Prevalence, instigating factors and help seeking behavior of physical domestic violence among married women of Hyderabad, Sindh

Domestic violence against women is highly prevalent but under reported issue having social, legal, health and economic implications. It needs to be identified and addressed in order to decrease the sufferings of women. Our objective was to find out prevalence, instigating factors and help seeking behavior of physical domestic violence against married women. A total of 378 married women who were attending Department of Obstetrics and Gynaecology, Liaquat University Hospital from January 1, 2013 to March 31, 2013 for different obstetrical and gynaecological problems were randomly selected and interviewed. After informed consent, required information was collected on predesigned performa including demographic details, prevalence, instigating factors, help seeking behavior for physical domestic violence. About 31%[120] of women reported lifetime physical domestic violence. Husbands and in-laws were perpetrators in 70% [84] and 30% [36] cases respectively. Wives being disobedient and making arguments were the most common instigating factors for violence followed by husband's drug addiction, extra marital relationship and infertility. It was severe enough to require medical care in 24%[29] cases. Only 2% [2] women sought social and legal aid. Domestic violence was quite common among married women, however help seeking was minimal. There is need to identify and address this menace effectively

beta-lynch suture for the management of postpartum haemorrhage: an experience at Peoples Medical College Hospital

To report our clinical experience of the effectiveness and safety of applying beta-lynch suture for the management of primary postpartum haemorrhage. An observational, cross-sectional study. This study was conducted at the Department of Obstetrics and Gynaecology at Peoples Medical College Hospital Nawabshah from 1[st] January 2009 to 30 [th] June 2010. All the patients of primary postpartum haemorrhage in whom compression and conventional ecobolic had failed to achieve uterine contraction and haemostasis were subjected to beta-lynch suture. beta-lynch suture technique was applied in 33 patients, in 22 patients after vaginal delivery and in 11 patients at the time of cesarean section. This technique was successful in 31 [93.94%] patients and failed in only 2 [6.1%]. Patients who were proceeded to hysterectomy, none of the patient had infection. beta-lynch suture compresses and envelopes the uterus and manages massive life threatening postpartum haemorrhage successfully. It is effective, simple and fertility conserving procedure

Pregnancy outcome at maternal age 40 and older

Objective: the objective of this study was to compare pregnancy outcome of women aged 40 and above with those of 20- 30 year

Study design: cross-sectional and comparative study

Setting: department of obstetricsand Gynecology Peoples University of Medical and Health Sciences Nawabshah

Duration: from 1st July 2011 to 31st Dec 2011

Material and method: consecutive 100 cases of women aged 40 and above and 100 cases of women aged between 20-30 years were included in the study, and labeled as group A and B respectively. All patients were under gone general and physical examination and routine laboratories tests. The biological effects of age on the pregnancy outcome were observed, and results were tabulated

Result: the mean age for case group was 41.56 +/- 2.06 and that for control group 25 +/- 2 years. Among the maternal complication of increased maternal age were abortion in early half and preterm labor in second half of pregnancy [10%] and [12%] respectively. Hypertension [14%] and Diabetes [9%] were more common than in younger age group. Risk of fetal malformation [11%] was also three fold more than younger group [2%]. Increased rate of c- section [6%] was seen more with advanced maternal age with high parity

Conclusion: the advanced maternal age is candidate with high risk of maternal and perinatal morbidity andmortality. Appropriate management can be formulated to ensure better maternal and fetal outcome during pregnancy

audit of primary postpartum hemorrhage

The purpose of this study is to determine the causes of PPH, its risk factors, and treatment measures adopted. This prospective study was carried out in. the Department of obstetrics and gynaecology, Peoples Medical Collage Hospital Nawabshah from January 2009 to December 2009. Treatment measures including medical, surgical and blood transfusion were evaluated. A total of 165 cases of primary PPH were managed in one year. Uterine atony was identified major cause 128 [77.5%], traumatic causes of genital tract were 37 [22.4%], socioeconomic status was poor in 110 [66%] and lower middle class in 41 [24%]. Most of the patients 86 [52.1%] were delivered by traditional birth attendant, lady health visitors 36 [21.8%] and qualified medical doctors 29 [17.5%]. Blood pressure was unrecordable in 43 [26.0%], systolic B.P was below 80 mm in 55 [33.3%], systolic B.P above 100 mm in 67 [40.6%], hemoglobin [Hb%] level were b/w 8-10 gm% in 89 [53.93%], and less than 8 gm% in 76 [46.06%]. Blood transfusion was done in all cases. Uterine massage was done in 45 [27.27%]. Minor surgical procedures were performed in 57 [34.5], manual removal of placenta in 8 [4.8%], compression suture were applied in 2 [1.2%], hysterectomy in 20 [12.12%], and repair of uterus in 5 [3%]. Out of 62 cases who developed complications, 35 [21.21%] developed anemia, acute renal failure in 10 [6.06%], and disseminated intravascular coagulation in 3 [1.81%], maternal deaths due to irreversible shock and renal failure were in 10 [6.06%]. Maternal mortality during year 2009 due to PPH was 10 [29.41%]. PPH is a preventable problem. Maternal mortality and morbidity resulting from it can be reduced by identifying the risk factors, early referral, proper assessment and treatment of the cause. Conservative procedures should be considered prior to undertaken hysterectomy, and hysterectomy should be performed as the last option