Frequency of perinatal mortality at Bolan medical complex hospital Quetta

To determine the extent and feto maternal factors contributing to perinatal Mortality. A prospective review study. This study was Gynecological and Neonatal Intensive care units of BMCH, Quetta from January 2006 to December 2011 A prospective review of all still births from 24 weeks of pregnancy and on words and neonatal deaths within first seven days of life either in obstetric ward or neonatal nursery was done. The details of each mother and new born were recorded on standardized proforma. The perinatal mortality rate was 99/1000during last 6 years, 102/1000 in 2006, 97/1000 in 2011 Most common maternal cause for perinatal morality was hypertensive disorders of pregnancy 26%, then antepartum hemorrhage 23.8%, birth asphyxia 23%, Congenital anomaly contributed 5.3%, unexplained 7% of all. Perinatal mortality is a major health problem caused by poor maternal health, lack of antenatal visits, multiparity, prematurity and infections of both mother and new born. Antenatal care, birth spacing, proper referral and standardized management during labour and in nursery can reduce the perinatal mortality

randomized clinical trial of 200 patients of oral vs vaginal misoprostol in second trimester pregnancy termination

To assess the safety, effectiveness and the factors that affect the outcome of Misoprostol both oral and vaginal route for second trimester pregnancy termination. Randomized study. This study was conducted at the department of Gynae and Obst Unit IV Bolan Medical College Complex Hospital Quetta between July 2009 to December 2011. The patients were randomized to receive either oral or vaginal Misoprostol [400ug] every 4 hours for maximum 5 doses. The course of Misoprostol was repeated where women did not abort within 24 hours. The study includes 200 cases in each group of oral and vaginal route of Misoprostol administration. There was no significant difference in mean maternal age, number of pregnancies, parity and duration of pregnancy or history of first trimester between both groups. There was no significant difference in the success rate at 48 hours [oral 65%, vaginal [70%]. However, the success rate at 24 hours at vaginal group [70%] corresponds with oral group [50%]. Misoprostol is a safe and effective regimen for second trimester medical miscarriages. Vaginal route resulted in higher success rate then the oral route at 24 hours, however the miscarriage rate was similar at 48 hours

Primary post partum hemorrhage. An obstetric catastrophe: a review of 270 cases

To see the frequency, causes of Primary Postpartum Hemorrhage [PPH], and identify the management options and to apply them successfully for control of primary PPH. So as to reduce the maternal morbidity and mortality rate. Retrospective study. This study was conducted in Gynae Unit-IV, Bolan Medical Complex Hospital, Quetta from January 2011 to July 2012. The data was collected from the records of patients who were admitted as case of Primary PPH and developed PPH during the delivery / Cesarean section. The data was noted on predesigned Proforma which include, complete obstetrical history, abdominal and pelvic examination and relevant laboratory investigations. The maternal condition was assessed and managed according to Hospital protocol. All maternal complications were noted. The patients who were bleeding at the time of delivery due to non - obstetrical condition were excluded from study. A total 270 cases of PPH were diagnosed. Major causes of Primary PPH were uterine atony in 143 [53%] retained placenta, in 49 [18%] ruptured uterus in 43 [16%] cases. The risk factors for uterine atony were prolonged 1[st] and 2[nd] stage of labour, grand multipara and retained placental tissues. Patients were managed both medically and surgically. The major morbidities were anemia 32%, hypovolemic shock 26%, puerperal sepsis 15% and acute renal failure 5%. Primary PPH is an important cause of serious morbidity and one of the leading causes of maternal mortality in the developing and developed world. The majority of deaths are preventable by the active management of 3[rd] stage of labour followed by a logical management protocol