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Tocolytics are the drugs that are used to prolong the time of child birth, for a short period - up to 2 days. If the labour starts too early during pregnancy also termed as preterm birth, which is supposed to be one of the major cause of neonatal mortality and morbidity, all over the world. Administration of tocolytic agents can help in preterm labour to delay the preterm labour by 48 hours. Tocolytics temporarily slow the contractions and hence it is possible to transport the patient to a hospital, where specialized care can be provided to premature baby and also corticosteroids can be administered, which help mature the baby’s lungs. Different class of drugs are studied as tocolytics. Beta-Adrenergic receptor agonists like Terbutaline, Ritodrine, Fenoterol, Metaproterenol, Hexoprenaline, Albuterol, Orciprenaline, Nylidrin. Calcium channel blockers like Nicardipine and Nifedipine. Magnesium Sulfate. Nonsteroidal anti-inflammatories or prostaglandin inhibitors like Indomethacin, and Oxytocin inhibitors like Atosiban were found effective in different studies with some side effects, are discussed here briefly. Some Nitrates, alcohol, Progesterone have also been tried with not much significant effect. Calcium channel blocker specially Nifedipine is most studied and found to be safer and effective for tocolysis. Individual uterine relaxant therapy should take into account individual differences in metabolism and response to drugs.. Short term use of tocolytics has been proven more effective and safer than longer use of it for pre-term labour.

Laparotomy was once the preferred modality of treatment for various gynecological conditions. However, over the years, with the advancements worldwide, a new technique for surgery, laparoscopy, came into play. Since then, laparoscopy is preferred over laparotomy for diagnostic and therapeutic purposes since it was less invasive than laparotomy. Further advancements include laparoendoscopic single-site surgery (LESS), which is a procedure that, as the name implies, only uses one port. It includes using a single incision near the umbilicus in contrast to laparoscopy, which traditionally includes one main port incision and various other side ports. Through the port, multiple devices can be inserted into the cavity. The use of a single port can reduce post-operative complications and help reduce the duration of hospital stays. A single incision near the umbilicus would not leave a very significant scar, and the wound healing time would be comparatively less, reducing the hospital stay time. This novel technique is, therefore, an amalgamation of traditional surgery and recently surfacing minimally invasive surgery. Other modalities which are being used widely include vaginal natural orifice transluminal endoscopic surgery (vNOTES). Since the ports formed are frequently inconspicuous, these procedures leave patients with "scarless" results.

Infertility in developing countries is a distinct and complex problem that disproportionately affects women. Though not a physically restraining disease, it causes a huge social burden on the emotional, financial, and psychosocial quotients of those who suffer from it. Assisted reproductive procedures are frequently used to treat infertility. Years ago, the emergence of ovulation induction represented a significant advancement in treating female infertility. Letrozole, an aromatase inhibitor, is a potential therapy for ovulation induction. Numerous clinical conditions, including anovulatory infertility, polycystic ovarian syndrome, unexplained infertility, and early stages of endometriosis-related infertility, as well as many with improved live birth rates, have been proven to benefit from letrozole treatment. Letrozole is a superior alternative to the widely utilized ovulation induction with clomiphene citrate. While clomiphene citrate has certain limitations, letrozole successfully overcomes these limitations because of its lack of prolonged anti-estrogenic activity, short half-life, and lack of estrogen receptor activation. In most cases, this results in mono-follicular development and excellent live birth rates. According to the most recent research, letrozole can be used as the first-line therapy to treat infertility caused by polycystic ovarian syndrome and other causes. Letrozole is also emerging as a possible treatment for male infertility of unknown cause, proving to be an effective way of influencing hormonal profiles and increasing various seminal parameters such as sperm motility and concentration, as it inhibits aromatization affecting the feedback mechanism to the hypothalamus. This review focuses on our current knowledge of the uses of letrozole for female and male infertility, its mechanisms, and its benefits.

Infertility is a problem that affects both developed and developing countries today. Many couples choose to have financial stability before conception, irrespective of age. Tubal blockage accounts for 30%-40% of a woman's fertility. Congenital abnormalities, acute and persistent inflammatory diseases, endometriosis, and different pathologies are associated with infertility and cause partial or complete obstruction of the fallopian tubes. Approximately 30% of women experience infertility due to fallopian tube illness, with 10%-25% of these women experiencing proximal fallopian tube obstruction. The fallopian tube is an integral part of the union of sperm, and its normal function is a prerequisite for natural conception. Tubal obstruction is a common cause of infertility. These patients are keen to unblock their blocked fallopian tubes and restore reproductive function. Accurate diagnosis and optimal treatment options are essential for treating infertility.

Apoplexy of the Pituitary gland is rarely seen critical disorder marked by acute throbbing of head / altered mental status / visual disturbances /decreased consciousness, due to sudden haemorrhagic changes of the pituitary or infarction of the same. There are numerous factors which precipitate apoplexy of the pituitary, sepsis being one of the least common cause, as is elaborated in this case study. Inspite of having a distinctive presentation, pituitary apoplexy eludes diagnosis and proper management as it is complicated by related co-morbidities. Its occurrence in a postpartum lady is an even rarer incident. This article shows a rare occurrence of apoplexy of macroadenoma in a postpartum woman which was managed conservatively.

Background: Umbilical cord true knot is a rare condition which affects about 1% of all pregnancies. Though the incidence is lower, it often goes undetected in antenatal period despite the availability of prenatal sonography and may lead to a compromised fetal outcome as presented in this case. In this case the presence of true knot of umbilical cord was missed despite routine sonography done just 1 week prior to delivery, when patient presented to casualty with complains of decreased fetal movements since 24 hours. This modality is said to be associated with adverse fetal outcome such as birth asphyxia or in adverse cases intra uterine fetal demise. Risk factors include long cord, polyhydramnios, small sized fetus, etc. Case Summary: 27 years old gravida two, para two, with 1 live issue with k/c/o hypothyroidism with previous lesions came with complaints of decreased fetal movement since 24 hours at 36 weeks 3 days of gestational period. The patient recorded regular ANC checkups and routine investigations within normal limits. Her USG scan done at 34.2 wks showing single loop of cord around neck and normal doppler findings. On examination her vitals were normal .Her abdominal examination showed uterus of 34 wks size, longitudinal lie, cephalic presentation and irritable with mild contractions present with scar tenderness . Her FHS were present/irregular/112 bpm with less variability. On p/v examination os was admitting tip of finger, cervix soft, 25% effaced, station high up, presenting part vertex, membrane present. She was advised admission and a cardio-tocography (CTG) was done which showed recurrent deep atypical variable decelerations with decreased beat to beat variability. An emergent cesarean section was taken. Newborn was a female diagnosed with true umbilical cord knot, 2 cm away from fetal insertion with cord length of 84 cm. The baby was shifted to NICU in view of respiratory distress. Conclusion: Despite of modern day ultrasonography and Doppler studies, true umbilical cord knot still remains a lesser diagnosed entity and so every pregnant patients should be monitored carefully with a watch for daily fetal movement count (DFMC)and weekly non stress test (NST) for fetal well being.

Robot-assisted surgery is the next phase in the process of transhumanism. Presently, robotic surgery is used in various benign and malignant gynaecological procedures. Robot-assisted surgery is significantly superior to open surgeries in post-surgical hospital stays; however, the difference is less significant in the case of laparoscopic surgery. Estimated blood loss in robotic surgery may be less. Regarding postoperative time, the results have been inconsistent due to variations in surgeons' experience. The primary drawbacks of robotic systems are their high installation and maintenance costs and lack of tactile feedback. Though robotic surgery allows easy dissection and fine suturing and has a faster recovery rate, to decide whether it should become the mainstream of gynaecological procedures, more randomized controlled trials are needed.

An essential role played by cardiotocography (CTG), is promptly detecting non-reassuring foetal status during delivery, as these abnormal changes are a prime reason for women to undergo a caesarean section. But all abnormal changes in cardiotocography does not lead to poor outcome in terms of liquor that was meconium stained or a low APGAR score at birth. As a result, research is the need of the hour, to understand their correlation; hence, showing the benefit of CTG in the precise detection of non-reassuring foetal status is correlated from the intraoperative findings discovered later. This review article aimed to see if there was a link between perioperative findings and foetal consequences in women who had a caesarean section due to foetal condition, which was not reassuring according to cardiotocographic findings.

Aim To study the prevalence of anemia in antenatal care (ANC) patients and their sociodemographic factors associated with anemia. Materials and methods In this retrospective hospital-based study, data were collected from medical record section from 1st January to 31st December 2011. Patients admitted to labour room for delivery were selected as per the WHO classification of anemia. Various sociodemografic factors were also studied. Data were analyzed with the help of frequency and percentage tables. Association between variables were checked by Chisquare test. Results Out of 6,356 patients delivered, 6,300 patients were anemic. Maximum percentage of patients (93.8%) were in the category of moderate anemia. A total of 4174 patients were in age group of 21 to 25 years. It was found that 56.4% of patients are primigravida. Seventy-eight percent patients belong to rural population. Baby weight of 3,046 patients were in group of 2.1 to 2.5 kg. Conclusion It was found that out of 6356 patients delivered, 6300 were anemic. Maximum patients (93.8%) had moderate anemia, mild and severe anemia was found in 0.8 and 5.4% of patients. How to cite this article Mandve P, Nawale K, Motghare VM, Pajai S. Study of Anemia in Antenatal Care Patients: A Retrospective Study. J South Asian Feder Obst Gynae 2014; 6(3):133-138.