Accuracy of estimated fetal weight by clinical assessment and ultrasonography

To compare accuracy of estimating fetal weight of term fetus by clinical assessment and Ultrasonography. Comparative Clinical Trial Study. This study was conducted in obstetrics and gynecology unit of Hayt abad Medical complex. This study was carried out on 300 subjects, with full term; normal pregnancy. Patients had fetal weight estimation by two approaches. 1] Clinical assessment done by Leopold's maneuvers and symphysio fundal height in centi-meters and 2] Sonographic measurement by using Toshiba capacee with curvilinear transducer of 3.5 MHz. Birth weight at delivery was used on gold standard. The accuracy of these two methods of estimating fetal weight was compared using student t test, and [2] P>.05 was considered significant. Out of 300 cases, 292 cases were compared both. Ultrasonically and by clinical assessment while 8 babies could not be picked up of ultrasonically because of fetal weight more than 4.0 KG, out of 292 cases [218] 72.7% were assessed. Correctly by clinical assessment while [224] 74.7% were assessed correctly by ultrasonography. Clinical assessment is equally accurate as ultrasonography in normal term birth weight estimation

Prevalence and management of anencephaly at Saidu teaching hospital, Swat

Anencephaly is a fatal congenital abnormality characterised by absence of cerebral hemisphere and cranial vault. Overall incidence of anencephaly is 3.8-6.0/1,000 births. This study was conducted to determine the prevalence, diagnosis and management of anencephaly in District Swat. This Prospective study was carried out over a period of one year from January 2007 to December 2007 at Saidu Teaching Hospital/Saidu Medical College Swat. Pregnant women having foetuses with neural tube defects [NTDs] admitted in Labour Room/Obstetric Ward of the Saidu Teaching Hospital Swat were selected as subjects. Those women who delivered normal babies were taken as control subjects. A proper history was taken from each subject and all the relevant information were recorded on a proforma. A total of 5,560 subjects were included in this study. Out of them, 69 were having NTDs, 63 had anencephaly, 4 had spina bifida, and 2 foetuses were having multiple neural tube defects. Prevalence of anencephaly was 11.33/1000 births and that of spina bifida was 0.72/1000 births. Eighty percent [80%] anencephaly and 50% spina bifida were diagnosed by ultrasonography. Most of the cases [52, 75.36%] were delivered through normal vaginal delivery after induction. Twelve [17.40%] had spontaneous vaginal delivery, 4 [5.80%] had caesarean section, and hysterectomy was done in 1 [1.45%]. Anencephaly is common congenital anomaly in Swat. Complications can be prevented by implementing screening program for early diagnosis, treatment, and management. Prevalence can be decreased by folic acid supplementation periconceptionally

Detection of abnormal cervical cytology by Pap smears

Cervical intra-epithelial neoplasia and cervical cancer remain important health problems for women worldwide. Cervical cytology by Papanicolaou stained smears is an effective means of screening for cervical pre-malignant and malignant conditions. This study was designed to determine the prevalence of cervical intra epithelial neoplasia in this region and the role of pap smears for its detection. It was hospital based study on patients who attended the Out Patient Department of Lady Reading Hospital, Peshawar, Pakistan, from January to September 1997. Patients presenting with vaginal discharge, dyspareunia, post-coital bleeding, backache or pain hypogastrium were included. Patients having vaginal bleeding other than post-coital, were excluded from the study. Relevant information was obtained from the patients and recorded. Samples were collected and transferred to glass slides, fixed and stained by Papanicolaou stain. Each slide was carefully examined. Three hundred patients were included in this study. One hundred and twenty three [41%] patients had complaints of vaginal discharge, 39 [13%] post-coital bleeding, 108 [36%] dyspareunia and 30 [10%] backache and /or pain hypogastrium. Regarding contraception, 37 [12.33%] patients were pill users, 31 [10.33%] were on injectable contraceptives, 32 [10.67%] were using barrier method of contraception, 34 [11.33%] patients were having an intrauterine contraceptive device and 160 [55.33%] patients were not using any method of contraception. Pap smears revealed that 8 [2.67%] patients were having cervical intra-epithelial neoplasia. Among these patients, 1 [12%] had intra-uterine contraceptive device, 3 [38%] were on oral contraceptive pill, while 4 [50%] were not using any contraceptive method. One hundred and seventy eight [59.33%] patients were having past history of genital infection where as 128 [42.67%] patients had no such history. Age at first coitus was below 20 years in 268 [89.33%] patients whereas it was above 20 years in only 32 [10.67%] patients. All these patients belonged to poor socio-economic class. Cervical intra epithelial neoplasia is not uncommon in our set up. It can be diagnosed early by Pap smears