RESUMEN
Maternal mortality remains a great challenge to health systems in developing countries. Reliable maternal mortality rate in Pakistan is not exactly known. The estimated range of maternal mortality is 190-1700 deaths per 100,000 live births. Our objective was to find out the maternal mortality rate and its main causes in a tertiary care centre in Faisalabad. This is an observational descriptive study. Maternal death which took place in Gynaecology Unit of Allied Hospital/Punjab Medical College Faisalabad from April 2006 to March 2010 were included in this study. Accidental incidental maternal death, patients with medical and gynecological problems and those beyond 42 days post partum were excluded. Total of maternal deaths during these four years was 168 in 24667 births with MMR of 6.81/1000. The common causes of maternal deaths were obstetrical hemorrhage in 58[34.5%], hypertensive disorders in 31[18.45%], puerperal septicemia in 23[13%] and unsafe abortion in 20[11.9%]. Other direct causes were found in 12 [7.1%] patients. One forty eight [88.09%] patients belonged to uneducated class, 110[65.48%] from rural area whereas 95[56.5%] hadn't received any antenatal care. High MMR [Maternal Mortality Rate] can be prevented with timely and proper antenatal and post natal facilities
RESUMEN
To determine the frequency of cervical intraepithelial neoplasia [CIN] with papanicolaou [PAP] smear and identifying the disease in premalignant phase, thus preventing the development of invasive cancer. Observational type of study. Outpatient department of Obstetrics and Gynaecology of Allied Hospital, Faisalabad from Jan. 2003 to Dec. 2003. All the patients attending the Gynae outpatient department at Allied Hospital, Faisalabad with Gynaecological symptoms were subjected to a detailed history, examination and then underwent papanicolaou smear cytology with wooden Ayers Spatula. Patients having vulvovaginitis, menstruation and obvious cervical growth were excluded. The smear was sent to College, Faisalabad. A total of 500 patients underwent cervical cytology. 47 patients [9.4%] showed positive smears, while 453 patients [90.6%] were negative for cytology. Out of 47 patients 22 [46%] were found to have CIN - I, 13 [27%] CIN - II, 8 [17%] CIN - III and 4 patients [8.5%] showed invasive cancer. Majority of patients [51%] with positive smear were between ages [35-44 years], grand multiparous, presented with abnormal vaginal discharge and belonging to lower social economic status. Study shows that our population have significant number of premalignant cervical disease. So screening with pap. smear should have wide application all over the Pakistan to reduce the incidence of cervical cancer
RESUMEN
To detect and treat complication of illicit abortions along with status of abortionist and method used by them. Descriptive study. Department of Gynae and Obstetrics, Allied Hospital, Faisalabad. March 2002 - February, 2003. 50 patients selected either married or unmarried and evaluated for illicit induced abortion performed by untrained personnel and methods used by them. Out of 50 patients, 45 were married and 5 were unmarried. The reasons for termination were illegitimate pregnancy in 7 cases, decreased spacing in between pregnancy in 32 cases and grand multiparity in 11 cases. In 37 patients dilatation and curettage was used as method for termination of pregnancy. In remaining 13 patients methods used were metallic sharp instruments, medicines [herbal/allopathic] and IUCD insertion. 37 patients presented with acute abdomen ended up in emergency laparotomy. 9 patients were treated by curettage only. 2 patients were managed conservatively. 5 patients died due to septicaemia. Illicit induced abortion is a major public health issue. Results highlight the magnitude of the induced abortion and its consequent morbidity. Further more, it also indicate that health care providers, irrespective of legality issues, provide such services on demand. Illicit induced abortion and its complications can be avoided with better and easy provision of contraceptive measures and family planning resources