Molar pregnancy - experience at a tertiary care hospital of South Punjab

To determine the frequency, clinical presentation and management outcomes of molar pregnancy. Descriptive cases series. Department of Obstetrics and Gynaecology Unit-II. Bahawal Victoria Hospital, Bahawalpur, from January 2005 to December 2007. The case records of all the gestational trophoblastic cases during the study period were analyzed regarding their history, clinical examination, investigations, treatment and follow up. The main outcomes were measured in terms of duration, antecedent pregnancy, investigations, treatment and follow up. There were a total of 21499 admissions during study period which included 54 cases of molar pregnancy. Hence frequency of Molar pregnancy was 2.5/1000 pregnancies. Most of the patients belonged to the extremes of ages. Most common presenting complaint was bleeding per vagina in 39[72.2%]. Out of 54 patients, suction evacuation was done in 51[94.4%] patients and in only 3[5.5%] patients, ended up in hysterectomy. Forty one [75.9%] patients received no adjuvant therapy, 13[24.1%] received chemotherapy. Among all 54 cases, 51[94.4%] patients fully recovered and 3[5.6%] died because of extensive disease and reported late. In this series, frequency of molar pregnancy was as equal as in different parts of the world. Proper management in the early stages influences the outcome of the disease. Hence the key point of whole discussion is to detect the disease in early stage to decrease the mortality and morbidity of patients

Sacrocolpopexy "gold standard" for vault prolapse

To evaluate and compare the efficacy, blood loss, operative time and complications with the use of Prolene thread vs. Rectus Sheath. Cross sectional, analytical study. Department of Obstetrics and Gynaecology Unit-II, Bahawal Victoria Hospital, Bahawalpur from Jan 2000 to Dec 2007 [eight years]. All the cases of vault prolapse during the eight year study period were included and booked from the out patient and emergency department of BVH. A total of 40 cases were divided into two group. Group A having 20 patients who were managed by prolene No.1 and Group B also containing 20 patients managed by rectus sheath. All cases were analyzed regarding their complaints, preceding operations, clinical examination, investigation, treatment and follow-up. Total 40 cases were analyzed. It was found that no recurrence was seeen in Group A [with Prolene Thread]. The blood loss was minimal, operative time range was only 0.5 to 1 hour. It was very economical whereas in Group B, Two patients had recurrence of complaints "Mass coming out of vagina [10%]. Time required to remove rectus sheath strip to complete the procedure of sacrocolpopexy was 1.5 to 2.5 hours in Group B. Blood loss was more in Group B than Group-A. Two patients [10%] had incisional hernia. Equal no of patients in each group had low persistant backache. Sacrocolpopexy is gold standard procedure for the treatment of vault prolapse. If it is performed with the help of prolene, give excellent results