ABSTRACT
Uterine fibroids or leiomyomas are benign tumours that develop in the uterus, a female reproductive organ. These cause severe complications in females during pregnancy. This study was conducted to see the impact of leiomyoma in pregnant females to make decision for its management in future. During one year of study, total 10,842 patients presented in CMH Lahore for antenatal check-up were included in the study. Out of them, 80 patients had leiomyoma in first trimester. They were followed during antenatal period. Maternal age, parity, size of fibroid, complications during pregnancy, labour and delivery, mode of delivery and indications of caesarean section were noted. The prevalence of fibroids [>/= 5 Cm] in pregnant females was 0.74%. The most common complication observed was PPH [31, 38.75%] cases. Miscarriage occurred in 8 [10%] cases, cord prolepses was observed in 6 [7.5%] cases, placental abruption in 6 [7.5%] cases, placenta previa in 2 [2.5%] cases and retained placenta was observed in 1 [1.25%] case. Breech presentation was found in 10 [12.5%] cases and abdominal hysterectomy was done in 10 [12.5%] cases. Preterm labour occurred in 8 [10%] cases and IUGR was present in 5 [6.25%] cases. No maternal was reported during the study. Among all females, 64 [80%] continue their pregnancy up to term [37-40 weeks of gestation], out of which vaginal delivery occurred in 19 [29.69%] while 45 [70.3%] had LSCS due to failure in progress in 17 [37.8%], cord prolapsed in 6 [13.3%] cases, fibroid in lower segment in 3 [6.7%] cases, breech presentation in 10 [22.2%] cases and low lying placenta in 2 [4.4%] cases. Pregnancy with fibroid is associated with increase in caesarean section rate especially due to dysfunctional labour and malpresentation. There is also increase in incidence of postpartum haemorrhage and associated hysterectomy.
ABSTRACT
To determine the frequency of surgical site infection [SSI] and its unknown risk factors in obstetrical and gynaecological procedures. Descriptive study. Obstetrics and Gynaecology department of Combined Military Hospital, Lahore from Oct 2009 to April 2010. Patients who had undergone their surgical procedures in obstetrics and Gynaecology from October 2009 to April 2010. A total number of 1199 procedures were performed. Only 23 [1. 92%] got SSI. Out of these 19 [82.6%] were lower segment cesarean section and 4 [17.4%] cases hysterectomies. In these infected cases, 19 [82.6%] were less than 40 years of age and 4 [17.4%] cases were more than 40 years of age. Six [26.1%] patients belonged to high and 17 [73.9%] to low socioeconomic class. Nineteen [82.6%] patients weighted more than 75 kg and 4 [17.4%] were less than 75 kg. Only 2 [8.7%] were diabetic and 21 [91.3%] were non diabetic. Surgical site infection remains the commonest complication of surgery and is a burden on health care resources. It can be prevented by identifying those at higher risk and modifying skills for their care. Increasing age, obesity, Diabetes and low socioeconomic class could be the risk factors for SSI