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Destructive operations diminish the bulk of the foetus for facilitating vaginal delivery. Procedures such as craniotomy or decapitation can be carried out to deliver a dead baby in appropriately selected cases. Ours is a retrospective case series at a single tertiary facility during the first wave of the COVID pandemic. From July 2020 to January 2021, six destructive operations (five craniotomies and one decapitation) were performed in women who had arrest of descent in the second stage of labour but had intrapartum foetal demise. The average operative time was 30 minutes with a mean hospital stay of 4.3 days, which was significantly less than CS, and with much less morbidity. None of these women had significant post-partum haemorrhage or sepsis. Destructive procedures should be considered for better obstetric future of the patient, and a lesser burden on the health facility. What was practiced in COVID times should be extended beyond.

Anaemia, the most common medical disorder associated with pregnancy, is a silent killer. Most severely anaemic pregnant women are asymptomatic and present late in the third trimester with medical and obstetric complications.

We undertook this study in order to compare the efficacy of 25 microg versus 50 microg of intravaginal misoprostol for cervical ripening and labour induction at term. The study population consisted of 120 women with term singleton pregnancies in vertex presentation booked for caesarean section. They had a Bishop scoring of <6 and a reactive fetal heart rate tracing. They were randomized into two groups, A and B, to receive 25 microg and 50 microg of vaginal misoprostol, respectively, 4 hourly with a maximum of five doses until the patient had three contractions in 10 minutes. There was no significant difference in the induction delivery interval between the two groups (12.52+/- 7.05 h in the 25 microg group versus 11.72+/- 6.74 h in the 50 microg group; P = 0.58). Of the women in the 25 microg group, 83.3% delivered vaginally as did 71.67% of those in the 50 microg group, but the difference was not statistically significant (P = 0.128). There were significantly more women requiring oxytocin augmentation in the 25 microg group than in the 50 microg group (P = 0.03). However, there were no significant differences in the rates of caesarean and operative vaginal delivery, meconium stained liquor, fetal distress or in the incidences of hyperstimulation between the two groups. Neonatal outcomes were similar. The intravaginal administrations of 25 microg, as well as 50 microg of misprostol, are equally efficacious in inducing labour. The 25 microg group more often required oxytocin as an adjunct.

Laparoscopic female sterilization is widely practiced and is very safe. However, mesosalpingeal tears and mesosalpingeal haematomas are common complications especially when performed by an inexperienced surgeon. It was found that the observation of a simple 'prong sign' could prevent these complications and possibly reduce failure rates.

Inversion uterus is an unusual complication of vaginal delivery. Mismanaged third stage of labor is the most commonly identified predisposing risk factor. The condition requires immediate intervention. This retrospective study was conducted in Lady Hardinge Medical College and Associated Hospitals, New Delhi, India with the aim to study the clinical profile and outcome of patients admitted with inversion uterus. A total of six cases of inversion uterus were managed during the five year period reviewed. All patients had acute inversion and were managed successfully by manual reposition except one with chronic inversion which required laparotomy. In this case Huntington's technique was used to reposit back uterus. The patients were discharged in satisfactory condition with a mean hospital stay of nine days. Early diagnosis, resuscitation and replacement of inverted uterus are essential components of management of this rare but life threatening situation. Proper management of third stage is recommended.