RESUMEN
To study knowledge, attitudes and practices oft he patients of induced abortion. Descriptive analytical study. This study was conducted from July 2004 to March 2005 in the department of obstetrics and gynecology, Islamic International Medical College, Railway General Hospital, Rawalpindi and Federal Government Services Hospital, Islamabad. The patients who were admitted in the Obstetrics and Gynecology with a history of induced abortion were included in the study. A special questionnaire was designed to explore the reasons which compelled them to undergo this illegal and dangerous procedure rather than using some contraception before. The patients were interviewed by a single post graduate trainee on a pre- designed Performa. The data collected was entered on SPSS- 10 and analyzed. The results were shown in percent. Most of the abortions [66%] were done by dais at their homes, while 28% terminations were done by doctors at their clinics. Majority of the patients [90% and 60% and respectively] were aware of not only the religious and legal implications of abortion but also knew that it could cause great harm to their health, including the fact that it could be fatal. Majority of women [74%] were not using any contraceptive measure for no specific reason.ln majority of patients [92%] it was an unwanted or unintended pregnancy which was terminated. Only 14% of patients showed reservations in using some contraceptive measure like religious position, husband's disapproval or fear of side effects. The problem of induced abortion is not merely a medical problem to be resolved through medical means. Rather it falls into the social norms of people. The physician is supposed to understand the deep seated psychological inhibitions and motives which lead the patient to have [or not have] abortion
RESUMEN
To assess the effectiveness of ECV in singleton breech presentation at term and to determine its effect on maternal, delivery and perinatal outcomes in women to whom the procedure was offered. Aquasi experimental study. The study was carried out in the Department of Obstetrics and Gynaecology, Railway hospital, Rawalpindi, fromAugust2006 to December2008. Eligible women, presenting with uncomplicated breech, between 37-41 weeks gestation, underwent ECV on day care basis. Fifteen minutes before the procedure, injection salbutamol 0.5 mg was administered. Cases with contraindication to ECV or salbutamol injection were excluded from the study. Success rate of ECV [in terms of conversion from breech to cephalic presentation at the completion of procedure confirmed through ultrasound] along with maternal, delivery and perinatal outcomes were assessed. Maternal and fetal demographic characteristics were also recorded as secondary outcome measures. For statistical analysis, SPSS version 10 was used and Chi-square test applied with a p<0.05 taken as significant. Of the 42 ECV procedures, 25 [59.5%] were successful. None of the patient suffered from serious maternal complications. Seven [16.7%] parturients complained of severe palpitations and 4 [9.5%] of marked discomfort during the procedure. Reversible fetal bradycardia was seen in 1 [2.4%] patient. Reversion to a non cephalic presentation occurred in two cases. Vaginal delivery was carried out in 21 patients out of the 25 who successfully underwent external cephalic version while all the patients with failed ECV underwent caesarean delivery. The 5 minute Apgar score was more than 8 in all except one baby. Adverse maternal and fetal outcomes of breech presentation at term are rare and there was no increased risk of complications after external cephalic version. Findings provide important data to quantify the frequency of adverse outcomes that will help facilitate informed decision-making and ensure optimal management of breech presentation