Difficulties in obstetric practice in a hill subdivision.

The present study includes 2249 cases of delivery over a period of 4 years. Difficulties faced, complications and their management were highlighted. Teen-age pregnancy was 14.98% while 52.33% cases were in the age group of 20-25 years. A total of 26.30% cases were booked. There were 53.66% primigravida cases, 43.88% cases from gravida II to gravida IV and 2.44% were grande multipara. Noted complications were pre-eclampsia 7.4%, eclampsia 0.4% and pulmonary tuberculosis 3.7%. All the patients were anaemic. Severe anaemia was noted in 3% cases, moderate in 21% cases and mild in 76% cases. Abortion cases both spontaneous and induced or criminal were 17.02%. While considering the total number of pregnancy cases, caesarean section was performed in 4.22%. Male babies were 51.30% whereas 48.68% were females. Majority (41.48%) of the babies weighed between 2.1 and 2.5 kg range. Fresh and macerated stillbirths were 7.4%.