ABSTRACT
Objective: to evaluate the efficacy of a single dose of MTX for ectopic pregnancy management
Material and Methods: 37 patients were carefully selected according to inclusion criteria. beta-hCG was done at diagnosis and at day 7. A single IM dose of MTX was given and patients were kept admitted till recovery
Results: out of the 37 patients, 5 patients had ruptured ectopic pregnancy in spite of taking MTX. 26 had single dose and had a time of ectopic pregnancy resolution averaging 26.4 days. The remaining 6 patients received an additional dose of MTX with the time resolution of 35 days
Conclusion: the successful medical management of ectopic pregnancy was seen in 26 patients [81 %] in whom beta-hCG levels became negative after administration of single MTX
ABSTRACT
With increasing caesarean section rates during the past decades, a rising trend of placenta percreta is observed. Although rare, placenta percreta can present as acute abdomen due to haemoperitoneum during antepartum period. A 24 years old pregnant lady with two previous caesarean sections, presented in emergency at 12 weeks of gestation with syncope, acute abdominal pain and distension. Ultrasonography revealed an ectopic pregnancy in right adnexa with intraperitoneal haemorrhage. On laparotomy, there was moderate hemoperitoneum, both adnexa were normal and placental tissue was protruding through a bleeding previous caesarean scar. Hysterectomy was done. Histopathological report was consistent with the diagnosis of placenta percreta
ABSTRACT
To determine the frequency pattern of presentation and causative agents of lower urinary tract symptoms in pregnant females. Descriptive study. Department of Obstetrics and Gynaecology, Fatima Memorial Hospital, Lahore, from January 2003 to May 2003. One thousand consecutive pregnant women, attending the antenatal clinics of Fatima Memorial Hospital, were included in the study. Women with renal pathology, postrenal transplant and those on immunosuppressive agents were excluded. All women underwent complete examination of urine. Those who had one or more urinary complaints had culture and sensitivity test of urine. Other variables studied were the symptomatology. Out of one thousand pregnant women, 426 [42.6%] complained of one or more urinary symptoms. Diurnal and nocturnal frequency was the most commonly encountered symptom [87.32%], followed by irritative symptoms and voiding difficulties. Complete urine examination of symptomatic patients revealed < 5 pus cells /HPF [high power field] in 322 cases and 6-20 pus cell/HPF in the remaining 104 cases. The urine culture of the symptomatic patients [426 cases] showed growth in only 37 cases [8.69%]. Escherichia [E.] coli was the commonest organism [89.1%] followed by Staphylococcus [S.] aureus [8.1%] and candidiasis [2.7%]. Lower urinary tract symptoms are frequently present in pregnant women, which can be due to both pregnancy-induced changes on urinary system as well as urinary infection. It is important to differentiate between the two because former requires only reassurance whereas the latter needs antibiotic treatment