beta-lynch suture for the management of postpartum haemorrhage: an experience at Peoples Medical College Hospital

To report our clinical experience of the effectiveness and safety of applying beta-lynch suture for the management of primary postpartum haemorrhage. An observational, cross-sectional study. This study was conducted at the Department of Obstetrics and Gynaecology at Peoples Medical College Hospital Nawabshah from 1[st] January 2009 to 30 [th] June 2010. All the patients of primary postpartum haemorrhage in whom compression and conventional ecobolic had failed to achieve uterine contraction and haemostasis were subjected to beta-lynch suture. beta-lynch suture technique was applied in 33 patients, in 22 patients after vaginal delivery and in 11 patients at the time of cesarean section. This technique was successful in 31 [93.94%] patients and failed in only 2 [6.1%]. Patients who were proceeded to hysterectomy, none of the patient had infection. beta-lynch suture compresses and envelopes the uterus and manages massive life threatening postpartum haemorrhage successfully. It is effective, simple and fertility conserving procedure

Early pregnancy complications and risk factors

To determine the underlying risk factors in early pregnancy complication and outcome. Case series study. This study was conducted in the Department of Obstetrics and Gynaecology at Peoples Medical College Hospital Nawabshah from January 2010 to December 2010. all the women with first trimester pregnancy with different complications were included in this study, while those women with uneventful first trimester were excluded. The included women were registered on pre-designed proforma studied variable including demographic details, gestational period, type of complication, risk factor treatment and outcome. The data was examined in terms of mean and percentage with a confidence interval of 95%. Analysis was done on SPSS version 10. out of 661 total early pregnancy admissions, 309 [46-74%] patients had different early pregnancy of complication. Their mean age was 29.22 +/- 6.22 years. Commonest complications found were abortion in 206 [66.66%] cases. The underlying risk factors found in miscarriage were antiphospholipid syndrome in 8 [3.88%] cases, diabetes mellitus in 35 [16.99%] cases. Hypertension in 50 [24.27%] cases, PCOS in 15 [7.28%] cases and infection in 10 [4.85%] cases. 60 [61.22%] cases were treated by minor surgical procedures and 38 [38.77%] cases treated with conservative medical therapy. Outcome were anaemia in 245 [79.28%] cases, psychological upset in 189 [61.16%], infection in 131 [42.39%] and coagulopathy in 17 [5.50%] cases. Miscarriage was found as the most frequent early pregnancy complication and the most frequent risk factor was hypertension. Outcome included anaemia, psychological upset and infection

Induced abortion - a continuing threat to maternal life

In Pakistan, therapeutic induced abortion is a controversial issue and continued to be a significant contributor of maternal mortality and morbidity. The aim of the present study is to assess the magnitude of septic abortion in a tertiary care hospital over a period of 2 years with special emphasis on maternal mortality and morbidity. This prospective study was aimed to determine the frequency of induced abortion, to know the reason for requesting abortion, assess the associated maternal morbidity and mortality in our setup. Descriptive study. This study was conducted at the Department of OBGY, PUMHSW Nawabshah from 1[st] January 2009 to 31[st] December 2010. Hospital record of patients who were admitted with unsafe abortions in 2 years [2009- 2010] were reviewed to evaluate the demographic and clinical profile in relation to age, parity, marital status, indication and method of abortion, qualification of abortion provider and maternal mortality. Unsafe abortion contributes 4.4% of total patients admitted with abortion over 2 years. Mean age of them was found +/- SD 30.14 + 8.56 and mean parity was 6.07 +/- 3.00. 78.6% patients belong to poor community and > 70% patients were married and used it as a method of contraception. Uterine instrumentation was the commonest method [78%] used to induce abortion. Majority of women were admitted with life threatening complications like haemorrhage [75%], sepsis [53.57%], hypovolumic shock [39.28%] and faecal peritonitis in 21.42%. DIC in 10.71%, uterine perforation in 28.57% and mortality in 4 [14.28%]. 5 [17.85%] were managed conservatively, 13 [46.42%] had re-evacuation, 10 patients had exploratory laparotomy, out of them 2 needed peritoneum toilet, while in 5 patients gut resection and anastomosis and in one permanent colostomy was done. Uterine trauma found in 8 patients [28.57%] in whom 3 [10.70%] ended up in hysterectomy. Unsafe abortion contribute 14.28% of death in study group. The present study conclude that unsafe abortion is a major neglected health issue needs attention and high degree of commitment. Its elimination requires advocacy, policies to support woman right and improving access to family planning services