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To establish communication with relatives of obstetrical patients with coronavirus disease 2019 (COVID-19) admitted to an isolation ward by systematic use of quality improvement tools during the COVID-19 pandemic as there were many challenges in communicating with relatives.The study was conducted in the Department of Obstetrics and Gynecology at a tertiary-care teaching hospital based on four systematic steps of Point of Care Improvement methodology. After identifying the problem, a quality improvement team was constituted, which formed a specific aim. After root-cause analysis with fishbone tool, three Plan-Do-Study-Act (PDSA) cycles with various interventions were planned.The outcome was measured as percentage of relatives of obstetrical patients admitted to the hospital with COVID-19 who were counseled about vital patient-related information. The baseline percentage of counseling of relatives of COVID-19-positive obstetrical patients admitted to the hospital was 14% per day. After three PDSA cycles, the target of 66.5% was achieved.Communication with the relatives of COVID-19-positive obstetrical patients admitted to isolation wards in the hospital could be easily streamlined without any additional resources using the principles of quality improvement during the COVID-19 pandemic.

Introduction: Most cases of bronchopulmonary sequestration (BPS) regress. Prenatal intervention is needed in cases of fetal hydrothorax or hydrops. Laser is commonly used to ablate the feeding artery. Case Presentation: In a fetus with BPS, radiofrequency ablation (RFA) was used to ablate the feeding artery arising from descending aorta at 29 weeks gestation. There was an extralobar BPS and significant pleural effusion causing mediastinal shift and collapse of lung. The effusion and tumor started decreasing from day 3 after procedure, and by the time patient delivered at 36 weeks gestation, the lesion had almost resolved. Conclusion: With proper technique, RFA can be safely used to ablate feeding artery in BPS.

Zika virus (ZIKV) belongs to the family of flaviviruses and is transmitted by mosquitoes of the genus Aedes (A. aegypti and A. albopictus). ZIKV infection in pregnancy can have serious implications on the fetus and the neonate. Vertical transmission to the fetus can occur irrespective of symptomatic or asymptomatic infection in the pregnant woman and the risk can persist throughout pregnancy. The exact frequency of maternal-to-fetal transmission of Zika virus is difficult to determine accurately. The greatest risk of serious fetal sequelae is seen if the infection occurs within the first and second trimester. However, they can also be seen with infections in the third trimester. This document describes the presentation, feto-maternal manifestations, role of prenatal Ultrasound in diagnosis of infection, testing methods and the management in pregnancy and screening in the neonatal period. In the absence of robust evidence as to the definite effects, this document is aimed at providing practice recommendations for the management of this infection.

At the outset of reorganization, pregnant women with scheduled appointments were contacted and reassured. They were screened telephonically for symptoms before calling them to the facility for counseling and testing. Part of the genetic counseling was also done telephonically and appointments rescheduled accordingly.

The study was conducted to establish use of printed investigation sheets as checklists for timely workup and clinical evaluation of antenatal women with medical diseases; admitted in maternity ward, by third day of their hospital admission. This was aimed to standardize care, avoid repeated blood sampling of patients, avoid delay in starting the treatment and help teams perform optimally by systematic use of quality improvement (QI) tools.The present study was conducted in the Department of Obstetrics and Gynaecology at a tertiary care teaching hospital using point-of-care quality improvement methodology systematically. A QI team was made who formulated an aim statement, conducted a root-cause analysis, performed plan-do-study-act (PDSA) cycles. The outcome was measured as complete clinical evaluation of antenatal women with anaemia, hypertension, and/or diabetes by third day of admission in the maternity ward.The baseline data showed that median percentage of patients with complete clinical evaluation was only 29.2%. After a root-cause analysis with fishbone tool, three PDSA cycles were conducted to achieve the target of 80%. After the third PDSA cycle, complete clinical evaluation in anaemia, hypertension, diabetes showed an improving trend with a median of 75%.Adopting simple principles of quality improvement, initiating use of printed investigation sheets as checklist can streamline and expedite clinical evaluation of antenatal patients with medical problems so as to avoid unnecessary delay in initiating the management in busy maternity wards.

Objective There is concern regarding the safety of delayed cord clamping (DCC) in babies born at less than 34 weeks'' gestation. Therefore, the primary objective of this study was to compare the rates of hyperbilirubinemia and polycythemia during initial 7 days in infants born at less than 34 weeks'' gestation and randomized to receive DCC by 120 seconds or early cord clamping (ECC) within less than 30 seconds. Methods One hundred pregnant women were randomly subjected to DCC or ECC at the time of birth in a tertiary referral hospital setting. Blood samples were obtained from each newborn at 48 hours and 7 days for hematocrit measurement. Serum bilirubin levels were estimated once the infant had clinically significant jaundice or at 72 hours. For the statistical analysis, the χ2 test, Student''s t-test, or Wilcoxon rank sum test was used. Results The hematocrit was significantly higher in the DCC group than in the ECC group (P