Obstetrics hysterectomy-five years experience at Jinnah postgraduate medical centre, Karachi

During the five years period [1st] January 1988 to 31st December 1992], 106 hysterectomies were performed for obstetric indications in the Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre [JPMC], Karachi. The frequency was 1 in 331 deliveries [total 35.172 deliveries]. In all except one hysterectomy was performed as a life saving measure. The major indications were rupture uterus in 61 [58%] cases and severe postpartum haemorrhage due to uterine atony in 18 [17%]. Other indications included haemorrhage due to placenta praevia in 11 [10%], placenta accreta 7 [7%] and abruptio placentae 5 [5%], severe infection 2 [2%] and broad ligament haematoma following caesarean section 1 [1%]. There were 10 [9%] maternal deaths all due to severity of the conditions necessitating hysterectomy. Obstetric hysterectomy can save many lives but requires proper judgement and skill. Senior resident staff in obstetric units in the developing countries should be trained for it

Frequency of chlamydia trachomatis in pregnant women

Frequency of chlamydia trachomatis infection was investigated in eighty-five pregnant women by direct immunofluorescence [IF] and iodine staining methods. The overall frequency of true positive by both methods was 8.2%. Direct immunofluorescence method alone detected chlamydia infection in 16.5% women with 50% sensitivity and 93% specificity and by iodine method in 14.1% women with 58.3% sensitivity and 90.4% specificity. This shows that as compared to IF iodine method is more sensitive and less expensive and easier to perfrom. The frequency of chlamydia trachomatis infection in our study population appears to be age dependent with younger patients being more likely to be infected than the older patients

Rupture of the uterus in full-term pregnancy

Of 48,519 deliveries conducted at Jinnah Postgraduate Medical Centre [JPMC] over 7 years [January, 1986 to December, 1992], 257 were of ruptured uterus, giving a rate of one in 189 deliveries. Main cause of rupture was obstructed labour. Maternal mortality was 3.9% and foetal mortality 88% in cases admitted with uterine rupture and 17.6% in rupture occurring within the hospital

Dietary and serum calcium in pregnant women

Dietary and serum calcium were estimated in 200 normal pregnant women between 37-41 weeks of gestation and in cord blood of their new born. Calcium intake per person per day was low, 11.8mmol/L, as compared with the daily recommended allowance of 30 mmol/L Mean maternal serum calcium level was also low [1.9 mmol/L] and only 20% of mothers had serum calcium within normal range. Mean calcium value in cord blood was at lower limit of normal range, being 2.3 mmol/L; 38.5% of cord samples [77] were below the normal range

Perinatal mortality in Jinnah postgraduate medical centre, Karachi

During the one year period from 1 st January to 31 st December, 1989, there were 6,826 deliveries and 695 perinatal deaths, of these 553 were still-born and 142 were neonatal deaths [died within 7 days of birth]. The perinatal mortality rate was 101.8 per thousand total births. The still-birth rate was 81 per thousand total births. Of the perinatal deaths, 7.9% occurred in booked and 92.1% in non-booked cases. The commonest cause of death was antepartum haemorrhage [APH], 24.2% followed by mechanical which accounted for 23.6% deaths. Abruptio placentae was the leading cause among all still-births and low-birth weight [LBW] in all neonatal deaths

Serum calcium, urea and uric acid levels in pre-eclampsia

Serum calcium, urea and uric acid levels were determined in 100 normal pregnant women and 50 patients with pre-eclampsia. Serum calcium levels were significantly lower and urea and uric acid levels higher in pre-eclampsia. Low levels of calcium were found as early as 28 weeks and can therefore be used for early diagnosis of pre-eclampsia