CLASSIFICATION OF CAESAREAN SECTION THROUGH ROBSON CRITERIA: AN EMERGING CONCEPT TO AUDIT THE INCREASING CAESAREAN SECTION RATE IN A TERTIARY CARE RURAL TEACHING HOSPITAL

Background: The proportion of caesarean sections at the population level is a measure of the level of access to and use of this intervention. Over the last few years, governments and clinicians have expressed concern about the rise in the numbers of caesarean section births and the potential negative consequences for maternal and infant health. There is a lack of a reliable and internationally accepted classi?cation system to produce standardized data, enabling comparisons across populations and providing a tool to investigate drivers of the upward trend in caesarean section. Among the existing systems used to classify caesarean sections, the 10-group classi?cation (also known as the 'Robson classi?cation') has become widely used in many countries in recent years,thereby allowing a comparison of caesarean section rates with fewer confounding factors. In the present study, all cases delivered by cesarean section Methods: during the period of six months were recorded and classi?ed according to Robson's 10 group classi?cation system. Results: Overall, CS rate calculated for our hospital in this speci?ed period was 36.6%, There was a trend of increased percentage of cesarean section in group 5 and 8 respectively in present study. Even though the overall CS rate in the study is not Conclusions: high as compared to other Indian or International studies, it is important that efforts to reduce the overall CS rate should focus on reducing the primary CS rate. More analytical studies based on Robson's 10-group classi?cation are needed locally, to evaluate the indications of CS within each group.

Ovarian Serous Cystadenofibroma- A Rare Tumour

Ovarian cystadenofibroma is a relatively rare benign ovarian tumour that contains both epithelial and fibrous stromal components. It is usually seen during the fourth and fifth decades. This tumour has features of malignancy in ultrasound and may also macroscopically appear as malignant during surgery. Since this tumour has a rare malignant potential, it is well-advised to be aware of the possibility of a cystadenofibroma before selecting an aggressive surgical approach in young patients. Ovarian cystadenofibroma is a relatively rare benign tumour that is seen in women aged 15–65 years.[1] The routine imaging features of this tumour may mimic a malignant neoplasm, but the presence of the fibrous component often gives a specific/characteristic MRI appearance that may help differentiate it from malignant ovarian tumours.[2–5]

Monozygotic Monoamniotic Twin Pregnancy with TRAP Sequence and Acardiac Amorphous Foetus.

The ‘Twin Reversed Arterial Perfusion (TRAP)’ sequence or acardiac twinning, or chorioangiopagus parasiticus is an anomaly which is unique to the monochorionic multiple pregnancies and is a rare complication that affects around 1 in 100 monozygotic twin pregnancies and about 1 in 35,000 overall, with no recognized familial recurrence.[1] They have almost doubled over the last two decades as a result of both the increasing average maternal age and with the increased use of assisted reproductive techniques. Physiologically, there is lack of a well-formed cardiac structure in one foetus (acardiac) that acts as a parasite as it is haemodynamically dependent on the structurally normal co-twin (pump twin) through a superficial artery-to-artery placental anastomosis. Various theories that explain the pathogenesis of the anomaly attribute it to either dysmorphogenesis or presence of arterio-arterial anastomosis, with latter being the most popular.[2] In arterio-arterial anastomosis there is a reversal of blood flow from the umbilical artery of pump twin into umbilical artery of the perfused twin therefore bypassing the placenta, henceforth poorly oxygenated blood contributes to deficient development of the head, upper limbs, torso and heart while the better oxygenated blood flowing via umbilical artery through common iliac artery and aorta allows better development of the lower part of the body.[1]-[3]

The incidence detection of tuberculosis in patients with infertility and abnormal uterine bleed: a study in North Indian population

Background: Tuberculosis (TB) remains a major global health problem, responsible for ill health among millions of people each year. TB ranks as the second leading cause of death from an infectious disease worldwide, after the human immunodeficiency virus (HIV). The latest estimates included in this report are that there were 9.0 million new TB cases in 2013 and 1.5 million TB deaths (1.1 million among HIV-negative people and 0.4 million among HIV-positive people). In India the incidence of genital tuberculosis is nearly about 18%. And in female genital tract it is estimated that 18% in India suffer from genital TB.Methods: The study was carried-out during November 2014 to March 2016 at Maharishi Markandeshwar deemed to be University, MMIMSR Mullana (Ambala).  A total of 100 females of reproductive age attending the Gynaecology Outpatient were finally recruited on the basis of inclusion and exclusion criteria.Results: In our study majority i.e. 39 (39.0%) patient were found in the group of 20-29 years of age followed by 38 (38.0%) patients in the group of 30-39 years of age. Only 23 (23.0%) were found in the group of 40-49 years of age. In our study majority i.e. 54 (54.0%) patients were from Haryana followed by 44 (44.0%) patients were from Uttar Pradesh and only 2 (2.0%) patients were from Punjab. Out of 100 patients majority i.e. 76 (76.0%) patients had negative TB with either of investigation and only 24 (24.0%) patients had positive TB with either of investigation.Conclusions: Female genital tuberculosis affects the females of reproductive age group. The disease manifests itself as pelvic inflammatory disease in its acute form with menstrual irregularities and later infertility, and is almost always secondary to a primary lesion elsewhere.