Infertility: still an enigma; an overview of infertile couples in outpatients of gynae

[1] To find out the major causative factors in primary versus secondary infertility in study group. [2] To suggest an easy plan of investigation for an infertile couple. Descriptive study. Gynecology and Obstetric Unit in Independent University Hospital, Faisalabad. Two years from Jan 2008 to Dec 2009. Convenience sample technique was used to collect the patients. Anovulation had contributed 20% in primary infertility and 16% in secondary infertility. Tubal factor was more common in secondary infertility. Male factor was 40% in primary infertility and 16% secondary infertility. Counseling, reassurance and efficient, timely and appropriate management plan is essential to minimize the distress of infertile couples

Multiple Pregnancy; frequency of maternal and fetal complications

To determine the frequency of maternal and fetal complecation in multiple pregnancy. Observational study. In the department of obstetric and gynecology unit I Allied Hospital Faisalabad. One year from 22-07-2003 to 22-07-2004. Fifty patient included in the study. These patient's were examined throughly and relevant information recorded in a performa giving detailed history, clinical examination, investigations and type of management. Anemia was the most common prenatal complication followed by preterm labour, PIH and preeclampsia PROM in 8 patients, IUGR in one patient. The most common intrapartum complication was postpartum hemorrhage followed by retained placenta cord prolapse and shoulder presentation. About 12 babies required admission and perinatal deaths occurred in 9 twins. Multiple pregnancy are at high risk of antipartum and intrapartum complications. The study also proved that multiple pregnancy associated with increased risk of anemia preterm labour, PIH preeclampsia, IUGR and postpartum hemorrhage and also associated with increased perinatal mortality and morbidity

unusual presentation of pelvic tuberculosis

Tuberculosis is highly prevalent in developing countries like Pakistan and should be considered in the differential diagnosis of patients with pelvic mass, ascites and raised serum CA 125 levels. A case of pelvic tuberculosis with markedly raised serum CA 125 levels and initial diagnosis of ovarian tumour was made

Congential adrenal hyperplasia

Congenital Adrenal Hyperplasia is the most common cause of female intersex and is an autosomal recessive disorder resulting in enzyme deficiency 21-hydroxylase. The case series describes three such cases that are investigated and managed at Independent University Hospital Faisalabad

Myomectomy done during caesarean section

To evaluate the outcome of myomectomy during caesarean section. A retrospective study. Gynae unit I, Allied Hospital Faisalabad. Period: From 2001 to 2002. A total of 40 patients attending gynae unit I of Allied Hospital having pregnancy with fibroid were included in the study. A special consent was taken from the patients for performing myomectomy. A performa was used to collect the data regarding maternal morbidity and mortality and perinatal outcome, the results were then analyzed. It was seen in this study that in 28 patients the duration of hospital stay was 7-10 days which is not more than the stay during caesarean section. It was only in 02 patients the stay was more than 10 days. Regarding blood transfusion in 90% of the cases required only two pint of blood during operation. Regarding blood loss in 20 patients it was only 500m1. The loss was more than 1000 ml in only 04 cases. Perinatal outcome. The outcome was satisfactory and th e babies weight corresponded with the gestational age

Full term secondary abnominal pregnancy

In properly evaluated patients full term abdominal pregnancy can be managed, although advanced abdominal pregnancy is a complex condition demanding challenging management. This care report describes case of a young lady 35 years age who was diagnosed as a case of secondary abdominal pregnancy and was managed successfully

Sub mucous fibroids [Effective surgical approach]

One case of removal of 34 submucous fibroids is presented because of its rarity

Maternal mortality; a neglected tragedy

More than half a million maternal deaths occurred worldwide each year and 98% of these are in developing world. The objectives of the study were to calculate maternal mortality rate and determine the major causes of maternal mortality. A prospective study. Department of Obstetric and Gynaecology Unit-I, Allied Hospital, Faisalabad from 01.01.2002 to 31.12.2002. All maternal deaths during this period were included after taking detailed history and examination. There were total 25 maternal deaths and Maternal Mortality Rate [MMR] was 557/100,000 live births. The main causes were hemorrhage, septicemia and eclampsia. To achieve the objective of reduction in MMR, we must enhance emergency obstetric care with the adoption of the fast referral system particularly in the far-flung rural areas of Pakistan

Role of PGF2alpha in mid trimester termination of pregnancy

Objectives: To find out the efficacy of extra-amniotic PGF2alpha for termination of pregnancies in 2[nd] trimester when the uterus is very unresponsive to the action of oxytocin Design: A retrospective study

Place and Duration of Study: Obstetrics and Gynecology Unit I Allied Hospital Faisalabad from 01.01.2000 to 30.06.2001

Patients and Methods: Fifty patients who were admitted in Obstetrics and Gynaecology inpatient department as a case of missed abortion, IUD congenital abnormalities, incomparable with life PR. Prom. These patients were analyzed in great details regarding history, clinical examination and investigations. We used PGF2a extra amniotically

Results: All the patients expelled the fetus and placenta safely with no adverse effects on mother. None of our patients required hysterectomy

Conclusion: It is highly effective, simple safe and convenient method of midterm termination of pregnancies

Antenatal fetal surveillance [AFS]

With the advent of modern equipment and testing systems, antenatal fetal surveillance is helpful in reducing perinatal mortality and morbidity by deciding upon the time and mode of delivery. The commonly used tests are non stress test [NST], amniotic fluid index [AFI], biophysical profile [BPP] and oxytocin contraction test [OCT]

review of ectopic pregnancy in DHQ hospital Faisalabad

Ectopic pregnancy is a life threatening condition which poses a difficult diagnostic challenge because of varying modes of presentation. I. To evaluate various aspects of patients admitted with signs and symptoms suggestive of ectopic pregnancy. II. To highlight the fact that our patients still attend late resulting in high morbidity. III. To arrive at an early diagnosis in the patients who seek early consultation. DESIGN: Case study SETTING: Gynaecologic unit of DHQ Hospital Faisalabad between September 1993 and January 1995. SUBJECTS: Thirty seven patients with suspected ectopic pregnancy. Seventeen patients were diagnosed as ectopic pregnancy, giving an incidence of 1 in 250. Total number of deliveries during this period was 4161. MANAGEMENT AND The predisposing factors, signs and symptoms and various diagnostic tests were evaluated. All patients underwent laparotomy but conservative surgical procedure in the form of linear Salpingostomy was only possible in one case. CONCLUSIONS: Early diagnosis requires careful clinical evaluation and use of multiple modalities and it is essential for proper management

Incidence of rupture uterus at DHQ hospital Faisalabad

This study was carried out at DHQ hospital Faisalabad during the period of 18 months from Jan. 1991 to June 1992. Total 3916 deliveries were conducted in this period. There were 35 cases of uterine rupture. Incidence of rupture uterus was 0.89%. Almost 80% of the patients of rupture were unbooked. About 48.57% of the patients were more than para-5. 63% [22] rupture uterus occurred in unscarred uterus and 37% [13] in scarred uterus. 88.58% of the rupture occurred during labour. Majority of which was of more than 24 hours duration. Scar dehiscence was found in 3 cases. In about 63% of the patients, oxytocin drug was misused. Lower segment was the most common site of rupture [88.57%]. Hysterectomy had to be performed in 68.57% of the patients. Post operative complications were more in the unscarred group of patients. Maternal mortality of 14.28% and foetal mortality of 82.85% due to rupture uterus was found in this study which is a significantly high figure

Incidence of cervical intraepithelial neoplasia in Faisalabad

During the period of 18 months from Jan 1991 to June 1992, total of 1300 women were subjected to cervical smear test; 1282 smears were technically adequate for cytological study; 62, [4.84%] smears were positive. Positive cervical smear was most prevalent in women having average age 43.41% years and average age at marriage 18.18 years. Average gravidity of women having positive smear was 7.22. Out of 62 positive cervical smears 19 turned out to be false positive on histology of the biopsy specimen, 33 had Cervical Intraepithelil Neoplasia [CIN] one had invasive cervical cancer while 9 patients did not come for follow up