Screening for postpartum depression in ; recently delivered mothers

To identify the risk factors for postpartum depression and compare the rate and severity in abdominal versus vaginally delivered women at Fatima Hospital at Baqai Medical University using Edinburgh Postnatal Depression Sale [EPDS]. It was a cross sectional comparative study conducted from 1[st] December 2007 to 28[th] February 2009. At Fatima Hospital total 393 women were interviewed using translated questionnaire of EPDS at 6-8 weeks postnatal, when they came for their post-delivery checkup in OPD. Women of all parities and age groups, who consented for the interview, were included in the study. Women who delivered stillborn, malformed and preterm babies were excluded. Additionally, women with complicated deliveries e.g. instrumental deliveries, extended episiotomies and with PPH were also excluded. Women were studied in two groups. Group-1 consisted of 195[47.3%] vaginally delivered women and group-2 consisted of 198[50.4%] abdominally delivered women. For convenience of patients EPDS was translated into Urdu. Statistical analysis was done by using SPSS version 15. Score of >12 out of 30-point scale was used to diagnose postpartum depression while score of >15 indicated severe postpartum depression. According to this criteria, over all 15% of women had confirmed PPD; while 22/195 [11.3%] vaginally delivered women and 35/198[17.8%] women delivered by caesarean section were found to have PPD. Risk of postpartum depression was higher in the women delivered by caesarean section compared to vaginally delivered women [p-value of 0.004]. Both groups had the same chance of severity of symptoms. By using EPDS criteria our study identified that 15% of delivered women at Fatima Hospital at Baqai Medical University had sign and symptoms of postpartum depression. Risk of post partum depression increased with traumatic birth experience, while the risk of severe postpartum depression was independent of mode of delivery

Conflicts of women health in teenage pregnancy

Early marriage and subsequent pregnancy is desired in Pakistan and is generally considered a blessing but it also carries some risks to the mother and resultant product. To determine the frequency of teenage pregnancy and complications it imposes on teenage mother when compared with non teenage mothers. It is a descriptive comparative study. A review of hospital record from 1st January 2008 to 31st December 2008 was carried out to compare the obstetric complications in 212 teenage pregnant mothers with that of 4052 non teenage mothers [Mothers =20 years of age] Prevalence of teenage pregnancy was 4.97% of the total pregnancies occurring at Sobhraj Maternity Hospital during the study period. 73.11% of all teenage mothers were primigravida and 48. 58% followed the proper antenatal care. Teenage pregnant mothers had significantly increased incidence of anemia, preterm labor, pregnancy induced hypertension, pre-eclampsia and decreased incidence of glucose tolerance as compared to non teenage mothers. Risks of ante partum hemorrhage [APH], post partum hemorrhage [PPH] and placenta previa were found similar in the two groups. The results indicated that the risks of complications of pregnancy like anemia, preterm labor, pregnancy induced hypertension and pre eclampsia were more in teenage pregnant mothers. This requires increased need of Pakistani communities to review and consider the correct age marriage, so that the health of pregnant mothers can be protected. A healthy mother is necessary to bring up a healthy child

Role of combined diagnostic laparoscopy and simultaneous diagnostic hysteroscopy for evaluation of female subfertility factors

To find out the role of combined diagnostic laparoscopy and simultaneous diagnostic hysteroscopy in evaluation of female infertility. Descriptive Study. Star General Hospital from January 2009 to December 2009. Patients were selected from infertility clinic for female factor evaluation by diagnostic laparoscopy and simultaneous diagnostic hysteroscopy. Due studies as well as observation of pelvic and intrauterine cavity was done under general anaesthesia during laparoscopy and hysteroscopy. A total of 62 women underwent combined diagnostic laparoscopy and simultaneous diagnostic hysteroscopy. Age ranged from 25 years to 38 years and a mean age was 28.4 years. Bilateral tubal patency was demonstrated in 40 [64.5%] patients. Bilateral tubal blockage found in 10 [16.12%] and unilateral tubal occlusion was present in 12 [19.3%] cases. Myomas were found in 4 [6.45%], three found on laparoscopy and one at hysteroscopy. Endometrial polyps were revealed in 6 [9.6%] and Asherman syndrome in 2 [3.2%] patients on diagnostic hysteroscopy. Uterine anomalies were found in 8 [12.9%] patients including arcuate uterus in 4 [6.45%], septate in 2 [3.2%], bicornuate and uterine didelphys in one each. Of total, 5 [8.0%] were found to have endometriosis, 12 [19.35%] had polycystic disease of ovary [PCOD], and 3 [4.8%] had functional cyst of ovary. Pelvic adhesions were found in 7 [11.2%] patients. As a whole pelvic pathologies were confirmed in 52 [83.8%] patients and intrauterine pathology in 17 [27.4%] by simultaneous diagnostic hysteroscopy and laparoscopy. In investigating the causes of female infertility a combined diagnostic laparoscopy and hysteroscopy provides best approach to diagnose the pathologies

Term pregnancy with uterovaginal prolapse and severe anemia

Cases of uterovaginal prolapse common in high parity societies. Cases concurrent with pregnancy are rare, but can present with its complication and require specific advice and management