Induction of labour single vaginal PGE 2 Vs early amniotomy and I/V oxytocin

To compare two methods of induction of labour. Amniotomy with intravenous oxytocin infusion versus single use of prostaglandin E2 vaginal tablet. Design Perspective randomized clinical trial. The department of Gynae and Obs Nishtar Hospital Multan and Ganga Ram hospital lahore 100 patients were recruited .50 were randomized for amniotomy followed by oxytocin infusion. Second group underwent labour induction with PGE2 which was repeated after 6 hours, if n o change in bishop score is observed. 17 .2 .2004 to 17 .2.2005 In the study the results regarding mean Bishop score change, duration of labour and apgar score at 5 minutes were comparable in both groups. In the group 2 mean induction to delivery time was 9 hours.[6-12 hrs].The mean cervical change score was 8.5 Duration of labour in group 2 was in the mean of 7hrs. In group 1 mean cervical change was 7.5 [range5-7], induction to delivery time was 10.5 hrs. The duration of labour was 7.5 hrs. Analgesic requirements varied in both groups. No patient with PGE2 required pain relief before membrane rupture. In the oxytocin group narcotic analgesia was given from the start of uterine contractions. PGE2 vaginal tablet for induction of labour in case of unfavourable cervix is superior to use of amniotomy and oxytocin. It was found to be safe and effective with minimum of patient interference

Clinical manifestations of benign ovarian tumours

To examine the cases of Benign Ovarian Tumours and their clinical manifestations. Prospective study of consecutive cases of Ovarian tumours, identified using gynaecological case records. Tertiary care teaching hospital affiliated with Fatima Jinnah Medical College Lahore, managing more than 1500 gynaecological cases annually. 50 cases of Ovarian tumours managed in Department of Gynaecology and Obstetrics Sir Ganga Ram Hospital, Lahore between 1st May 2004 to 1st May 2005. The most common presenting complaints were abdominal pain or discomfort and palpable tumour causing abdominal distension. Abdominal pain was present in 70% of benign ovarian tumours. 20% of the patients had pain due to torsion of ovarian cyst. The complaint of a palpable tumour was found in 4 7% of cases. Vague abdominal and bowel complaints were present in 2 2.5% of cases. 6[15%] patients were asymptomatic. Of these 2 were diagnosed by ultrasound and 3 at the time of emergency Cesarean section and one on routine pelvic examination. Menstrual irregularity and urinary complaints were present in a small number of patients. None of the patient complaint of weight loss or post menopausal bleeding. Benign Ovarian Tumours are most common cause of ovarian enlargement and a very common cause of hospital admission. Symptoms and signs are non specific and presentation is a late stage

Prevalence and perinatal mortality of cord prolapse and presentation

To analyse the prevalence and perinatal mortality in cord prolapse. All cases of cord prolapse managed in gynae unit 3 at Sir Ganga Ram Hospital were identified. From 20 March 2004 to 20 March 2005. 23 patients of cord prolapse and presentation were identified During this time 5408 births took place giving a prevalence of I in 235 total births which comes upto 0.42%. There were 6 cases of cord presentation [0.11%] and 17 cases of cord prolapse [0.31%].19 cases were born alive[82.6%]. There were 4 still births giving a still birth rate of 17.4% or 174/1000 births with cord prolapse and presentation. One neonatal death occurred among 19 live born babies giving a rate of 5.21% or 52.1/1000 live births. The uncorrected perinatal mortality was 217/1000 births or 21.7% with cord prolapse and presentation. Cord prolapse and presentation occur with prevalence of 0.43% The perinatal mortality rate in this series was 21.7% of births with cord prolapse and presentation