there were 2.1 cases of cervical cancer for every 100,000 females of all ages. Moreover, 10.21 million Iraqi women between the ages of 15 and 44 were at risk for developing cancer.Method: At Al Zahra Teaching Hospital in Al Najaf City, a cross-sectional study was carried out over the course of nine months, from January 1 to October 1 2022. Throughout the research period, all female patients who went to the alzahraa cervical screening unit were included (112). At the cytology lab, slides were evaluated using the Bethesda Scoring System, and smears were collected using the Ayre's spatula. Highlighting relationships between cytological results and socio-demographic details using the Chi-square test. Binary logistic regression was used for the significant variables. In our statistical analysis, a significance level of 0.05 was considered to be present.Results: The majority of the sample (91.1%) had normal pap smear results. 8.9% of the remaining women reported abnormal pap smear results. Vaginal discharge (42%), after-coital bleeding (1.8%), and irregular bleeding (25%) were the most frequently reported patient concerns. Cervical cancer in just one case was found. The link between abnormal pap smears and females under the age of 40 was statistically significant (p = 0.047 for both). Smoking increased the risks of having abnormal pap smears [p=0.000; OR=0.011; CI 95% (0,001-0.095)], whereas being 40 years old increased the odds [OR=6.559; CI 95% (.801-53.727)].Conclusions: Ten percent of the sample had abnormal pap smear results, and there was a very significant association between smoking and abnormal pap smear results in females under 40. A successful cervical cancer screening programme must be activated, promoted, and made aware of along with the risk factors that it entails.