Abnormal cardiotocography; perinatal outcome

To observe the effect of abnormal Cardiotocography to delivery interval on perinatal outcome in terms of Apgar score. Descriptive case series study. Baqai Medical University department of obstetrics and gynecology Fatima Hospital Karachi from Jan 2011 to July 2011. One hundred patients were registered who had pathological Cardiotocography. Bishop's score was noted and decision to deliver the patient was made according to the abnormality, and bishop's score. If bishop's score was good and vaginal delivery was imminent, then her second stage was shortened by operative vaginal delivery. Fetal distress was managed by left lateral position, O2 inhalation and hydration. If delivery was not imminent then decision of urgent LSCS was made, meanwhile fetal distress was managed. Decision - delivery interval was recorded, and fetal outcome was noted in terms of Apgar score and resuscitation needed. During this period one hundred pregnant women at term had pathological CTG for which they were delivered urgently. Among them 12% of parturients were delivered within 30 min, 68% delivered within 30-60 min, 12% delivered in 60-90 min and only 8% were delivered in 90-120 min. Seventy four [74%] of parturients were delivered by emergency lower segment caesarean section and 26% of parturients were delivered by instrumental vaginal delivery. Fetal outcome in terms of 1 min Apgar score, 38% of neonates had Apgar score of <7, 46% had >7 and 16% had Apgar score of <5. This group of neonates required resuscitation and 5 min Apgar was good. No neonate was admitted in Neonatal unit. In this study it is concluded that with fetal heart rate abnormality, if fetus is delivered within 60 min, it is not associated with poor fetal and neonatal outcome, provided fetal distress is managed while preparing for emergency lower segment caesarean section

Ovarian hyperstimulation syndrome; in spontaneous conception a case report

It is known that most cases of Ovarian Hyperstimulation Syndrome [OHSS] are associated with the therapies for ovulation induction. However, OHSS may rarely be associated with a spontaneous ovulatory cycle, usually in the case of multiple gestations, hypothyroidism or polycystic ovarian syndrome. We report a case of moderate OHSS in spontaneously conceived twin pregnancy in a 24 years old woman. The clinical picture showed amenorrhea, nausea, vomiting, abdominal pain and moderate ascites. After examinations, imaging and laboratory investigations, the diagnosis was established. The patient was managed expectantly with no complications. Although spontaneous ovarian hyperstimulation is a rare entity, it is important that the physician recognizes this condition. Prompt diagnosis and successful management is likely to avoid serious complications, which may develop rapidly