Objectives: The present study was to evaluate the various risk factors and intraoperative complication in lower segment caesarean section at tertiary care centre. Methods: A detail assessment such as age, parity, detailed obstetric history, course of present pregnancy, indication of previous caesarean, antenatal, intra and post-operative complications in previous pregnancy, any history of surgical procedure like D and C, findings of physical and obstetric examination, investigations (ultrasonography especially for placental localization) were taken. Surgical findings, additional procedures, complications were noted. Results: Mean maternal age of primary CS and repeat CS was highly statistically significant differenced (p=0.003). Gestational age (p=0.846), time taken for surgery (0.32) and approximate blood loss (p=0.226) between primary CS and repeat CS women was not statistically significant. Placenta previa 2 (25%), obstructed labour 2 (25%) and second stage arrest 2 (25%) were the most common indication of primary caesarean section. Scar tenderness 13 (32.5%), placenta previa 8 (20%), fetal distress 7 (17.5%), CPD 5(12.5%), and malpresentation 4(10%) were the most common indication of repeat caesarean section. Out of total 48 cases of CS, adhesion 28(58.33%), extension of uterine incision 17(35.42%), advance bladder 9(18.75%), excess blood loss 12(25%) and uterine dehiscence 6(12.5%) were the most common intraoperative complications. Conclusions: Intra operative complication was greater in repeat CS as compared to primary CS. Adhesion, extension of uterine incision, advance bladder and excess blood loss were the most common intra operative complication in repeat CS. Therefore, A repeat cesarean section should be elective and well planned beforehand wherever necessary to reduce the incidence of intraoperative and postoperative complications. We should also encourage vaginal birth and try to reduce in number of unnecessary primary caesarean sections.

Methodology: A retrospective observational study conducted in the Department of General Surgery, Government Siddhartha Medical College and Government General Hospital, Vijayawada, started on September 2025 after getting the Institutional Ethics Committee Approval. (IECSMCGGH/2025/AP/210) and data was collected from the old records of 2 years. Data on clinical findings, FNAC results, operative diagnosis, and final histopathological examination (HPE) were reviewed. Diagnostic accuracy parameters—sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy—were calculated using HPE as the gold standard. Statistical significance was assessed using the chi-square test (p < 0.05). Results: Of 120 patients, 102 (85%) were female and 18 (15%) male, with a mean age of 38.6 ± 11.4 years. FNAC diagnosed 70 (58.3%) as benign, 25 (20.8%) as suspicious (follicular/Hürthle), 15 (12.5%) as malignant, and 10 (8.4%) as inadequate. Histopathology confirmed 72 benign (60%) and 18 malignant (15%) cases, with 30 showing non-neoplastic pathology. Correlation between FNAC and HPE was 89.1%. Sensitivity was 83.3%, specificity 94.7%, PPV 83.3%, NPV 94.7%, and overall diagnostic accuracy 91.6%. Discordance (10.9%) was mainly seen in follicular and Hürthle lesions. Conclusion: FNAC remains a simple, safe, and cost-effective preliminary diagnostic tool for thyroid nodules, with high specificity and accuracy. Nevertheless, histopathology remains the definitive diagnostic modality, particularly in indeterminate and follicular patterned lesions. Multidisciplinary correlation enhances diagnostic yield and prevents under or over treatment.