Active versus conservative management of prelabour rupture of membranes at term

To compare maternal and foetal outcome of active versus conservative management of premature rupture of membranes after 37 completed weeks of pregnancy. This quasi-experimental study was carried out at Gynae unit, Lady Reading Hospital, Peshawar from September 2004 to September 2005 and included 100 patients out of which 50 were managed conservatively and 50 actively. After confirming the leakage of amniotic fluid, patients were randomized by lottery method to conservative or induced group. The patients in the group that was managed conservatively were shifted to obstetrical ward to await the onset of regular uterine activity for at least 48 hrs. After Bishops scoring, patients were induced with vaginal prostaglandin E2 tablet. Both groups received intravenous antibiotics. Total number of patients with PROM at term was 3.84%. Total cost of stay in hospital and management was greater in induced group [P. value <0.05%]. Latent time was short in induced group whereas hospital stay was prolonged in induced group. About 80% of patients in conservative group delivered by NVD as compared to 60% in induced group. Among complications mild fever and PPH were significantly [P. value <0.05] more common in conservative group. There was neither neonatal death nor stillbirth in both groups. No statistically significant difference [P. value >0.05] was observed in respect of perinatal outcome and infectious morbidity in babies. Conservative management of PROM at term should be viewed more positively for at least 48 hrs under appropriate antibiotic cover and with active management of 3[rd] stage of Labour

Clinicohistological pattern of ovarian tumours in Peshawar region

Ovarian tumours are one of the major health problems confronting the general practitioners in general and gynaecologists in particular. Ovarian tumours may either be asymptomatic, found on the routine ultrasound examination or symptoms may be vague till the patient has an acute emergency like torsion or rupture of a benign cyst. The worst is late presentation of a malignant ovarian tumour. There is marked variation in the presentation of the tumour as well as in histological types. This study was undertaken to analyse modes of presentation and various histopathological patterns of ovarian tumours. This study was conducted from 1st January, 2002 to 31[st] December, 2002, in Gynaecology 'A' Unit, Lady Reading Hospital [LRH] Peshawar. After admitting patients with ovarian tumours a detailed case history was taken followed by thorough clinical examination. All the relevant details were recorded using the questionnaire. Patients were investigated after performing various surgical procedures; the specimens of ovarian tumours were subjected to Histopathological examination in the histopathology section, Lady Reading Hospital, Peshawar. Amongst the total numbers of 5732 gynaecological admissions during study period the total numbers of ovarian tumours were sixty-eight. Out of which benign ovarian tumours were 61 [89.71%] and malignant ovarian tumours were 7 [10.29%]. There were no tumours with borderline malignancy. The commonest histological pattern observed in the study was epithelial tumours [76.5%] including both benign and malignant tumours. The commonest benign tumour was serous cyst adenoma [24%] followed by mature cystic teratoma [18%]. Common malignant ovarian tumours were granulosa cell tumours and Endometriod carcinoma [each 28.5%]. Epithelial tumours are the commonest variety of ovarian tumours followed by Germ cell tumours. The histological type of ovarian tumour correlates with the prognosis of the tumour

Frequency of benign and malignant ovarian tumours in a tertiary care hospital

To find out frequency of benign and malignant ovarian tumors in a single unit in a period of one year. This was a descriptive cross sectional hospital based study conducted in Gynae 'A' Unit, Lady Reading Hospital Peshawar from 1[st] January, 2002 till 31[st] December, 2002. Patients with ovarian tumors were admitted followed by a detailed case history and thorough clinical examination. All the relevant details were recorded on a questionnaire. Patients were investigated and after performing surgery, the specimens of ovarian tumors taken were subjected to histopathological examination in the Pathology Department, Lady Reading Hospital, Peshawar. Out of the total 5732 gynecological admissions in one year research period, the total number of patients with ovarian tumors was 71 [1.2%]. Hence the frequency of ovarian tumors was found to be 12.3/1000 for all the gynecological admissions. Out of 71 cases, 61[89.71%] were benign ovarian tumors and 7[10.29%] were malignant ovarian tumors. There were no tumors determined with borderline malignancy. In three cases the histopathology reports were not reviewed. The commonest benign tumour was follicular cysts [27.86%] followed by serous cyst adenoma [24.59%]. Common malignant ovarian tumours were granulosa cell tumours and endometriod carcinoma [each 28.5%]. Ovarian tumors constitute a significant proportion of gynecological admissions with benign tumors being more frequent than malignant ones