European Journal of Molecular & Clinical Medicine

Background: The spontaneous pregnancy loss for a women can be physically and emotionally taxing. Spontaneous abortion is the term given to a miscarriage or termination of a pregnancy that takes place before the twentieth week of gestation on its own. Pregnancies that end in a natural abortion within the first trimester are the only ones that can be referred to as having a "early pregnancy loss." Pregnancies that have a prior history of spontaneous abortions ought to be regarded as high-risk pregnancies, and additional precautions ought to be taken during the ante-natal period in preparation for these outcomes. The goal of this study is to look into the outcomes of pregnancies among women who had a history of spontaneous abortions in previous pregnancies.
Methods: In the department of Obstetrics and Gynecology, Dr. D.Y. Patil Medical College, Hospital, and Research Centre in Pune, a prospective and comparative research was conducted. The sample size for the study was 400, with study group of 200 cases and control group of 200 cases.
Patients with history of spontaneous abortion in previous pregnancy, irrespective of cause and period of gestation were included in study population. For control group, patients with history of previous term delivery, irrespective of mode of delivery were included
Results: In threatened abortions, we observe that 20 (10%) patients had symptoms of threatened abortions while 13 (6.50%) patients had threatened abortions in control group. There are more number of cases of threatened abortion in previous abortion cases when compared to previous normal delivery.

Preterm prelabour rupture of membranes (pPROM) occurs in 2–3% of all pregnancies leading to 30–40% of preterm births. The latent period from membrane rupture to delivery is typically brief after pPROM. The present study undertaken is to identify the risk factors causing pPROM and to study fetal and maternal outcome associated with pPROM.
Materials & Methods: A hospital based prospective study done on 60 patients admitted with pPROM under the Obstetrics and Gynaecology department, at district Hospital during one year period. The onset of complications like fetal distress, fetal heart rate variations, chorioamnionitis were looked for. In cases of fetal jeopardy or any other obstetric complications, labour was cut short by the caesarean section. The babies were followed up in the postnatal period. Neonatal mortality and morbidity were noted. Neonates were monitored for the complications of birth injuries, signs of asphyxia, meconium aspiration and sepsis. Both mother and baby were followed up till their stay in the hospital. Statistical analysis was performed with SPSS statistical software with all the relevant data compiled and entered.
Results: Among the selected cases, pPROM was noted in 6 (10%) mothers in the age group of <20 years, 33 (55%) mothers in the age group of 21-25 years, 14 (23.33%) mothers were in the age group of 26-30 years, and 7 (11.66%) mothers above 30 years of age. Majority of cases belong to socioeconomic status V with a total of 39 cases (65%). Number of multigravida in the study was 22 (36.66%) and primigravida were 38 (63.33%). Out of 60 patients studied, 49 cases (81.66%) were booked and 11 cases (18.33%) were unbooked. Out of 20.58% of neonatal morbidity, complications were maximum in 35-36 weeks group. NICU admissions were more common in 28-31 weeks group. Risk factors were commonly found among 32-34 weeks group with 45%. Out of 13.33% who had latent phase of >3 days, 10% of them were of <34 weeks of gestational age.
Conclusion: We concluded that the most common age group to suffer from pPROM was 21-25 years. There were no risk factors in most of the mothers, but the risk of breech presentation can be avoided by coitus in the later weeks of pregnancy reduces the risk of pPROM. Neonatal care facilities can be improved to manage neonatal emergencies so as to reduce neonatal deaths.

Background: Second stage caesarean sections (SSCS’s) are becoming more common. More possibilities of foetal and maternal harm are linked to second stage caesarean sections. Although there are a number of methods stated to deliver the foetal head during a second stage caesarean operation, the "pull" approach has less risks. Aim & Objective: The purpose of the current study is to learn more about the surgical challenges, maternal complications, and neonatal problems associated with recurrent caesarean sections in second stage labour. Material and Methods:This was prospective observational study conducted at a rural tertiary care canter Karad. All second stage caesarean sections performed between June 2020 to May 2022 were analysed in terms of incidence, indications of caesarean-section, intra-operative and postoperative complications, maternal and fetal outcome. Results: During the study period there were total 6102 deliveries was observed. Out of them 100 were 2^nd stage caesarean sections contributing to 2.8% of total sections. Patwardhan method was used in 33% cases for delivery of deeply engaged head. Intra-operative complications were identified 51% patients in that majority of 26 patients had extraction difficulty in which 19 patients had lower uterine segment tear and angle extension and 7 patients had hematoma. In 11 patients there was atonic post-partum haemorrhage out if which 10 patients were managed medically and 1 patient underwent surgical intervention (B-lynch suture). In 3 patients there was injury to the bladder in which bladder repair was done. Conclusion: Caesarean sections during the second stage of labour are substantially more likely to result in maternal morbidity. The morbidity and death of new-borns are also rising. A professional obstetrician must use sound judgement when deciding whether to perform a caesarean section at complete cervical dilation.

Background: Hypertensive disorders of pregnancy are known to cause adverse maternal and fetal complications and outcomes. In view of assessing its burden and feto-maternal complications and outcomes in the current study setting, the study was conducted.
Material and Methods: This is a retrospective study conducted among 8941 women with more than 20 weeks of gestation, admitted for delivery under the department of Obstetrics and Gynaecology at Koppal Institute of Medical Sciences during the study period of 2 years from July 2019 to June 2021. The primary outcome was assessed in terms of proportions of hypertensive disorders of pregnancy and eclampsia. Secondary outcomes were assessed in terms of feto-maternal complications and outcomes among those with hypertensive disorders of pregnancy. All the quantitative data were presented in percentages.
Results: The proportions of hypertensive disorders of pregnancy were 10.64% and eclampsia was noted to be 1.9%. Majority (63.1%) of the study subjects were between 18 to 23 years, mostly from rural areas (89.8%) and belonged to lower socio-economic status (95.1%). The highest proportion of them (87.9%) had crossed a gestational age of 34 weeks and also primigravida formed the majority (68.4%). None of them were booked and 41.7% of them underwent lower segment caesarian section. 5.3% of the study subjects had maternal complications with common complications being HELLP syndrome, renal complications, pulmonary edema and cerebral venous thrombosis. 0.7% of them died. 28.9% of neonates had complications viz., low birth weight, preterm and small for date babies. Intrauterine deaths were noted among 8.1%.
Conclusion: 1 in 10 mothers had hypertensive disorders of pregnancy and nearly 2 of such 100 hypertensive mothers landed in eclampsia. Feto-maternal complications were documented among 5.3% mothers and 28.9% neonates. Maternal mortality was reported in 0.7% and 8.1% of fetuses had intrauterine deaths contributing to perinatal deaths.