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Objectives: To compare maternal and fetal outcomes in patients with non-operated valvular heart disease and patients who had surgery before or during pregnancy., Methods: The 308 women with valvular heart disease who delivered in this hospital in the last 8 years were divided into three groups. The 218 (70.7%) women in group 1 had no surgical intervention; the 42 (13.6%) women in group 2 underwent balloon mitral valvotomy during pregnancy; and the 48 (15.5%) women in group 3 had surgical intervention before pregnancy (35 had balloon mitral valvotomy, eight had mitral valve replacement, and five had mitral valve repair). Maternal and fetal outcomes were compared for these three groups., Results: The antenatal events differed significantly: 175 (80.3%), 40 (94.2%), and 46 (95.8%) patients in groups 1, 2 and 3, respectively, had uneventful pregnancies. In group 1, 14 (6.4%) patients had congestive heart failure (P>0.05) and 24 (11%) patients had cardiac arrhythmias, which was statistically significant. The rate of preterm deliveries did not differ significantly among the three groups. The groups did not differ in mean birth weight, mode of delivery, low birth weight, Apgar scores less than 8, stillbirths, neonatal death, or congenital anomalies., Conclusions: Mitral valve surgery before or during pregnancy did not significantly improve maternal and fetal outcomes but decreased adverse events such as congestive heart failure and cardiac arrhythmias. It should be therefore performed only in selected cases.

Objectives: To assess the prevalence of incidental Fitz-Hugh-Curtis syndrome in women undergoing diagnostic laparoscopy for sterilization, infertility or chronic pelvic pain., Methods: This was a prospective study over a 4-year period in which a total of 320 women undergoing diagnostic laparoscopy for sterilization [Group I, 200 women (62.5%)], infertility [Group II, 60 women (18.7%)], or chronic pelvic pain [Group III, 60 women (18.7%)] were enrolled. After examination of the pelvic area and abdominal cavity, the liver area was visualized in all cases for evidence of perihepatitis and adhesions between liver and anterior abdominal wall or diaphragm (Fitz-Hugh-Curtis syndrome). Statistical analysis was performed using the chi-square test, with a P-value set at 0.05 for significance., Results: The mean age was similar in the three groups, while mean parity was obviously less in the infertility group. Fitz-Hugh-Curtis syndrome was observed in 16 women (8%) in Group I, 10 women (16.6%) in Group II, and 18 women (30%) in Group III. The prevalence was highest in Group III and the difference was statistically highly significant in Group III vs. Group I (P<0.001), and in Group III vs. Group II (P<0.01). It was higher in the infertility group than in the sterilization group (P<0.05 in Group II vs. Group I)., Conclusions: There was a very high prevalence of incidental Fitz-Hugh-Curtis syndrome in the chronic pelvic pain and infertility groups, and even in the sterilization group.

Objectives: To analyze the maternal and perinatal outcome in varying degrees of anemia., Methods: A total of 447 pregnant women were divided into group I (Hb>11 g%, n=123 women), group II (Hb 9-10.9 g%, n=214 women), group III (Hb 7-8.9 g%, n=79 women) group IV (Hb<7 g%, n=31 women). Their maternal and perinatal outcome, mode of delivery, duration of labor and postpartum complications were noted and analyzed using multiple logistic regression to calculate odds ratios (95% CI) for duration of labor, mode of delivery and low birth babies. Chi square or Fisher's exact test was employed for difference in proportions and Student's t-test for testing difference between means., Results: Mean age (27+/-4.25 years) and number of women with parity >3 were highest in group IV. The patients with Hb<8.9 g% had a 4-6-fold higher risk of prolonged labor compared to Hb>11 g%. The odds ratios for abnormal delivery (cesarean and operative vaginal deliveries) showed a 4.8-fold higher risk (95% CI 1.82, 12.7) in patients with Hb

A 23-year old second gravida presented with 8 1/2 months of amenorrhoea. The fundal height corresponded with 36 weeks of pregnancy with a single live foetus. Ultrasonography revealed a live foetus and a cystic mass over lower sacral region. Emergency caesarean section was performed and the baby was delivered with intact sacrococcygeal teratoma. The histopathological examination confirmed the diagnosis of sacrococcygeal teratoma with mature neural elements. The baby had died on day 10 and the postpartum period of the mother was uneventful.

Two cases of haematocolpos in adolescent girls due to imperforate hymen are reported. Both of them presented with lower abdominal pain and urinary retention. Hymenotomy was performed in both the cases. The condition is discussed with brief review of literature.

Objectives: To compare the efficacy and safety of drotaverine hydrochloride and valethamate bromide in shortening the duration of labor., Methods: In a randomized controlled trial of 150 nulliparous women in established labor with cervical dilation of 4 cm, 50 women were given drotaverine (group I), 50 women were given valethamate (group II) and another 50 women were not given any medication (group III). Duration of labor, mode of delivery, side effects, and neonatal outcome were measured in all cases. Appropriate non-parametric tests and chi(2) tests were used for assessment of statistical significance., Results: In the three groups, 100%, 96% and 46% women delivered within 6 h, respectively. The injection-to-delivery interval was significantly reduced in the drotaverine group (193.96 min) in contrast to the valethamate group (220.68 min) and control group (412.84 min). The rate of cervical dilation was highest in the drotaverine group (2.04 cm/h) compared with the valethamate bromide group (1.86 cm/h) and control group (1.01 cm/h). There were no major maternal or fetal adverse effects in any group, but minor side effects were more common in the valethamate group., Conclusion: Both intramuscular drotaverine hydrochloride and valethamate bromide are effective in acceleration of labor; however, drotaverine accelerates labor more rapidly and is associated with less side effects.

A prospective study was performed of 100 caesarean sections (31 elective, 69 emergency) to determine the incidence of blood splashes to the masks and goggles of surgeons, assistants and scrub nurses. The rate of blood splashes was 40% on surgeons' masks, 49.29% on surgeons' goggles, 31% on assistants' masks, 21.12% on assistants' goggles, 23.1% on scrub nurses' masks and 15.71% on scrub nurses' goggles. The use of masks and protective goggles is strongly recommended to avoid body fluid contamination and acquiring disease in obstetrics.

A study was conducted on 180 women with 2 or more obstetric losses totalling 410 foetal wastages. Control cases included 100 women without obstetric losses. Significant titre of immunoglobulin M against rubella was found in 17.77% patients with 2 or more obstetric losses in contrast to 9% of control patients (p less than 0.005). Significant titre of immunoglobulin M was observed in cases of abortions (5.75%), preterm deliveries (12.67%), macerated stillbirths (8.19%), fresh stillbirths (8.69%) and neonatal deaths (8.34%).

A total of 452 women with unexplained infertility were selected for the present study. From them 310 women were put on thioridazine tablet (5 mg), 1 h after dinner from the 8th day of the menstrual cycle to the 18th day in each cycle. Coitus was advised about 1-2 h after the drug intake and proper posture was advised to the patients. The other 142 patients were given placebo therapy. Patients were followed up for pregnancy for 1 year which was confirmed by ultrasonographic examination. Ninety-four patients (30.2%) in the study group conceived in contrast to 22 (15.42%) in the control group (P less than 0.001). Incidence of abortions, congenital malformations and perinatal mortality and mode of delivery were not significantly different in the two groups. Thioridazine due to anxiolytic effect in low dosage appears to be promising in the treatment of unexplained infertility.

A total of ten patients with lesions of neurofibromatosis during pregnancy were followed up for pregnancy complications. Seven cases (70%) had hypertensive disorders of pregnancy; four had severe PET (pre-eclamptic toxemia) including one case of eclampsia, one had mild PET and the other two had only mild gestational hypertension. A total of 60% had preterm labor and in none of these did the baby survive; thus perinatal mortality was 600/1000. Mean gestation was 33.0 weeks and mean birthweight was only 1.924 kg. Thus, neurofibromatosis during pregnancy is associated with poor obstetrical outcome and requires greater care.

Schmidt's syndrome, also known as polyglandular deficiency syndrome, is the presence of Addison's disease and hypothyrodism in a single patient. It is usually associated with other autoimmune disorders like vitiligo, diabetes mellitus, myasthenia gravis. A rare case of an 18-year-old girl having Schmidt's syndrome and vitiligo who presented with puberty menorrhagia is reported. A brief review of the literature is also given.