Raised BMI and disturbed Menstrual cycle

Objective: To determine the frequency of raised BMI in females with disturbed menstrual cycle

Study Design: Cross-sectional study

Setting: Department of Obstetrics and Gynecology, Govt General Hospital Samanabad Faisalabad

Duration: 1-11-17 to 31-05-18

Methodology: This was a cross sectional study carried out at Department of Obstetrics and Gynecology, Govt General Hospital Samanabad Faisalabad. In this study the cases of fertile age group i.e. more than 12 years of age having any menstrual disturbance present for at least last 3 menstrual cycle were selected. The cases with bleeding disorder, hormonal issues and those with uterine anomalies were excluded. The BMI was calculated and the BMI >/=25kg/m[2] was labelled as raised

Results: There were total 100 cases in this study with mean age of 20.21+/-4.57 years. The mean duration of abnormality in menstruation was 7.21+/-2.34 months. There were 64 [64 percent] of cases that were taking treatment for this. Raised BMI was seen in 32 [32 percent] of the cases. Raised BMI was significantly higher in number in cases that had age of menarche later than 14 years of age where it was seen in 16 [47.06 percent] cases with p= 0.01. It was also significantly high in cases that had history of prior treatment where it affected 23 [40.35 percent] cases with p value of 0.03

Conclusion: Raised BMI is common in females with menstrual irregularities and it is significantly high in cases that had age of menarche more than 14 years and are also took some treatment for it

Frequency of adverse maternal outcome with valvular heart disease

Objective: To determine frequency of adverse maternal outcome in women with valvular heart disease

Study design: Cross-sectional study

Sampling technique: Non-probability consecutive sampling

Place and duration: Department of obstetrics and Gynae Allied and DHQ hospital Faisalabad for 1 year from 01-01-2017 to 31-12-2017

Patient and methods: 254 pregnant women with heart disease were included in study. Final diagnosis of valvular heart disease was made by echocardiography. Maternal outcome in term of cardiac failure and arrhythmia measured

Results: out of 254 patients 93[36.6 percent]were of 20-25 years of age,127[50 percent]were in 26-30 years age group and remaining 34[13.4 percent]were more than 30 years of age.123[48.4 percent]were gravida 1,84[33 percent]were gravida 2,35[13.8 percent]gravida 3 and remaining 12[4.8 percent]were gravida 4 and more.174[68.5 percent]patients were booked and remaining 80[31.5 percent]were unbooked.103[40.6 percent]were diagnosed before pregnancy,15[5.9 percent]in First trimester,101[39.7 percent]in second trimester and 35[13.8 percent]in third trimester.133[52.4 percent]patients were of mitral stenosis,52[20.4 percent]of mitral stenosis and regurgitation,27[10.6 percent]of aortic stenosis,21[8.2 percent]of multivalve disease,13[5.2 percent]of prosthetic valve and 8[3.2 percent]of coronary artery disease.193[76 percent]patients were delivered vaginally,45[17.7 percent]undergo C-Section and 16[6.3 percent]induced abortion.10[3.9 percent]developed heart failure,18[7.1 percent]arrhythmias,13[5.1 percent]bleeding and 7[2.7 percent]patients died

Conclusion: Heart disease in pregnancy is a high-risk condition. Multidisciplinary approach achieves good maternal outcome

Frequency of morbid adherence of placenta

Objective: To determine the frequency, causes and outcome of patients with morbidly adherent placenta. Study Design: Descriptive case series. Place and Duration of Study: The study was conducted at Gynae Unit-I of Aziz Fatima Medical And Dental College from March 2012 to March 2013

Methodology: One hundred patients with previous uterine operations; like caesarean section, myomectomy, hysterotomy or diagnostic curettage, patients with placenta praevia or those patients with retained placenta removed with difficulty under anesthesia; were included in the study. All the primigravidas and cases with retained placenta due to uterine abnormalities were excluded. The admitted patients meeting the inclusion criteria were registered for the study after taking informed consent. Patients were clinically examined and appropriate investigations were done. All relevant information was recorded on a proforma especially designed for this study. All the data was entered and analysed through SPSS version 10

Results: Only 6 patients out of 100 selected cases had morbidly adherent placenta, all cases were booked. Five cases were between 25-30 years and one was 20 years of age. Their parity range from 1-6. Five patients had previous history of caesarean section.Placenta was found in lower uterine segment in all cases. One patient presented with preterm labour and one with antepartum haemorrhage. Prior to surgical intervention, proper work up of the patients was done. Colour Doppler of all the patients was done. All the patients had caesarean section done. Three of the latter had placenta accreta, 2 had placenta percreta and one had placenta increta. The placenta was removed piece meal in 4 cases. In one case a conservative approach i.e [segmental resection of the portion of the lower uterine segment where placenta was adherent] was done. In one case, caesarean hysterectomy was done. Blood transfusion was required in all cases ranging from 3-8units. Duration of hospital stay was 5-10 days and maternal mortality was nil

Conclusion: Morbid Adherence of placenta is an obstetrical emergency, which carries an increased risk of perinatal and maternal mortality and morbidity. Antenatal care needs to be improved and morbid adherence of placenta should be diagnosed at the earliest possible time. Previous caesarean section and placenta previa in current pregnancy were the major risk factors observed in 5[83%] of the cases. Previous history of dilatation and curettage was present in 1[16.6%] case

unusual presentation of pelvic tuberculosis

Tuberculosis is highly prevalent in developing countries like Pakistan and should be considered in the differential diagnosis of patients with pelvic mass, ascites and raised serum CA 125 levels. A case of pelvic tuberculosis with markedly raised serum CA 125 levels and initial diagnosis of ovarian tumour was made

Full term secondary abnominal pregnancy

In properly evaluated patients full term abdominal pregnancy can be managed, although advanced abdominal pregnancy is a complex condition demanding challenging management. This care report describes case of a young lady 35 years age who was diagnosed as a case of secondary abdominal pregnancy and was managed successfully