Thrombocytopenia, defined as a platelet count of <150,000/microliter occurs in 7–12% of pregnant women at delivery. While the most common cause of thrombocytopenia in pregnancy is benign and causes only a mild fall in platelet count, some etiologies are life-threatening. This review is a summary of some of the common causes of thrombocytopenia and outlines a systematic approach to diagnosis and management.

Introduction: Pain is an inevitable outcome of any surgery and control of postoperative pain is very important to improve patient comfort and reduce morbidity. The present study aims to compare the degree of postoperative pain relief using inj paracetamol and transdermal diclofenac patch after cesarean delivery. Materials and methods: A randomized controlled trial was done involving 200 women (100 women were involved in the transdermal diclofenac patch group and 100 women in the inj paracetamol group) to compare the efficacy of each drug as analgesia following cesarean delivery. Results: Both the statistical and clinical observations among the 200 patients showed that 100 mg diclofenac sodium administered transdermally as a patch has equal efficacy as compared with 1000 mg of paracetamol infusion given every 8 hours. Conclusion: Diclofenac patch and injection paracetamol as infusion have similar efficacy in providing postoperative pain relief for 24 hours after the cesarean delivery.

Background: The literature on indications and their evaluation in mid-trimester abortions in the South Asian population is scarce. This retrospective study aims to identify the causes behind these abortions. Materials and methods: The data of 55 women who had aborted in the labor room of a tertiary care center in Delhi between January 1, 2022 and March 3, 2023 were studied. The data included age, blood group, gestation, parity, indication, method of termination, biometry of abortus, placental weight, cord length, and complications. Results: The analysis of these 55 women showed the commonest cause of abortion as missed abortion/intrauterine fetal demise (IUFD) (ten women, 18.2%) followed by inevitable abortion (seven women, 12.7%), preterm premature rupture of membranes (PPROM in six women, 10.9%), and voluntary termination of pregnancy (five women, 9.1%). The other causes included congenital birth defects, genetic abnormalities, and severe maternal diseases. Invasive prenatal testing in a few fetuses who had congenital anomalies revealed additional genetic abnormalities. Conclusion: It highlights the need for a detailed evaluation of all pregnancies with reliable prenatal tests for aneuploidy screening, good first-trimester scan, detailed target scan for fetal anomalies at about 20 weeks, and evaluating maternal disorders properly.

Introduction: The rate of exclusive and early breastfeeding in India is only 64% (NFHS 5- National Family Health Survey) even though WHO has suggested exclusive breastfeeding for 6 months. Breastfeeding plays a crucial role in the development of a newborn, not only physically but mentally as well. Most of the would-be Mothers spend maximum time with their mother or mother-in-law who has the biggest influence on counseling these new-to-be mothers. These grandmothers know the benefits of breastfeeding, the importance of a special diet, and proper hydration for good quality milk but report inadequacies in the treatment of breast complications and the need for exclusive breastfeeding till 6 months of life. Which is why we decided to explore the knowledge, attitude, and practices about exclusive breastfeeding among these grandmothers. Material and methods: A survey was done in Dr. D. Y. Patil Hospital Pimpri, in which 270 grandmothers were interviewed out of 309 deliveries in the hospital over a period of 3 months from July to September 2022. This study was done as a part of World Breastfeeding Week activities. A questionnaire was formed to ask grandmothers about antenatal and postnatal counseling, exclusive breastfeeding, early initiation of breastfeeding, the importance of colostrum, etc. Analysis of the collected data was done using percentages and represented diagrammatically. Results: It was observed that though 70% of grandmothers knew about the early initiation of BF, only 43% of patients actually initiated breastfeeding within one hour. The importance of colostrum is known by only 66% of grandmothers but colostrum feeding was encouraged by 81% of grandmothers. Almost all grandmothers knew about 6-month period of exclusive breastfeeding and it is practiced by most of them. A very minor 19.32% of mothers are counseled antenatally about breastfeeding while 90% of mothers are counseled postnatally by grandmothers. Conclusion: Breastfed babies seem to have better immunity and development than those fed by top feeds. The awareness about this is much less than what it should be. So, it is important to raise the awareness amongst community through the most powerful resources. So, interventions to promote exclusive breastfeeding should be tailored to the needs of each population by identifying the factors that influence the practice in a given context. Grandmothers have knowledge that has been validated by their experiences and can directly affect the new, would-be mothers and their breastfeeding practices. Clinical significance: These results indicate that there is a significant gap between knowledge and practices about exclusive and early breastfeeding and more active steps should be taken to change the attitude of grandmothers so that they will more actively and positively counsel the mothers to breastfeed. It is important to raise the awareness and implications of exclusive breastfeeding. Categories: Obstetrics and gynecology, Breastfeeding, Breastfeeding awareness.

Aim and background: Several myocutaneous flap approaches have been described for repairing large vulvar defects caused by deforming radical cancer procedures in the female perineum. In general, vulvar cancer has a favorable prognosis when adequately treated with multidisciplinary treatment. Case presentation: In this case report, we describe a patient who underwent a radical vulvectomy for locally advanced squamous cell carcinoma of the vulva, and the defect was reconstructed by an anteromedial thigh flap. Conclusion: Anteromedial thigh flap offers many advantages including adequate soft tissue coverage, a shorter route for flap transfer, an unnoticeable scar, quick recovery times, and better functional outcomes. Clinical significance: Large abnormalities are now more easily repaired, and the morbidity linked to such radical procedures in advanced vulvar cancer has decreased due to the reconstruction option with an anteromedial thigh flap.

Aim and background: The incidence of stroke in pregnancy is 10–34 per 100000 deliveries. In 15% of cases, stroke is preceded by a transient ischaemic attack (TIA). Prevention of stroke, appropriate fetal monitoring, and timely delivery can lead to successful maternal and neonatal outcomes. Case description: We present a case,. where a mother was treated for TIA and the fetal Doppler was repeated every 72 hours to look for reflection of cerebral vascular events in the placental vasculature. Doppler enabled timely delivery resulting in successful maternal and neonatal outcomes. Conclusion: A 26-year-old, low-risk primigravida with 31 weeks pregnancy was referred with a history of sudden onset heaviness in her head, tingling and numbness, inability to lift left upper limb, and difficulty in speaking for 30 minutes. Magnetic resonance imaging (MRI) was suggestive of linear acute infarcts in sub-cortical white matter in the right superior frontal lobe and parietal lobe. Dopplers were repeated every 72 hours. Stoke was prevented by a therapeutic dose of Low molecular weight-heparin (LMWH) daily. Decision to deliver was guided by derangement in fetal Doppler when Cerebro placental ratio deranged to less than one, leading to a successful maternal and neonatal outcomes.

Aim and background: Twin reversed arterial perfusion (TRAP sequence) is a rare condition of monochorionic twin pregnancies in which one twin does the work of supplying blood for both twins. The twin supplying blood is known as the ‘Pump twin’, the other twin is known as the ‘Acardiac twin’ – lacks a heart or has one that is not fully formed. Incidence is 1/35,000 births and 1/100 monochorionic twin pregnancies. Case presentation: Herein, we report a case of TRAP sequence in an in-vitro fertilization (IVF) monochorionic twin pregnancy, which was successfully managed by intrauterine laser coagulation of the umbilical cord of the acardiac twin finally resulting in a live birth at 36 weeks of pregnancy. Conclusion: Twin reversed arterial perfusion sequence is a complication that is seen in monochorionic twin pregnancy, and it has a poor prognosis. Clinical significance: Early selection of proper treatment modality by making the diagnosis with ultrasonography is of great importance for a successful pregnancy outcome.

The science of Genomics is an exciting new tool that can transform our approach to pregnancy and female reproductive health. In this article we provide a comprehensive overview of the use of genomics in different clinical aspects of obstetrics and gynecology, and their usefulness in routine clinical practice.