Iatrogenic vesicovaginal fistula

To find the frequency of iatrogenic VVF in patients admitted for repair of VVF in Lady Willingdon Hospital, Lahore. An observational study. Lady Willingdon Hospital, Lahore, from January 2007 to December 2008. All cases of VVF treated at the centre during the study period were included in the study. The patients were admitted and evaluated through detailed history, physical examination, relevant investigations and evaluation under general anaesthesia [EUA]. Iatrogenic VVF was defined as the one following gynaecological procedure. Repair was done through abdominal or vaginal route based on the findings of EUA. Results of repair were noted and analyzed using SPSS version 12. Iatrogenic cases of VVF made more than half of the total cases [54%] while 46% were due to obstructed labour. Women under the age of 40 years, made up 77% of the total cases. The success rate for repair of VVF was 87%. This study shows that iatrogenic injuries in women under 40 years of age form a major share in the etiology of VVF requiring a check on the experience of surgeons doing the gynaecological and obstetrical surgeries in a developing country

Prenatal diagnosis of beta thalassemia

Seventy one women were screened for prenatal diagnosis of Beta-Thalassaemia by using chorionic villus sampling technique. Sixteen fetuses [21.6%] were found homozygous for B-thalassaenia. Out of 17 live births, 11 have undergone blood tests and the results of blood test corresponded to prenatal diagnosis made through chorionic villus sampling

Foetal lung maturity: lecithin/sphingomyelin ratio and phosphatidyl glycerol levels in amniotic fluid of diabetic mothers

Maternal diabetes affects the normal maturation of foetal lungs. In normal pregnancy, lecithin/sphingomyelin [L/S] ratio correlates with the gestational age, whereas in complicated pregnancies, biochemical maturation of foetal lung may be accelerated or delayed depending upon maternal foetal or placental conditions. Sixty patients divided into two groups [Group I containing 16 normal patients while Group IIb contained 44 diabetic patient subdivided into Group IIa of 12 diabetic patients whose diabetes had been controlled by diet only and Group II with 32 patients controlled by insulin]. their blood glucose and HbA1c, was done for glucose profile, whereas amniotic fluid lecithin/sphingomyelin ratio and phosphatidyl glycerol were done at 28 to 38 weeks of gestation and at delivery. In diabetic patients, appearance of L/S ratio lagged behind as compared to the control grout Phosphatidyl glycerol levels in the control group was detected as early as 28 weeks of gestation, whereas in diabetic patients, these levels were not detected till 32 weeks and thereafter the levels still remained low as compared to the control group. Respiratory distress syndrome was predicted in 3 babies delivered to the diabetic mother and, proved fatal in 2 of them. Our study showed that the predictive value of phosphatidyl glycerol in foetal lung. maturity in diabetics was 100% as compared to the L/S ratio. However, before 37 weeks of gestation, the appearance of phosphatidyl glycerol in amniotic fluid in diabetic patients lagged behind the control group and that lag was more conspicuous in diabetics controlled on insulin. Phosphatidyl glycerol in amniotic fluid is, therefore, a better indicator or foetal lung maturity in diabetic pregnancies as compared to the L/S ratio