Comparison of outcome of caesarean section with and without post placental intrauterine contraceptive device insertion a randomized controlled trial

Objective: to compare the outcome of Caesarean Section with and without post placental Intrauterine Contraceptive Device [IUCD] insertion in terms of frequency of bleeding and wound infection

Study Design: randomized controlled trial

Place and Duration: Department of Obstetrics and Gynaecology, Allied Hospital, Faisalabad from 1[st] January 2013 to 30[th] June, 2013

Methodology: three hundred and two pregnant women admitted for elective emergency caesarean section, willing to use intrauterine contraceptive device as a method for temporary contraception were randomly divided into two groups A and B. Group A had intrauterine contraceptive device inserted after delivery of placenta and membranes. Group B did not have intrauterine device inserted. In post-operative period both groups were evaluated for heavy lochia or abdominal wound infection on day 3 and day 7

Results: in the experimental group [A] ten patients [6.6%] and in control group [B] 8 patients [5.3%] had wound infection. P value calculated as 0.627 which shows no statistical difference in 2 groups. Regarding heavy lochia in group A 4 patients [2.6%] and in group B 2 patients [1.3%] had heavy lochia. P value calculated as 0.410 which was statistically not significant

Conclusion: there is no significant difference in outcome of caesarean section with and without post placental IUCD insertion

Vaginoplasty using Sheare's Method followed by amnion graft in patients of vaginal agenesis associated with mayer-rokitansky-kuster-hauser syndrome

Objective: to evaluate outcome of vaginoplasty by Sheare's method followed by amnion graft in cases of vaginal agenesis due to Mayer-Rokitansky-Kuster-Hauser [MRKH] syndrome

Study Design: descriptive observational

Place and Duration: Department of Obstetrics and Gynaecology, Allied Hospital, Faisalabad from 1[st] January 2012 to 31[st] December, 2014

Methodology: nine patients with MRKH syndrome underwent vaginoplasty by Sheare's method in which the space between two labia was dilated with Heagar's dilator along the vestigial Mullerian ducts. Thus two tunnels were created and the central septum excised to form a single vagina. A mould covered with amnion was then placed in the neovagina. All cases were followed up for six months

Results: amnion graft was taken completely and presented no intra-operative or post-operative complications in all 9 cases. There was contracture of neovagina in one case only and this was due to non-compliance with continued mould placement after discharge from Hospital

Conclusion: Sheare's method of vaginoplasty followed by amnion graft is an easy procedure with minimal or no complications and provides excellent anatomic and cosmetic results

Efficacy of magnesium sulphate in prevension of fits in severe pre-eclampsia

Objective: To evaluate the efficacy of magnesium sulphate as prophylactic agent in prevention of fits in severe pre-eclampsia

Study Design: Interventional Quasi experimental study

Setting: Department of Obstetrics and Gynaecology, Punjab Medical College and affiliated hospitals, Faisalabad

Subject: Sixty patients of severe pre-eclampsia fulfilling the inclusion and exclusion criteria

Main Outcome Measures: Occurrence of fit in case and control group, side effects of the drug like flushing, diminishing of reflexes, respiratory depression and hypotension in the case group

Method: Sixty patients with severe pre-eclampsia were divided into two groups: Group A was taken as case and treated with MgSO[4], group B was taken as control and was not given MgSO[4]

Results: Out of the 30 patients treated with MgSo[4] none [0%] had eclampsia in group A. In group B 4 [13.3%] patients developed eclampsia. Side effects of the drug were looked for in group A. Flushing was seen in 6 [20%] patients diminishing of reflexes was deserved in 1 [3.3%] patient

Conclusion: MgSO[4] is an effective drug for prevention of fits in patient of severe preeclampsia

Successful pregnancy in a patient with Eisenmenger's syndrome

Pregnancy with Eisenmenger's syndrome having high maternal mortality as pulmonary hypertension is aggravated often leads to poor outcome. But a multidisciplinary approach and close follow up can achieve a good maternal and fetal come. Here we report a case of successful pregnancy in a patient with Eisenmenger's syndrome

Frequency of cervical intraepithelial neoplasia in women attending allied hospital, Faisalabad

To determine the frequency of cervical intraepithelial neoplasia [CIN] with papanicolaou [PAP] smear and identifying the disease in premalignant phase, thus preventing the development of invasive cancer. Observational type of study. Outpatient department of Obstetrics and Gynaecology of Allied Hospital, Faisalabad from Jan. 2003 to Dec. 2003. All the patients attending the Gynae outpatient department at Allied Hospital, Faisalabad with Gynaecological symptoms were subjected to a detailed history, examination and then underwent papanicolaou smear cytology with wooden Ayers Spatula. Patients having vulvovaginitis, menstruation and obvious cervical growth were excluded. The smear was sent to College, Faisalabad. A total of 500 patients underwent cervical cytology. 47 patients [9.4%] showed positive smears, while 453 patients [90.6%] were negative for cytology. Out of 47 patients 22 [46%] were found to have CIN - I, 13 [27%] CIN - II, 8 [17%] CIN - III and 4 patients [8.5%] showed invasive cancer. Majority of patients [51%] with positive smear were between ages [35-44 years], grand multiparous, presented with abnormal vaginal discharge and belonging to lower social economic status. Study shows that our population have significant number of premalignant cervical disease. So screening with pap. smear should have wide application all over the Pakistan to reduce the incidence of cervical cancer