Peculiar risk factors and complications of pregnancy induced hypertension in a tertiary care hospital of Peshawar

To determine the frequency of risk factors and complications associated with pregnancy-induced hypertension [PIH] in a hospital based study. Desriptive Study. Study was conducted in obstetric and gynecology department of Khyber teaching hospital Peshawar from March 2006 to March 2007. Sixty eight patients were included in the study. Relevant informations was recorded from patients and treatment chart of the patients on a questionnaire designed in accordance with the objectives of the study. The age range of the patients was from 14 to 48 years with mean age of 27.5 years, and mode of 26 years. The distribution of symptoms was: Increased blood pressure [100%] edema feet [86.76%], nausea, vomiting [32.34%] sudden weight gain [27.94%] visual changes such as blurred or double vision [22.05%] etc. Frequency of risk factors of PIH was: Primigravida [8.72%] previous pre-eclampsia [7.35%] diabetes mellitus [16.17%] obesity [10.29%], chronic hypertension [7.35%], large placenta [4.4%]. While no risk factors recorded in 10.29% patients. Complications of PIH occurred only in 52.94% cases. Frequency of various complications was: haemolysis, elevated liver enzymes and low platelets [HELLP] 80.55%, convulsions 16.66%, pulmonary edema 8.33%, cortical block and intra uterine growth retardation in 2.77% each. Increased blood pressure, edema feet, sudden weight gain, visual changes were main symptoms of PIH in our patients. Primigravida, previous pre-eclampsia, diabetes mellitus, chronic hypertension, obesity and large placenta were found to be as major risk factors of PIH. HELLP, convulsions and pulmonary edema were recorded major complication of PIH

Intracervical PGE2 gel for cervical ripening and induction of Labour

The objectives of the study were to evaluate the efficacy of interacervical gel as a cervical ripening agent in the unfavourable cervix. The changes in the Bishops score, onset of labour and its progress were secondary outcome measures. Fifty patients were enrolled in this prospective study conducted in Gynae "A" unit of Khyber Teaching Hospital, Peshawar from January to December 2004. Patients with singleton living fetus, cephalic presentation, gestational age of >36 weeks completed were included. Half milligram [0.5mg] of prostaglandin E2 gel intracervical was used for intracervical application. The application was repeated after 6-12 hours if the Bishop score remained unfavourable i-e < 5. The indications were postdates pregnancy [50%], PIH [18%], Diabetes Mellitus [18%] and Rh isoimmnization [6%]. The success rate in terms of vaginal delivery was 82%. The lower segment caesarean section rate was 18%. The commonest indication for caesarean section was failure to progress. The complications side effects were minimal and the neonatal outcome was good. This study showed that intracervical application of prostaglandin E2 gel is effective, safe acceptable method for ripening of cervix in women with unfavourable cervix

Reproductive Health ststus of women in NWFP

NWFP and Balochistan provinces are considered to be less developed provinces as compared to other provinces of Pakistan. Due to social setup women in NWFP have less access to education, job and other facilities as compared to women in Punjab and Sindh province. A survey for comparative study is done to see the status of women as a whole and in different category of women like educated and non educated women

Microflora in pregnancy

Three hundred high vaginal swabs from pregnant women were cultured to investigate the vaginal flora during pregnancy. Two hundred swabs obtained from a private clinic were cultured aerobically for bacteria only; the remaining 100 from antenatal clinic of Khyber Hospital Peshawar were cultured both aerobically and anaerobically for bacteria and fungi [candida]. Vaginal smears from patients in antenatal clinic were also examined for the presence of Trichomonas vaginalis.The organisms isolated were streptococcus faecalis, Escherichia coli, staphlococcus aureus, streptococcus agalactiae pseudomonas aeruginesa and Candida albicans. Candida albiicans was the most common organism isolated. Staphlococcus epidermidis was the only pathogenic growth obtained. Trichomonas vaginalis was observed in only 5 mears. The only anaerobic growth was that of gram positive cocci