Effects of obesity on pregnancy and its outcome

The objective of study was to find out adverse effects of obesity on pregnancy. A case - control study comparing outcome of pregnancy in obese women with a control group of non obese. Obstetrics unit of Military Hospital Rawalpindi from 20th December 2004 to March 2006. The study included 100 obese ladies with body mass index [BMI] 28-35 and 100 non obese ladies with BMI 18-25. Pregnancy in obese women associated with increased risk of complications. These women had a higher frequency of pregnancy-induced hypertension [RR 1.75; 95% CI 1.08 - 2.81] and gestational diabetes mellitus [RR 3.0; 95% CI 1.13 - 7.94], a higher cesarean section rate [RR 1.78; 95% CI 1.91 - 2.67], increase in postpartum hemorrhage [RR 3.50; 95% CI 1.19 - 10.27] and higher babies weight [RR 2.83; 95% CI 1.50 - 5.15]. This study concluded that obese woman were at high risk of antepartum, intrapartum and postpartum complications with an increased risk of operative delivery

Abdominal sacrocolpopexy vs vaginal sacrospinous ligament fixation for vaginal vault prolapses

To compare the success rate and outcome of two operations for vaginal vault prolapses-Vaginal Sacrospinous Ligament Fixation [SSL] versus Abdominal Sacrocolpopexy [SCP]. Prospective randomized controlled trial. Department of Obstetrics and Gynaecology CMH Peshawar between Jan 99 to Sep 2003 and Department of Obstetrics and Gynaecology MH Rawalpindi between Sep 2003 to Feb 2008. Thirty Women were randomly allocated to either procedure. There were a total of 15 patients in either arm. Follow up was at 3 and 6 months. Thirty women with vault prolapse were selected and out of these, 15 each were randomized to SSL and SCL. The mean age of women was 54 years [range 42-70], mean weight 68 Kg [range 50-95 Kg], the duration of surgery was longer for SCP [46.1 versus 75.3 min, [p<0.001] versus SSL. Average blood loss was also more for SCP versus SSL [320.2 versus 407 ml [p<0.001]. Post operative hospital stay was less for SSL [3.4 days] versus SCP [6.1 days] [p<0.001]. Regarding symptoms of persistent prolapse at 3 and 6 months only one patient had symptoms in sacrocolpopexy arm due to cystocoele. There was no evidence of recurrent vault prolapse. Objective assessment of prolapse was superior for abdominal surgery, but patient satisfaction was equal. Anatomical result of abdominal procedure seemed superior with vault mean vaginal length [5.09 versus 6.8 cm [p<0.001], but sexual function was preserved equally in both h arms. SSL is a patient friendly operation with shorter operation time and hospital stay. The anatomical results of SCP seem superior whereas functional results were equal in both arms