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Ectopic pregnancy is a life threatening condition. It is important to diagnose it early to prevent complications. This study aims to understand the risk factors, common age of presentation, signs, symptoms and management. This study was conducted for years in sir T hospital Bhavnagar. Aim: to determine the incidence, clinical features, risk factors and morbidity and mortality associated with ectopic pregnancy in a tertiary care hospital.

Introduction: There has been an increase in rate of caesarean section over past five decades. This is matter of public health concern as it increases the caesarean section related maternal morbidity and mortality. Asadvised by WHO guidelines and US health initiative C-section rate should not beyond 15%. According to NHFS-4 C-section rate in India 17.2%. The aim of present study aimed to assess the rate of CS and perform and analysis based on Robson classification system. Methods: In present study all the cases delivered by caesarean section during period of six months were recorded. Data were collected from medical records of women who delivered from October to march 2021.They were classified according to Robsons’10 group classification system. This was an attempt to see which relevant group contributed most to the c- section rates. Results: There was a trend of increased percentage of caesarean section in group5 patients in present study. Poor tolerance to pain and increased rate of previous c section contributes to this. Conclusion: We should make use of vaginal delivery after caesarean section but not at the cost of maternal and fetal health. These target groups require more in depth analysis to identify modifiable risk factors and apply specific intervention to reduce cs rates. Keywords: Indications, Caesarean, Robsons criteria.

In India the perinatal and maternal outcome in eclampsia cases is still poor due to inadequate antenatal care in rural areas, financial restraints and non-availability of transportation facilities, and social taboos causing delay in management resulting in poor maternal and neonatal outcome. Aim of the study was to evaluate fetomaternal outcome in patients with eclampsia. This retrospective study was conducted over a period of 2 years from May 2018 to April 2020 at department of obstetrics and gynaecology of Government medical college and Sir T General hospital, Bhavnagar , Gujarat , India. During the review period total 50 cases of eclampsia reported.Incidence in our study is 0.43%.Results showed 86 % of eclampsia patients were of age less than 25 years. 82% of patients had antepartum eclampsia , 14 % had postpartum eclampsia and 4% had intrapartum eclampsia . 90% patients had 1 episodes of convulsion. 8% patients had 2 episodes of convulsions.2% pateint had 5 episode of convulsion. Out of 50 patients 36 patients were delivered by C-section and 14 patients by vaginal delivery.1 patient had twin pregnancy.Out of 51 newborn, 5 were stillbirth and 1 early neonatal death.Maternal mortility was 2 % .Eclampsia is still one of the important and common obstetric emergencies, which has a significant role in maternal and perinatal outcome. Regular Antenatal Care (ANC), proper health education, improvements of socioeconomic conditions and spreading of awareness in the community has major roles in prevention of eclampsia. Timely and appropriate intervention including primary management, early referral and judicious termination of pregnancy help in reducing morbidity and mortality of both mother and fetus. Keywords: Eclampsia, Fetomaternal outcome.

Background: Pregnancies in grand multipara have been considered risky for many decades as there are higher chances of complications during pregnancy, labour and puerperium in these women. This study aims to find out various maternal and fetal complications associated with grand multiparty during pregnancy and labour. Methods: A descriptive observational study was conducted in the department of obstetrics and gynaecology of Sir T General hospital and Government medical college and hospital, Bhavnagar, Gujarat, from May 2019 till April 2020. It includes 185 cases of grand multipara women. All the women who delivered had four or more previous viable pregnancies were included in the study. Results: In the total 185 cases that were included in the study, the common medical illnesses found in grand multipara were anemia (25.40%), preeclampsia/ eclampsia (4.86%) and gestational diabetics mellitus (1.86%). Other complications observed were malpresentations (2.70). Caesarian section was required in 16.21% of the cases. In perinatal outcomes, 9.72% births were still birth. 34.59% babies were of low birth weight. Conclusion: Grand multiparity remains a risk in pregnancy and is associated with an increased prevalence of maternal and neonatal complications but it might be unjustifiable to attribute all risk to parity alone, risk assessment should be based on age, past obstetric and medical history. Keywords: Grand Multipara, Maternal outcome, fetal outcome

Background: The present study was done to determine the relative contribution of each of ten groups of robson´s classification to overall cesarean section rate and identify modifiable group for intervention to reduce the cesarean rate.Methods: Retrospective review of record of cesarean section from the statistical Dept of Obstetrics and Gynecology sir T. hospital, Bhavnagar from January 2017 to October 2017 and classify them in to Robson´s ten group classification system to find out total number of cesarean among total number of delivery in above 10 months duration.Results: Total number of delivery in my study institute in 10 months was 3804 out of them 1182 was cesarean section, so the overall cesarean section rate in Sir T. hospital, Bhavnagar was 31%. Group 1 (Nulliparous, single cephalic, >37 weeks in spontaneous labor), 2 (Nulliparous, single cephalic, >37 weeks, induced or CS before labor) and 5 (Previous CS, single cephalic, >37 weeks) contributes for around 66% of total cesarean. Group 5 (Previous CS, single cephalic, >37 weeks) was the major contributor among all. Least common cause of cesarean was group 8 (All multiple pregnancies (including previous CS)) and group 9 (All abnormal lies including previous CS).Conclusions: Incidence of cesarean was more common with patient having previous cesarean section. So, to decrease cesarean rate trial of labour should be given to the patient who was suitable for vaginal birth after cesarean section. Adequate assessment of pelvis and giving trial to patient having borderline pelvis also decrease the rate of cesarean in primi gravid (group 1).