Rectal misoprostol versus intravenous oxytocin in the active management of the third stage of Labour

Objectives: Postpartum hemorrhage [PPH] at third stage of labour may cause maternal morbidity. This study compared efficacy of rectal misoprostol and intravenous oxytocin in the active management of third stage of labour

Methods: The study involved 188 subjects in two groups. Group A was given Misoprostol 800microg rectally and group B was given oxytocin 10IU intravenously at the delivery of anterior shoulder of the baby

Results: The amount of blood loss was >500 ml in 12 patients in which 8 [8.5% from group A] were from group A and 4 [4.3%] were from group B. The frequency of PPH was statistically same in both study groups [P value = 0.62]. The mean change of Hb in group A was 2.71 +/- 0.15 g/dl and in group B 9.10 +/- 1.23 g/dl

Conclusion: Results suggested that I/V oxytocin is more effective compared to rectal misoprostol for the active management of the third stage of labour

experience of ovarian cysts/ tumors over a period oftwo years

Objective: To observe the various presentations,clinical course and outcome of patients presentingwith ovarian cysts/ tumors

Study Design:Observational study

Study Period: March 2010-March 2012

Setting: Department of Obstetrics andGynaecology, Punjab Employees Social SecurityHospital [PESSI], Islamabad

Methods: Thirty onepatients presented in Gynae department with ovariancyst/ tumor or incidentally found to have a cystduring work up for other problems were included inthe study. Their clinical presentations, associatedproblems, course of their management and outcomes were observed. The histopathology reports ofthe surgically managed patients were also collectedin the data

Results: Most of the patients were inreproductive age group and multipara. Thecommonest presentation was acute abdominal painin 12 [38.70%] patients, followed by chronic pelvicpain in 7 [22.58%] patients, menstrual problems in 4[12.90%], patients and postmenopausal bleeding in3 [9.57%]. two [6.45%] patients were incidentallyfound to have complex ovarian cysts during work upfor infertility. Another 6.45% patients presentedwith enlarged ovaries with multiple clear ovariancysts as a result of ovulation induction. Two patientshad adenocarcinoma. Out of them, one presentedwith recurrence. Corpus luteal cyst was thecommonest histopathological diagnosis [55%],followed by endometrioma [44%]. Ten patients[32.25%] were managed conservatively, whilesurgery was performed in 21 [67.75%] patients

Conclusion: Ovarian cysts are common inreproductive age group. Most of them are benignand respond to conservative management, providedthey are clear, with no signs of acute complicationsin these cases. Unnecessary surgery can be avoidedwith proper monitoring and selection of patients.Surgery is mandatory however in post- menopausalage group because of increased chances ofmalignancy

Quality of antenatal care provided at social security hospital, Islamabad

To assess the quality of antenatal care provided to pregnant women in our set up at social security Hospital Rawalpindi. Sectional. Department of Obstetrics and Gynaecology, Social Security Hospital, Islamabad from October to December 2011. Women attending the antenatal OPD were interviewed using a pre tested semi structured questionnaire. A total of 285 women were included in the study. They were interviewed at their first antenatal visit. Mean age of study population was 30 years and parity ranged from 0- 7. Majority were house wives and had their monthly family income less than 10,000 Rupees. Majority of the patients'were multigravidas. All [100%] patients were looked after by doctors in Out- Patient Department [OPD]. About 34.78% patients were educated about complications of Labour. Only 16.84% and 28.42% patients got advice about antenatal exercises and episiotomy care respectively. More than half [56.8%] patients were counseled for delivery in hospital, 26.31% patients were given contraception advice. About 57% received specific dietary advice for pregnant ladies and 45.26% were told about importance of breast feeding. Our study concluded that adequate antenatal care does not mean merely establishment or improvement of health centers or antenatal clinics, adequate supply of medicines and reducing waiting time, but italso involves education of pregnant women about good antenatal care and different health related issues