RESUMO
Abortion is a sensitive and contentious issue with religious, moral, cultural and political dimensions. It is also a public health concern in many parts of the world. An unsafe abortion is defined as a [Procedure for terminating an unintended pregnancy carried out either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both]. The purpose of the present study was to determine the demographic variables, maternal morbidity and mortality in cases of unsafe abortion. The study was carried out with department of Obs. and Gynae., SIMS / Services Hospital, Lahore, as prospective observational. 87 women presented with complications of unsafe abortion. They were interviewed about their history, the clinical features, period of gestation, method used and qualification of abortionist. The details of management, complications and outcome were also analyzed. The age ranged from 15 to 45 years, teenagers accounted for 11.49% of patients. Mean age is 29 years. 20% were nulliparous and parity ranged between zero to eight. Mainly abortions were conducted by Dais [43%]. Contraception prevalence rate was just 8%. In 70% of patients surgical intervention was required and blood transfusion was needed in almost all patients. Maternal mortality was 16.09% with septicemia being the major cause. Unsafe abortion and its attendant complications is still a problem in Pakistan. Main reasons are unattended pregnancies, low contraception usage and late presentation to the health facilities
RESUMO
Vaginal birth after caesarean section is currently the preferred method of delivery for pregnant women who had previous one lower segment caesarean section. This common practice warrants some reconsideration in light of recent clinical data on the risks associated with VBAC To evaluate conditions which can achieve successful vaginal birth after one caesarean section. Cross-sectional analytic study. Department of Obstetrics and Gynaecology, Unit-l, Services Hospital, Lahore. Study was carried out over a period of six months from 08-06-2006 to 07-12-2006. One hundred pregnant women meeting inclusion criteria were included. During trial of labour patients were closely monitored by vital signs, fetal cardiac activity, lower abdominal pain and tenderness, fetal distress, vaginal bleeding and loss of presenting part. Mean age of the patients was 34.27 + 6.45. According to distribution of cases by parity, maximum number i.e 64 [64.0%] was P 3-6.79 patients [79.0%] had prior vaginal delivery. Maximum 41.0% patients were due to fetal distress while in 28% indication for previous caesarean were breech presentation. In 71% patient membranes were intact while 29.0% patients presented with per vaginal leaking. 51.0% had dilatation between 3-4cm. VBAC was more successful in patients 58.0% with favourable Bishop score. BMI <20, prior vaginal delivery, non-recurrent indication for previous caesarean, spontaneous onset of labour, cervical dilatation or favourable Bishop score, weight of baby < 3.5kg predict an individual's likelihood of successful VBAC