ABSTRACT
Objectives: To elaborate the impact of family planning training on general practitioners' knowledge, attitude and practices regarding emergency contraception
Methods: A cross sectional survey involving 270 general practitioners was conducted in Hyderabad from 1[st] Oct to 31[st] Dec 2010. Participants were divided into two groups on the basis of attending family planning training course after graduation and were interviewed face to face. Data was noted on questionnaire asking their knowledge, attitude and practices regarding emergency contraception. Data was analyzed on SPSS version 11. Student t-test was applied to compare the proportions among two groups
Results: Out of 270 general practitioners, male and female participants were 132 [48.9%] and 138 [51.1%] respectively. Mean experience as private general practitioner was 7.48 +/- 7.6 years. One third of the participants 84 [31.1%] have attended five days training course on family planning in the past, while 186 [69.9%] did not have any training. Source of training was government institutes 46[17%] and non government organization in 38 [14.1%] cases. Significant positive difference was noted on emergency contraception knowledge, attitude and use in group who attended family planning training
Conclusion: Educational intervention has a positive impact on health care provider's knowledge, attitude and practices of emergency contraception
ABSTRACT
Objective: To determine fetomaternal outcome in women presenting with abruptio placentae at our setup. Design: A descriptive study. Setting: Department of Obstetrics and Gynecology Unit-II, Liaquat University Hospital Hyderabad, Sindh - Pakistan. Study was carried out from January to December 2007
Methods: All patients presenting with antepartum hemorrhage due to abruptio placentae at any gestational age after 28 weeks to term were included in the study. Women having bleeding due to causes other than abruption like placenta previa, vasa previa, carcinoma cervix and other local lesions were excluded. All the data collected through history, examination and investigations were recorded on a predesigned proforma. Data were analyzed using SPSS version 10.0
Results: Total number of cases admitted in labour ward was 2563. Forty-eight [1.87%] women had abruptio placentae. Maternal complications were postpartum hemorrhage [16.6%], disseminated intravascular coagulation [4.16%] and renal failure [6.25%]. Maternal death occurred in 4 women [8.33%]. Adverse fetal outcome was noted in severe cases of abruption. Still birth occurred in 41.6% cases
Conclusion: In our setup, frequency of abruptio placenta is comparable with local and international literature. Incidence of abruptio placenta is high in our women as most of the women belong to poor socio-economic class. Antenatal care plays an important role in decreasing the incidence of abruptio placenta
ABSTRACT
Objective: To determine the frequency of primary amenorrhea and to enlist etiological factors and outcome of treatment of primary amenorrhea. Design: A descriptive case series. Setting: Department of Obstetrics and Gynaecology [Unit-II] Liaquat University Hospital Hyderabad, Sindh - Pakistan, from January 2006 to December 2007
Methods: All patients presenting with primary amenorrhea were included in the study and patients having secondary amenorrhea including pregnancy were excluded. All the data collected by history, examination and investigations were recorded on a proforma. Data were analyzed using SPSS version 10.0
Results: Total number of patients admitted was 2, 505. Frequency of primary amenorrhea was 0.75%. Imperforate hymen was found in 21.05% cases, pure gonadal dysgenesis in 15.7%, constitutionally delayed puberty in 10.52%, hyperprolactinemia in 10.52%, polycystic ovaries in 5.26%, Turner's syndrome in 10.52% and testicular feminization in 10.52% cases. Patients with constitutionally delayed puberty had spontaneous onset of menstruation. Outcome was good in all patients with cryptomenorrhea. Two of them got married and conceived successfully. The patients with primary amenorrhea due to polycystic ovaries and hyperprolactinemia had resumption of normal menstruation after medical therapy. In patients with testicular feminization, testicular tissue was removed and estorgenprogestogen therapy was given
Conclusion: Primary amenorrhea is one of the important reasons for distress of family and patient herself. Literature review has shown that low frequency and fear of exposure of defect may be the reason for not seeking medical advice. In our setup too, these observations were found. Patient awareness and the proper counseling of parents regarding the treatment options available and need for follow up can help in deciding the sex of rearing and even restoring the fertility in many of these women
ABSTRACT
Objective: To see the efficacy of Magnesium sulphate in preventing and controlling fits in hypertensive disorders of pregnancy. Design: Descriptive Study. Setting: Department of Gynaecology and Obstetrics, Liaquat University Hospital Hyderabad from January to December 2002
Patients and Methods: Thirty one patients having severe hypertension [Systolic BP>/=160 and Diastolic>/=110mmHg] with or without proteinuria and fits were studied. Diagnosis was made through history, clinical findings and relevant investigations. Immediate management consisted of maintenance of intravenous line, clearance of airway and anti hypertensive medications for prevention and control of fits after excluding contraindications for magnesium sulphate therapy. All patients received Magnesium sulphate according to protocol. Occurrence and recurrence of fits, control of BP, side effects of magnesium sulphate, mode of delivery, maternal and fetal outcome were noted
Results: Total 91 patients were diagnosed with blood pressure 140/100mmHg or above having severe pregnancy induced hypertension [PIH], pre-eclampsia and eclampsia during study duration. Out of these, 31 patients met criteria for magnesium sulphate therapy. Age range of patients was 16-35 years. Only 7 cases were booked and all eclamptic patients were referred cases. Majority of women was nullipara. Gestational age at admission was more than 35 weeks in 20 patients [64.51%]. Twenty six women [83.87%] had blood pressure at admission > 160/110 mmHg. Fits were effectively controlled in eclamptic patients and none of the patients with preeclampsia and PIH developed fits who received magnesium sulphate. Fetal outcome was good in those who came at term with alive fetus and delivered by caesarean section. Nineteen [61.29%] fetus were alive, 8 were delivered still birth and 4 died during neonatal period. Only one patient had respiratory depression. There was no maternal death
Conclusion: Magnesium sulphate can be safely and effectively used for the prevention and control of fits in hypertensive disorders of pregnancy