Frequency of Surgical Intervention Due to Cord Around the Neck

Objective: To see the frequency of cord around the neck. Study Design: Retrospective Observational Study. Place and Duration of Study: This study was carried out at Shaikh Zaid Women Hospital, CMCH, SMBBMU, Larkana from January 20 12 to December 20 13. Materials And Methods: Total patient 8250 taken from Jan 2012 to Dec 2013. All cases were studied in detail with reference to course of labour, mode of delivery, interference required and maternal and fetal outcome. A detailed history was taken and general and systemic examination was done. The muller Munro Kerr maneuver was used to assess the adequacy of the pelvis and diagonal conjugate was accurately measured. Results: Total patient taken 8250, from Jan 2012 to Dec 2013 among them vaginally delivered 4238[51.3%], 92 have applied forcep 27[0.63%] babies delivered cord around the neck with 30 patient have applied vacuum out of which 16 [0.37%] cord around the neck. Spontaneously vaginal deliveries without surgical intervention 41 16 [3 1.9%], out of which 13 12 [1 5.9%] have cord around the neck. 2360 [28.6%] patient delivered through emergency LSCS. 722[17%] babies with cord around the neck and 1560 [18.9%] patient delivered through elective LSCS among them 759 [17.9%] babies delivered with cord around the neck. Conclusions: Most of these cases delivered vaginally with minimal maternal and fetal morbidity. Frequency of surgical intervention in these cases can be reduced by proper antenatal care especially in 31d trimester, by plotting partogram and using oxytocin judiciously during intrapartum period

Eclampsia and its Association with Seasonal Variations and other External Factors

Objectives: his study was carried out to evaluated the epidemiological aspects of patients presenting with eclampsia in the Shaikh Zaid Women Hospital, Larkana. Study Design: Descriptive retrospective observational study Place and Duration of Study: This study was carried out in the Department of Obstetric and Gynaecology SZWH, CMC and SMBBMU, Larkana from Jan 2012 to Dec 2013. Materials and Methods: All the patient admitted in eclmpasia were included in the study. All the patients were managing according to basic protocol for eclampsia. The data were compiled for frequency distribution of eclmapsia according to gage, parity, socioeconomic status of the patients and seasonal variation. Pregnant patient with other convulsive disorder and more than 7 days post-partum were excluded. Results: In the duration of study of 24 months 50.8% cases of Eclampsia occur in Summer, 25% in Autumn, 12.9% in Winter and 11.2% in Spring Season. During this period of 24 months > 10977 patients were admitted in SZWH, Larkana out of them 108[0.98%]were cases of eclampsia. Conclusion: Pre eclampsia and eclampsia are major obstructed complication with unclear etiologies. Understanding the exist association with different weather patterns may help us in understanding what factors may be involved in triggering these event.

Clinical presentation and treatment outcome of ovarian tumours at gynaecology ward

Objectives: To document the clinical presentation and treatment outcome of ovarian tumours across all age groups

Study Design: Retrospective data analysis

Place and Duration: This study was conducted at Gynae Unit III, Liaquat University Hospital for two years, from 19[th] July 2003 to 20[th] July 2005

Patients and Method: Patient files of ovarian tumour cases were accessed and a predesigned proforma was used to record the data regarding demographics, history, physical examination, signs, symptoms, investigations, type of surgical treatment, histopathology, chemotherapy, radiotherapy, follow up and mortality. SPSS 10 was used to analyse the data

Result: Out of all gynaecological admissions 1.29% patients presented with ovarian tumours. Out of 55 cases of ovarian tumours 15 [27.27%] were malignant with mean +/- SD age of 45 +/- 13.72 years, and 40 [72.73%] were benign with mean +/- SD age of 30 +/- 10.2 years. The commonest tumour found was of epithelial origin. Most of the patients presented in late stage when survival is poor

Conclusion: Ovarian tumours are most common in multiparous women of 40-45 years of age. Majority of the patients present in advance stage of disease, therefore prognosis is poor and mortality is high

Role of cervical cerclage in cervical incompetence

Objective: to determine the etiological factors, clinical presentation and pregnancy outcome in women who underwent cervical cerclage for incompetent cervix

Setting: obstetrics and Gynecology Unit-II, Liaquat University Hospital, Hyderabad-Pakistan. Data records from January 2004 to December 2006 were analyzed

Study design: a retrospective study

Material methods: the case files and OPD records of the cases of cervical incompetence were studies and data were recorded on a preceded proforma regarding patient's past obstetrical history, gestational age and cervical dilatation at the time cerclage placement, complications and pregnancy outcomes

Result: among 3033 patients admitted in the hospital 55 were diagnosed to have cervical incompetence, hence incidence come out 1.81% . In 41 patients cervical cerclage was applied, the method was "McDonald purse string suture". Out of 41 patient's miscarriage, pre-term and term delivery were 2.43% , 65.85% and 39.02% respectively. Fetal survival was 82.92% . No effect was seen on mode of delivery. There were no serious maternal complications

Conclusions: past history of recurrent mid-trimester abortion or pre-term delivery when combine with ultrasonography form reliable basis for diagnosis. Cervical cerclage seems to be the effective treatment of choice in patients with cervical incompetence