Dr. Neeta Sarma - Academia.edu (original) (raw)

Papers by Dr. Neeta Sarma

Research paper thumbnail of Pregnancy outcome in pregnant women with oligohydramnios at term pregnancy

New Indian journal of OBGYN, 2018

Objective: The aim of the study was to assess the pregnancy outcome in pregnant women with oligoh... more Objective: The aim of the study was to assess the pregnancy outcome in pregnant women with oligohydramnios at term pregnancy. Materials and Methods: This is a prospective, case-control study which was conducted at Silchar Medical College and Hospital over a period of one year from July 2016 to June 2017. It included 140 pregnant women at term pregnancy with amniotic fluid index ≤ 5cm. The control group included 200 pregnant women at term pregnancy with amniotic fluid index > 5cm. The two groups were compared. Statistical analysis was done using the Fisher's exact test to calculate the P value. Results: There was a significantly higher incidence of low fetal biophysical profile, induction of labour, overall caesarean rates and caesarean due to nonreassuring fetal status, fetal distress, low birth weight babies, 5 minute Apgar score ≤ 6, neonatal intensive care unit (NICU) admission rates, hypothermia, meconium aspiration syndrome and perinatal death in the group with oligohydramnios as compared to the group with normal liquor volume. The incidence of instrumental delivery, fetal congenital anomaly, hypoglycaemia, hypoxic ischaemic encephalopathy, neonatal jaundice was higher in the oligohydramnios group but was not statistically significant. Conclusion: Oligohydramnios adversely affects the perinatal outcome. However, a favourable outcome can be expected by good antepartum and intrapartum surveillance and neonatal care.

Research paper thumbnail of Induction of Labour with Vaginal Misoprostol in Intrauterine Foetal Death

Journal of evolution of medical and dental sciences, Nov 13, 2017

BACKGROUND Intrauterine foetal death is an unfortunate event met in obstetric practice. Misoprost... more BACKGROUND Intrauterine foetal death is an unfortunate event met in obstetric practice. Misoprostol has emerged as an efficient and relatively safe drug to deliver the baby in this condition. The objective of this study is to evaluate the safety and efficacy of vaginal misoprostol tablets for the induction of labour in intrauterine foetal death. MATERIALS AND METHODS This uncontrolled clinical trial was performed on 100 women with intrauterine foetal death from January 2016 to December 2016 at Silchar Medical College and Hospital. All women were properly evaluated. Informed consent was taken and vaginal misoprostol tablets at a dose of 50 mcg 4 hourly was used to induce labour. The results were assessed. RESULTS In a study of 100 women, mean natural age was 26.21 ± 4.98 years, mean gestational age was 38.81 ± 4.26 weeks, 61% women were primigravida and the rest were multigravida; 80% were booked cases, 72% belonged to rural areas and 76% were illiterates. The mean initial Bishop's score was 2.23 ± 1.82 (range 0 to 6), while following induction with misoprostol the mean Bishop's score was 6.98 ± 2.1, the mean difference was 4.75. P value was statistically significant. The mean induction-labour onset interval was 10 ± 6.65 hours and the mean induction-delivery interval was 13.60 hours with 46.46% women delivering within 12 hours. The mean misoprostol dose required was 152.5 ± 88.5 mcg. Induction was successful in all women, but laparotomy was needed in 1 women because of uterine rupture. The side effects noted were nausea (7%), vomiting (2%), diarrhoea (4%), fever (5%), uterine hyperstimulation (4%), ruptured uterus (1%), retained placenta (3%) and atonic post-partum haemorrhage (3%). CONCLUSION Misoprostol is an effective, economic and safe drug that can be used for cervical ripening and labour induction in intrauterine foetal death. Clinical significance-the response to misoprostol is influenced by the gestational age, Bishop's score and parity of the women.

Research paper thumbnail of Association of mode of delivery with maternal and perinatal outcome in SARS CoV-2 pregnancies: a retrospective observational study

The New Indian Journal of OBGYN, 2022

Background: The novel coronavirus pandemic has affected the pregnant women and newborns worldwide... more Background: The novel coronavirus pandemic has affected the pregnant women and newborns worldwide. It has become necessary to know the effect of mode of delivery on the mother and newborn in Covid-19 pregnancies as very few literature is found regarding this. Objective: To evaluate the association of mode of delivery with maternal and perinatal outcome in SARS CoV2 pregnancies. Methodology: Total 191 pregnant women who tested Covid positive and who delivered at a tertiary care hospital were included in the study, from July to December 2020. Maternal and perinatal outcomes in vaginal and caesarean delivery groups were compared. Results: More women delivered by caesarean section (51.3%). There is increased rate of clinical deterioration of mothers after caesarean section (p=0.03). In newborns, caesarean delivery was not found to be significantly associated with low birth weight (p=0.28) or birth asphyxia (p=0.31). 6 newborns born vaginally and 4 born by caesarean section tested positive for SARS CoV-2. Covid positive status of newborns was not significantly associated with increased risk of low birth weight (p=0.26) or neonatal sepsis (p=0.18). Statistically significant association was found between severe Covid symptoms in mothers and low birth weight of babies (p<0.0001), higher proportion of NICU admissions (p=0.0004) and early neonatal death (p=0.0005). Conclusion: There is increased rate of clinical deterioration of mothers after caesarean section but there is no association with increased need of NICU admissions or Covid-19 infection in newborns.

Research paper thumbnail of Acute renal failure in the obstetric population

The New Indian Journal of OBGYN, 2021

Objectives: The objective of the study is to determine the aetiology and maternal outcome of acut... more Objectives: The objective of the study is to determine the aetiology and maternal outcome of acute renal failure in pregnancy and postpartum period. Methods: The study was conducted over a period of five years from August 2014 to July 2019. 38 previously healthy women who developed acute renal failure (ARF) during pregnancy or postpartum period were included in the study. Those with known renal disease, diabetes, chronic hypertension, history of renal calculi or urological intervention were excluded. The cases were followed up for a period of six months. Results: 38 patients with pregnancy related ARF were included. The age range was 18 to 39 years (mean 27±4.1years). 2(5.3%), 16(42.1%) and 20(52.6%) women were in the second trimester, third trimester and puerperal period respectively. The different aetiologies were preeclampsia 7(18.4%), antepartum haemorrhage 4(10.5%), postpartum haemorrhage 8(21%), puerperal sepsis 12(31.6%), intrauterine foetal death 3(7.9%), acute fatty liver of pregnancy 1(2.6%), hyperemesis gravidarum 1(2.6%) and septic abortion 2(5.3%). Maternal mortality was 5(13.2%). Of the 33(86.8%) women who survived, 17(44.7%) had complete recovery of renal function and 14(36.8%) had partial recovery. Conclusion: Pregnancy related ARF may have adverse maternal outcome. Approach to each clinical condition leading to it must be individualized and appropriate therapeutic decision is to be taken.

Research paper thumbnail of Pregnancy outcome in pregnant women with oligohydramnios at term pregnancy

The New Indian Journal of OBGYN, 2018

Objective: The aim of the study was to assess the pregnancy outcome in pregnant women with oligoh... more Objective: The aim of the study was to assess the pregnancy outcome in pregnant women with oligohydramnios at term pregnancy. Materials and Methods: This is a prospective, case-control study which was conducted at Silchar Medical College and Hospital over a period of one year from July 2016 to June 2017. It included 140 pregnant women at term pregnancy with amniotic fluid index ≤ 5cm. The control group included 200 pregnant women at term pregnancy with amniotic fluid index > 5cm. The two groups were compared. Statistical analysis was done using the Fisher's exact test to calculate the P value. Results: There was a significantly higher incidence of low fetal biophysical profile, induction of labour, overall caesarean rates and caesarean due to nonreassuring fetal status, fetal distress, low birth weight babies, 5 minute Apgar score ≤ 6, neonatal intensive care unit (NICU) admission rates, hypothermia, meconium aspiration syndrome and perinatal death in the group with oligohydramnios as compared to the group with normal liquor volume. The incidence of instrumental delivery, fetal congenital anomaly, hypoglycaemia, hypoxic ischaemic encephalopathy, neonatal jaundice was higher in the oligohydramnios group but was not statistically significant. Conclusion: Oligohydramnios adversely affects the perinatal outcome. However, a favourable outcome can be expected by good antepartum and intrapartum surveillance and neonatal care.

Research paper thumbnail of Induction of Labour with Vaginal Misoprostol in Intrauterine Foetal Death

Journal of Evolution of Medical and Dental Sciences, 2017

BACKGROUND Intrauterine foetal death is an unfortunate event met in obstetric practice. Misoprost... more BACKGROUND Intrauterine foetal death is an unfortunate event met in obstetric practice. Misoprostol has emerged as an efficient and relatively safe drug to deliver the baby in this condition. The objective of this study is to evaluate the safety and efficacy of vaginal misoprostol tablets for the induction of labour in intrauterine foetal death. MATERIALS AND METHODS This uncontrolled clinical trial was performed on 100 women with intrauterine foetal death from January 2016 to December 2016 at Silchar Medical College and Hospital. All women were properly evaluated. Informed consent was taken and vaginal misoprostol tablets at a dose of 50 mcg 4 hourly was used to induce labour. The results were assessed. RESULTS In a study of 100 women, mean natural age was 26.21 ± 4.98 years, mean gestational age was 38.81 ± 4.26 weeks, 61% women were primigravida and the rest were multigravida; 80% were booked cases, 72% belonged to rural areas and 76% were illiterates. The mean initial Bishop's score was 2.23 ± 1.82 (range 0 to 6), while following induction with misoprostol the mean Bishop's score was 6.98 ± 2.1, the mean difference was 4.75. P value was statistically significant. The mean induction-labour onset interval was 10 ± 6.65 hours and the mean induction-delivery interval was 13.60 hours with 46.46% women delivering within 12 hours. The mean misoprostol dose required was 152.5 ± 88.5 mcg. Induction was successful in all women, but laparotomy was needed in 1 women because of uterine rupture. The side effects noted were nausea (7%), vomiting (2%), diarrhoea (4%), fever (5%), uterine hyperstimulation (4%), ruptured uterus (1%), retained placenta (3%) and atonic post-partum haemorrhage (3%). CONCLUSION Misoprostol is an effective, economic and safe drug that can be used for cervical ripening and labour induction in intrauterine foetal death. Clinical significance-the response to misoprostol is influenced by the gestational age, Bishop's score and parity of the women.

Research paper thumbnail of Acute Abdomen in Pregnancy- a Descriptive Study

Journal of Evolution of Medical and Dental Sciences, 2018

BACKGROUND Acute abdomen during pregnancy is often worrisome for an obstetrician owing to the dia... more BACKGROUND Acute abdomen during pregnancy is often worrisome for an obstetrician owing to the diagnostic and management challenges. A strong index of suspicion, clinical expertise and a multidisciplinary approach can go a long way to tackle such cases. The aim of this study is to analyse the presenting clinical features and the causes of acute pain abdomen during pregnancy and the management of such cases. MATERIALS AND METHODS A descriptive study was performed on 55 pregnant women presenting with acute pain abdomen admitted in Silchar Medical College and Hospital between July 2016 and June 2018. A detailed history and a thorough clinical examination was done. Women with labour pains were excluded from the study. The necessary investigations apart from the routine antenatal tests were carried out. Ultrasonography was performed in all. MRI was done when feasible or when diagnosis was unclear. Case management was individualised, and surgical and medical team involvement was made whenever needed. Surgical intervention was taken if indicated. All women were followed up. Data was analysed with Microsoft Excel. RESULTS 41.8%, 32.7% and 25.5% of the women were of the age group of 25 to 31 years, 18 to 24 years and 32 to 38 years respectively. 49.1% were Muslims, 20% were Hindus and 14.5% were Christians. 34.5% were booked cases. 81.8% were from rural areas. 36.4% of patients each presented with pain in the second and third trimester of pregnancy. The presenting symptoms were pain (100%), diminished appetite (45.5%), nausea (32.7%), bleeding per vagina (27.3%), increased urinary frequency (18.2%), backache (18.2%), shortness of breath (7.3%), diarrhoea (3.6%) and constipation (3.6%). In 89.1% women, pain was of less than 24 hours duration. 45.5%, 40% and 14.5% came with diffuse, lower and upper abdominal pain respectively. 87.3% complained of continuous dull pain, while 10.9% had intermittent, colicky pain. Anaemia (54.5%) and hypotension (49.1%) were the common associated findings. 29 (52.7%) cases were diagnosed to have an obstetrical cause of pain which included ectopic pregnancy (27.6%), miscarriage (20.7%), molar gestation (17.2%), ruptured uterus (17.2%), abruptio placentae (10.3%) and acute polyhydramnios (6.9%). In 26 (47.3%) cases the cause of pain abdomen was non-obstetrical which included acute appendicitis (19.2%), acute cholecystitis (15.4%), ureteric colic (15.4%), acute urinary tract infection (11.5%), acute pancreatitis (7.7%), intestinal obstruction (7.7%), acute peptic ulcer (7.7%), torsion of ovarian tumour (7.7%), blunt trauma with splenic rupture (3.8%) and red degeneration of uterine fibroid (3.8%). 82.8% of the women with obstetrical cause required surgical management. Amongst the 26 cases with non-obstetrical origin of pain, 8 (30.8%) underwent surgery-laparotomy (5) and laparoscopy (3). Significantly, higher number of surgeries were carried out in the second trimester (p < 0.05). The complications among women with non-obstetrical abdominal pain were-wound infection and preterm labour, amongst those treated surgically; preterm labour and intrauterine foetal death, amongst those managed conservatively. CONCLUSION Acute abdomen in pregnancy poses a diagnostic and therapeutic dilemma to the obstetrician. Prompt diagnosis and management is critical in such situations.

Research paper thumbnail of Pregnancy outcome in pregnant women with oligohydramnios at term pregnancy

New Indian journal of OBGYN, 2018

Objective: The aim of the study was to assess the pregnancy outcome in pregnant women with oligoh... more Objective: The aim of the study was to assess the pregnancy outcome in pregnant women with oligohydramnios at term pregnancy. Materials and Methods: This is a prospective, case-control study which was conducted at Silchar Medical College and Hospital over a period of one year from July 2016 to June 2017. It included 140 pregnant women at term pregnancy with amniotic fluid index ≤ 5cm. The control group included 200 pregnant women at term pregnancy with amniotic fluid index > 5cm. The two groups were compared. Statistical analysis was done using the Fisher's exact test to calculate the P value. Results: There was a significantly higher incidence of low fetal biophysical profile, induction of labour, overall caesarean rates and caesarean due to nonreassuring fetal status, fetal distress, low birth weight babies, 5 minute Apgar score ≤ 6, neonatal intensive care unit (NICU) admission rates, hypothermia, meconium aspiration syndrome and perinatal death in the group with oligohydramnios as compared to the group with normal liquor volume. The incidence of instrumental delivery, fetal congenital anomaly, hypoglycaemia, hypoxic ischaemic encephalopathy, neonatal jaundice was higher in the oligohydramnios group but was not statistically significant. Conclusion: Oligohydramnios adversely affects the perinatal outcome. However, a favourable outcome can be expected by good antepartum and intrapartum surveillance and neonatal care.

Research paper thumbnail of Induction of Labour with Vaginal Misoprostol in Intrauterine Foetal Death

Journal of evolution of medical and dental sciences, Nov 13, 2017

BACKGROUND Intrauterine foetal death is an unfortunate event met in obstetric practice. Misoprost... more BACKGROUND Intrauterine foetal death is an unfortunate event met in obstetric practice. Misoprostol has emerged as an efficient and relatively safe drug to deliver the baby in this condition. The objective of this study is to evaluate the safety and efficacy of vaginal misoprostol tablets for the induction of labour in intrauterine foetal death. MATERIALS AND METHODS This uncontrolled clinical trial was performed on 100 women with intrauterine foetal death from January 2016 to December 2016 at Silchar Medical College and Hospital. All women were properly evaluated. Informed consent was taken and vaginal misoprostol tablets at a dose of 50 mcg 4 hourly was used to induce labour. The results were assessed. RESULTS In a study of 100 women, mean natural age was 26.21 ± 4.98 years, mean gestational age was 38.81 ± 4.26 weeks, 61% women were primigravida and the rest were multigravida; 80% were booked cases, 72% belonged to rural areas and 76% were illiterates. The mean initial Bishop's score was 2.23 ± 1.82 (range 0 to 6), while following induction with misoprostol the mean Bishop's score was 6.98 ± 2.1, the mean difference was 4.75. P value was statistically significant. The mean induction-labour onset interval was 10 ± 6.65 hours and the mean induction-delivery interval was 13.60 hours with 46.46% women delivering within 12 hours. The mean misoprostol dose required was 152.5 ± 88.5 mcg. Induction was successful in all women, but laparotomy was needed in 1 women because of uterine rupture. The side effects noted were nausea (7%), vomiting (2%), diarrhoea (4%), fever (5%), uterine hyperstimulation (4%), ruptured uterus (1%), retained placenta (3%) and atonic post-partum haemorrhage (3%). CONCLUSION Misoprostol is an effective, economic and safe drug that can be used for cervical ripening and labour induction in intrauterine foetal death. Clinical significance-the response to misoprostol is influenced by the gestational age, Bishop's score and parity of the women.

Research paper thumbnail of Association of mode of delivery with maternal and perinatal outcome in SARS CoV-2 pregnancies: a retrospective observational study

The New Indian Journal of OBGYN, 2022

Background: The novel coronavirus pandemic has affected the pregnant women and newborns worldwide... more Background: The novel coronavirus pandemic has affected the pregnant women and newborns worldwide. It has become necessary to know the effect of mode of delivery on the mother and newborn in Covid-19 pregnancies as very few literature is found regarding this. Objective: To evaluate the association of mode of delivery with maternal and perinatal outcome in SARS CoV2 pregnancies. Methodology: Total 191 pregnant women who tested Covid positive and who delivered at a tertiary care hospital were included in the study, from July to December 2020. Maternal and perinatal outcomes in vaginal and caesarean delivery groups were compared. Results: More women delivered by caesarean section (51.3%). There is increased rate of clinical deterioration of mothers after caesarean section (p=0.03). In newborns, caesarean delivery was not found to be significantly associated with low birth weight (p=0.28) or birth asphyxia (p=0.31). 6 newborns born vaginally and 4 born by caesarean section tested positive for SARS CoV-2. Covid positive status of newborns was not significantly associated with increased risk of low birth weight (p=0.26) or neonatal sepsis (p=0.18). Statistically significant association was found between severe Covid symptoms in mothers and low birth weight of babies (p<0.0001), higher proportion of NICU admissions (p=0.0004) and early neonatal death (p=0.0005). Conclusion: There is increased rate of clinical deterioration of mothers after caesarean section but there is no association with increased need of NICU admissions or Covid-19 infection in newborns.

Research paper thumbnail of Acute renal failure in the obstetric population

The New Indian Journal of OBGYN, 2021

Objectives: The objective of the study is to determine the aetiology and maternal outcome of acut... more Objectives: The objective of the study is to determine the aetiology and maternal outcome of acute renal failure in pregnancy and postpartum period. Methods: The study was conducted over a period of five years from August 2014 to July 2019. 38 previously healthy women who developed acute renal failure (ARF) during pregnancy or postpartum period were included in the study. Those with known renal disease, diabetes, chronic hypertension, history of renal calculi or urological intervention were excluded. The cases were followed up for a period of six months. Results: 38 patients with pregnancy related ARF were included. The age range was 18 to 39 years (mean 27±4.1years). 2(5.3%), 16(42.1%) and 20(52.6%) women were in the second trimester, third trimester and puerperal period respectively. The different aetiologies were preeclampsia 7(18.4%), antepartum haemorrhage 4(10.5%), postpartum haemorrhage 8(21%), puerperal sepsis 12(31.6%), intrauterine foetal death 3(7.9%), acute fatty liver of pregnancy 1(2.6%), hyperemesis gravidarum 1(2.6%) and septic abortion 2(5.3%). Maternal mortality was 5(13.2%). Of the 33(86.8%) women who survived, 17(44.7%) had complete recovery of renal function and 14(36.8%) had partial recovery. Conclusion: Pregnancy related ARF may have adverse maternal outcome. Approach to each clinical condition leading to it must be individualized and appropriate therapeutic decision is to be taken.

Research paper thumbnail of Pregnancy outcome in pregnant women with oligohydramnios at term pregnancy

The New Indian Journal of OBGYN, 2018

Objective: The aim of the study was to assess the pregnancy outcome in pregnant women with oligoh... more Objective: The aim of the study was to assess the pregnancy outcome in pregnant women with oligohydramnios at term pregnancy. Materials and Methods: This is a prospective, case-control study which was conducted at Silchar Medical College and Hospital over a period of one year from July 2016 to June 2017. It included 140 pregnant women at term pregnancy with amniotic fluid index ≤ 5cm. The control group included 200 pregnant women at term pregnancy with amniotic fluid index > 5cm. The two groups were compared. Statistical analysis was done using the Fisher's exact test to calculate the P value. Results: There was a significantly higher incidence of low fetal biophysical profile, induction of labour, overall caesarean rates and caesarean due to nonreassuring fetal status, fetal distress, low birth weight babies, 5 minute Apgar score ≤ 6, neonatal intensive care unit (NICU) admission rates, hypothermia, meconium aspiration syndrome and perinatal death in the group with oligohydramnios as compared to the group with normal liquor volume. The incidence of instrumental delivery, fetal congenital anomaly, hypoglycaemia, hypoxic ischaemic encephalopathy, neonatal jaundice was higher in the oligohydramnios group but was not statistically significant. Conclusion: Oligohydramnios adversely affects the perinatal outcome. However, a favourable outcome can be expected by good antepartum and intrapartum surveillance and neonatal care.

Research paper thumbnail of Induction of Labour with Vaginal Misoprostol in Intrauterine Foetal Death

Journal of Evolution of Medical and Dental Sciences, 2017

BACKGROUND Intrauterine foetal death is an unfortunate event met in obstetric practice. Misoprost... more BACKGROUND Intrauterine foetal death is an unfortunate event met in obstetric practice. Misoprostol has emerged as an efficient and relatively safe drug to deliver the baby in this condition. The objective of this study is to evaluate the safety and efficacy of vaginal misoprostol tablets for the induction of labour in intrauterine foetal death. MATERIALS AND METHODS This uncontrolled clinical trial was performed on 100 women with intrauterine foetal death from January 2016 to December 2016 at Silchar Medical College and Hospital. All women were properly evaluated. Informed consent was taken and vaginal misoprostol tablets at a dose of 50 mcg 4 hourly was used to induce labour. The results were assessed. RESULTS In a study of 100 women, mean natural age was 26.21 ± 4.98 years, mean gestational age was 38.81 ± 4.26 weeks, 61% women were primigravida and the rest were multigravida; 80% were booked cases, 72% belonged to rural areas and 76% were illiterates. The mean initial Bishop's score was 2.23 ± 1.82 (range 0 to 6), while following induction with misoprostol the mean Bishop's score was 6.98 ± 2.1, the mean difference was 4.75. P value was statistically significant. The mean induction-labour onset interval was 10 ± 6.65 hours and the mean induction-delivery interval was 13.60 hours with 46.46% women delivering within 12 hours. The mean misoprostol dose required was 152.5 ± 88.5 mcg. Induction was successful in all women, but laparotomy was needed in 1 women because of uterine rupture. The side effects noted were nausea (7%), vomiting (2%), diarrhoea (4%), fever (5%), uterine hyperstimulation (4%), ruptured uterus (1%), retained placenta (3%) and atonic post-partum haemorrhage (3%). CONCLUSION Misoprostol is an effective, economic and safe drug that can be used for cervical ripening and labour induction in intrauterine foetal death. Clinical significance-the response to misoprostol is influenced by the gestational age, Bishop's score and parity of the women.

Research paper thumbnail of Acute Abdomen in Pregnancy- a Descriptive Study

Journal of Evolution of Medical and Dental Sciences, 2018

BACKGROUND Acute abdomen during pregnancy is often worrisome for an obstetrician owing to the dia... more BACKGROUND Acute abdomen during pregnancy is often worrisome for an obstetrician owing to the diagnostic and management challenges. A strong index of suspicion, clinical expertise and a multidisciplinary approach can go a long way to tackle such cases. The aim of this study is to analyse the presenting clinical features and the causes of acute pain abdomen during pregnancy and the management of such cases. MATERIALS AND METHODS A descriptive study was performed on 55 pregnant women presenting with acute pain abdomen admitted in Silchar Medical College and Hospital between July 2016 and June 2018. A detailed history and a thorough clinical examination was done. Women with labour pains were excluded from the study. The necessary investigations apart from the routine antenatal tests were carried out. Ultrasonography was performed in all. MRI was done when feasible or when diagnosis was unclear. Case management was individualised, and surgical and medical team involvement was made whenever needed. Surgical intervention was taken if indicated. All women were followed up. Data was analysed with Microsoft Excel. RESULTS 41.8%, 32.7% and 25.5% of the women were of the age group of 25 to 31 years, 18 to 24 years and 32 to 38 years respectively. 49.1% were Muslims, 20% were Hindus and 14.5% were Christians. 34.5% were booked cases. 81.8% were from rural areas. 36.4% of patients each presented with pain in the second and third trimester of pregnancy. The presenting symptoms were pain (100%), diminished appetite (45.5%), nausea (32.7%), bleeding per vagina (27.3%), increased urinary frequency (18.2%), backache (18.2%), shortness of breath (7.3%), diarrhoea (3.6%) and constipation (3.6%). In 89.1% women, pain was of less than 24 hours duration. 45.5%, 40% and 14.5% came with diffuse, lower and upper abdominal pain respectively. 87.3% complained of continuous dull pain, while 10.9% had intermittent, colicky pain. Anaemia (54.5%) and hypotension (49.1%) were the common associated findings. 29 (52.7%) cases were diagnosed to have an obstetrical cause of pain which included ectopic pregnancy (27.6%), miscarriage (20.7%), molar gestation (17.2%), ruptured uterus (17.2%), abruptio placentae (10.3%) and acute polyhydramnios (6.9%). In 26 (47.3%) cases the cause of pain abdomen was non-obstetrical which included acute appendicitis (19.2%), acute cholecystitis (15.4%), ureteric colic (15.4%), acute urinary tract infection (11.5%), acute pancreatitis (7.7%), intestinal obstruction (7.7%), acute peptic ulcer (7.7%), torsion of ovarian tumour (7.7%), blunt trauma with splenic rupture (3.8%) and red degeneration of uterine fibroid (3.8%). 82.8% of the women with obstetrical cause required surgical management. Amongst the 26 cases with non-obstetrical origin of pain, 8 (30.8%) underwent surgery-laparotomy (5) and laparoscopy (3). Significantly, higher number of surgeries were carried out in the second trimester (p < 0.05). The complications among women with non-obstetrical abdominal pain were-wound infection and preterm labour, amongst those treated surgically; preterm labour and intrauterine foetal death, amongst those managed conservatively. CONCLUSION Acute abdomen in pregnancy poses a diagnostic and therapeutic dilemma to the obstetrician. Prompt diagnosis and management is critical in such situations.