Safety and efficacy of hyderalzine in hypertensive disorders of pregnancy

To find out safety and efficacy of IV bolus hydralazine in reducing blood pressure in severe hypertension during pregnancy. All pregnant patients with systolic blood pressure 160 or above and diastolic blood pressure 109 mmHg with eclampsia and hypertensive emergencies were included. The initial dose of hydralazine was 5 mg IV bolus then repeated 1mg at 20 minutes interval. Outcome measures to start treatment were, systolic and diastolic blood pressure, time required for achieving the desired BP level, total dose needed, side effects of drugs, maternal and fetal outcome in terms of safety and efficacy. One hundred and ten patients with eclampsia and hypertensive emergencies were included in the study. The mean + SD [range] of maternal age was 26.70 + 6.70[18 -45 years]. Blood pressure before starting therapy was systolic 165.5 + 16.65, and diastolic blood pressure was 115.45 + 8.25mmHg. After starting therapy, a significant difference [P=< 0.001] was observed with fall in systolic blood pressure 131.2 + 9.49 and in diastolic blood pressure 93.68+6.30mmHg. In 94[85.5%] patients, IV bolus hydralazine took 60 minutes, however, in 3[2.7%] > 180 minutes time was required to control the blood pressure. Total dose of drug required was <6mg in 40[38.4%] patients, 6 to 14mg in 44[40%] and in 17[15.5%] women 15 to 20 mg of dose was needed to control the blood pressure. Only 9[8.18%] needed dose between 21 to 30 mg IV bolus hydralazine. Hydralazine is safe and effective in controlling the blood pressure in severe hypertension during pregnancy and after delivery

Pattern of pelvic mass among women attending a gynaecology department of university hospital in Sindh

To analyze patients with pelvic mass according to age, parity, clinical presentation, pathology and operative procedures according to the type of mass, at a tertiary care hospital of Sindh-Pakistan. Descriptive case series. Department of Obstetrics and Gynaecology [Unit I], Liaquat University Hospital, Hyderabad; from January to December 2007. All women of any age and parity presenting with pelvic mass, diagnosed on history, clinical examination and/or on ultrasound were included. Type of pelvic mass was confirmed at surgery and on histopathology. In total, 110 patients were studied. Sixty-one [55.45%] participants were aged between 30-50 years while only one patient was under 20 years and 2 over 70 years. The majority of women were parous. The main clinical presentation was lower abdominal pain in 42 [38.18%] patients, followed by menstrual disturbances in 38[34.54%] women. Eighty-four [76.36%] patients were diagnosed on first clinical examination, and confirmed further by ultrasound. Among all, 104 [94.54%] patients were diagnosed through ultrasound. Sixty-eight [61.82%] patients had genital tract tumors while 4 had non-gynaecological mass. In 10[9.1%] patients, size of mass was >20cm; however, malignant lesions were less common and under 10 cm in size. Every women presenting with pelvic mass irrespective of age and parity must be thoroughly investigated and treated. Non-gynaecological masses may also be diagnosed; therefore, surgeon must be competent enough to deal with these masses