2. VBAC – Is the risk acceptable? Overall Risk of Rupture Uterus: 4.5/1000 Induction with PG: 24.5/1000 Induction without PG: 5.2/1000 PNM & Low Apgar: 11 times higher No method to measure probability of success - Lydon & Rochelle: Data on >20000 women in Washington state – N Eng J Med

4. Are all roads leading to CS? - Guest Editorial: ObGynSurv Vol56 No10 ACOG Guidelines are so stiff that many Hospitals & Practitioners have stopped offering VBAC in US Patients with prev CS present late in labour in the hope of VBAC Risk of Rupture Uterus at home has climbed

6. “It is remarkable that a newborn baby does not smile for 6 weeks, but smiles frequently in utero.” - Prof. Campbell

7. The scourge of Diabetes 177 Million suffer from Diabetes in the World (WHO) 20% are Indian Asia’s count will hit 170 million by 2025 India & China will account for 100 million - IDI (International Diabetes Institute)

9. Why Asians? Genetically prone to Insulin Resistance Syndrome “Thrifty Genes” enabled survival during famine by storing fat in the abdomen Changing Life style & Food habits

10. Pregnancy & Diabetes 5% of all Pregnant women are Diabetic First Trimester Screening picks up Early onset GDM & Unrecognized Type II DM (30%) Early onset GDM carries higher risk of Hypertension, Increased need for Insulin, Neonatal Hypoglycemia & Perinatal Death Mx same as Pregestational Type II Diabetes

11. “Nevirapine is superior to Zidovudine in preventing Vertical Transmission to Babies born to HIV+ Mothers and Breast-fed by them” -HIVNET Trial Uganda - Reported in Lancet

13. Antenatal Corticosteroids The Good: Improves Resp Function – Reduces RDS Beneficial in even PPROM Protects from Ventricular Haemorrhage Halves the risk of Ventriculomegaly & Cerebral Palsy Less need for Volume expansion & Vasopressor Improves survival & Increases IQ

14. Antenatal Corticosteroids The Bad Reduction of Brain Weight Inhibits Myelination Suppresses Cortisol Secretion Adverse development of Blood-Brain Barrier Rise in Fetal BP Predisposes to Diabetes later

15. Antenatal Corticosteroids The Unknown: Advantage of Second Dose? Role of Intra amniotic Injection? -Newnham et al: Current Opinion in ObG Jan 2003

16. Durga alias Kanupriya was in Bangalore on October 3 for the 28 th Anniversary of the World’s First IVF-ET She said, “ I often feel like Edison’s Bulb”