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Introduction: The placenta with the umbilical cord is a vital link between the mother and fetus. Umbilical cord supplies water, nutrients and oxygen from the mother to the fetus. The most unique character of the umbilical cord is its coiling, where the contents of the cord course in a coiled helical fashion. The umbilical coiling index(UCI) can be measured antenatally using ultrasonography. In the present study we have attempted to assess the UCI antenatally by ultrasound screening and correlate abnormal antenatal UCI with the adverse maternal and neonatal outcome of pregnancy. Aims: To study umbilical coiling index ultrasonographically and to correlate it with pregnancy outcome. Methodology: 150 antenatal cases in the second trimester of pregnancy between 22 and 28weeks of gestation attending the outpatient department were included for the study in a continuous manner and subjected to antenatal UCI measurement. The cases were followed up till delivery and various factors were noted. Results: We confirmed that maternal medical comorbidities ( gestational hypertension and anemia) have a significant correlation with abnormal umbilical cord coiling index, either hyper-coiling or hypo-coiling or both.Some studies have shown a particular adverse effect being manifested in both hypo and hypercoiling. In the present study significant correlation of abnormal coiling has been found with only anaemia and hypertension in pregnancy. The question, therefore, arises:“Does abnormal UCI have any significant role in prediction of adverse outcome in pregnancy or is it just a random association?” This study does not reflect any significant role of abnormal UCI in the prediction of adverse perinatal outcome. Hence efforts to monitor UCI in the antenatal period may not have any justification in the present scenario. The latest edition of William’s Obstetrics also makes a similar comment. A population based larger study to generate cut offs for hypo and hyper coiling and finding any association between abnormal coiling and perinatal outcome may throw more light on the utility of UCI as a predictor of adverse outcome in pregnancy.

Background: Episiotomy, a surgically planned incision on the perineum and the posterior vaginal wall during the second stage of labor is one of the most performed surgical procedures in the world, especially for nulliparous women. Episiotomy itself is comparable to a 2nd degree perineal injury. The concept of restrictive episiotomy came where its use is restricted to only high-risk cases such as shoulder dystocia, short rigid perineum, face to pubis delivery, vaginal breech delivery, and instrumental deliveries. We decided to carry out a study to evaluate this common obstetric procedure and try to decipher its role in the present day obstetric practice. Methodology: This was a prospective cohort study on 200 women admitted to the labor room and satisfying the inclusion/exclusion criteria. The cases were then divided into two groups of 100 each by simple randomization by chit method. The participants of one group (Group A) were not given episiotomy unless it was inescapable and was considered as the study group and in the other group (Group B) episiotomy was given to all the patients and was considered as the control group. Results: The overall rate of episiotomy in the control group was 100% as per study protocol and that in study group 27%. The restricted use of episiotomy resulted in a significant reduction in overall episiotomy rate. Conclusion: This study was conducted to evaluate the practice of restrictive episiotomy and compare it with routine episiotomy. We found that the net outcome of restrictive episiotomy was better than routine episiotomy and this was statistically significant with respect to parturition-related perineal trauma, postpartum pain, and maternal satisfaction of the entire birthing process.