Maternal and neonatal outcome after elective induction at 41 weeks of pregnancy

Induction of labour is a well known procedure which is carried out in post date pregnancies, to reduce the maternal and neonatal risks associated with it. To find out the effects of elective labour induction in women at 47[+6] weeks of gestation in terms of neonatal and maternal outcome. This quasi-experimental study was conducted in Gynaecology and obstetrics department of Khyber Teaching Hospital Peshawar, which is a tertiary care hospital. A total of 50 patients with singleton pregnancy who had completed 41[+6] weeks of gestation, were included in this study. However the patients with risk factors like medical disorders [diabetes, hypertension, asthma, liver disease etc], liquor abnormalities, [oligohydramnios, polyhydramnios], twin pregnancy and with previous caesarean sections were excluded from the study. A proforma was designed to collect the descriptive as well as fetal and maternal out come. Descriptive data included age of the mother, gravidity, parity, gestational amenorrhea and bishop score. Data regarding maternal outcome included mode of delivery and postpartum haemorrhage. Data regarding fetal outcome included weight of the baby, meconium aspiration and NICU admission. Elective induction of labour was done in 50 patients at 41[+6] weeks of gestation. Mean age of patients was found to be 28 years +/- 4.59 SD. Regarding parity 23 [46%] of the patients were primigravida, 25 [50%] patients had parity between 2-5 and two patients [4%] had parity >5. Mean of Bishop score was 5.40 +/- 0.881 SD. Regarding mode of delivery 45 [90%] patients delivered vaginally and 5 [10%] delivered through emergency caesarean section. Post partum haemorrhage was observed in 3 [6%] patients. neonatal; outcome was analysed. Average weight of the baby was found to be 2.6 kg, 14% [7] had meconium aspiration; 12% [6] needed admission in NICU. Elective induction at 41 weeks of gestation is safe, Many of the maternal complications [shoulder dystocia, elective LSCS] and neonatal complications, increased rate, MAS, fetal distress during labour and neonatal morbidity] associated with prolong pregnancy can be avoided.

Minilaparotomy and ovarian diathermy drilling for clomiphene resistant poly cystic ovarian disease

This study was carried out to determine the effectiveness and safety of minilaparotomy and ovarian drilling for sub fertile women with clomiphene resistant polycystic ovarian syndrome. During a 2 year period [August 2000 to August 2002] 16 patients with polycystic ovarian disease were managed by minilaparotomy and ovarian drilling by diathermy. All the patients underwent full infertility workup and then treated with cyclical clomiphene citrate for 6 months. Six patients [37.5%] presented in age group 15'25 years. Eight patients [50.0%] were in age group 26'35 years. Only 2 [12.5%] patients presented in age group 36'44 years. Eleven [68.75%] patients had primary infertility. Five [31.25%] patients presented with secondary infertility. After treatment and 6 months follow up, ovulation occurred in 14 [87.5%] patients. Eleven [68.75%] women conceived pregnancy. Ovarian drilling is a powerful tool in the treatment of polycystic ovarian disease

study of thyroid activity in normal and molar pregnancy

Serum thyroxine [T4], triiodothyronine [T3] and thyrotropin [TSH] were detennined in 5 normal pregnant women without any accompanying disease and 15 pregnant women with hydatidifom mole. All the parameters within normal range in normal pregnant women. Serum T3 was raised in only four patients [27%] with molar pregnancy whereas it was within normal range in the remaining 11 patients. Serum T 4 was raised in the majority of patients. [60%]. Serum TSH was within normal range in 10 patients [66%] and was below 4 normal in only 5 patients [33.33 results revealed that thyroid activity is not increased in all the patients with molar pregnancy as to compared normal pregnant women. Factors responsible for increased thyroid activity are still controversial and they tray be rat TSH i.e HCG or HCG like substances, oestrogen etc. secreted by trophoblastic tissue