Grandmultiparas; frequency of hypertension placental abruption and postpartum haemorrhage in

Intrapartum complications that are classically associated with grandmultiparas include fetal malpresentation, dysfunctional labour, chronic hypertension, abruptio placentae, postpartum haemorrhage and macrosomic babies. Excellent maternal and fetal outcome is possible in grandmultiparas with improvement in health care system and free provision of health facilities to all pregnant women. The objective of the study was: to find the frequency of hypertension, placental abruption and primary postpartum hemorrhage in grandmultiparas. It was a prospective study with descriptive pattern. Gynaecology and Obstetric unit-I of Allied Hospital, Punjab Medical College Faisalabad. January to June 2006. Eighty patients were included in the study. Eighty grandmultiparas were randomly selected for the study. Detailed evaluation of all patients was done by thorough history, examination and investigation. Patients were analyzed for complications during pregnancy, labour and delivery, especially hypertension, placental abruption and primary post partum haemorrhage. Hypertensive disorders found to be in 32 [33.8%], placental abruption in 7[8.8%] and postpartum hemorrhage in 19[23.8%] of grandmultiparas. It was concluded from the result of my study that grandmultiparity is still a major obstetric hazard in developing countries like Pakistan with higher incidence of complications. Safe maternal and perinatal outcome is possible in grandmultiparas with improvement in health care system and free provision of health care facilities to all pregnant women

Major degree placenta praevia; frequency of risk factors, complications and perinatal outcome

Placenta praevia is a major cause of maternal and fetal morbidity and mortality. It is a major cause of obstetrical haemorrhage in second and third trimester of pregnancy. Placenta pravia usually presents with antepartum haemorrhge and as a source of maternal morbidity, it remained a significant cause of hospitalization and caesarean section. The study was carried out to see the frequency of risk factors, maternal complications and perinatal outcome in major degree placenta praevia. I]. To Find out major risk factors and maternal complications in major degree placenta praevia. II]. Know perinatal outcome in major degree placenta praevia. It is a descriptive study. Patients were selected by simple random sampling techniques. The study was carried out at Gynae Unit-I, Allied Hospital, Faisalabad from March 2005 to February, 2006. Seventy five patients selected for the study after fulfilling the inclusion criteria for major degree placenta praevia. The included patients were examined thoroughly and relevant information was recorded into proforma giving detailed history, clinical examination, investigation and management. In this descriptive study, total 75 patients were included as a diagnosed a case of major degree placenta praeiva. There were 15 patients presented asymptomatically and the rest of 60 patients were symptomatic. Out of 75 patients, majority of the patients belonged to the age group of 24-35 years. The mean age was 31.5 years. 2 patients expired due to massive PPH, 10 patients underwent obstetrical hysterectomy. In these 10 patients, 3 patients had placenta accrete, 1 patient had placenta increta and 2 had placenta percreta. Predisposing factors were previous gynaecological operations in 15 patients, history of previous C-section in 14 patients, history of previous placenta praevia 8 patients, advanced maternal age 5 patients and history of myomectomy in 3 patients. The remaining 39 patients had no predisposing risk factor. The mean gestational age was 36 weeks. 57 babies were delivered by emergency C-section and the remaining 18 patients underwent elective C-section. Live birth account was 66. Out of 75 babies, 9 babies were IUD, 48 were preterm, 17 were IUGR, 25 babies were having RDS and 3 babies were abnormal congenitally and 13 perinatal deaths occurred. Significant improvement in the neonatal care should be achieved in our tertiary environment to improve expected survival rate together with a reduction in overall morbidity for the premature new born

Gynaecological hysterectomy; indications, morbidity and mortality at a tertiary care hospital

The aims of study are [1]To make an audit of hysterectomies by either route in a teaching hospital.[2]To determine the morbidity and mortality associated with this procedure. Descriptive study. Gynae and Obstetrics units, Independent University Hospital Faisalabad. From 1-1-2006 to 31-12-2008. Retrospective collection of data by convenience sample technique. 27% cases were due to fibroids, 22% were due to uterovaginal prolapse, 19% [DUB], 13% [chronic PID]. The complications were 28% [UTI] by abdominal route and 13.3% were by vaginal route, 26.6% wound infection and 2.6% in vaginal hysterectomy, rest of complications were comparable by both routes. Vaginal hysterectomy has more promising results but is reserved for specific indications