Pattern of perineal tears during vaginal delivery at a public sector university hospital of Sindh

To determine the pattern of perineal tears during vaginal delivery in a tertiary healthcare facility. It is a descriptive study done in the Department of Obstetrics and Gynaecology Unit-I at Liaquat University Hospital Hyderabad, Pakistan from 1st September 2004 to 31st August 2005. Women with full term singleton pregnancy either primi or multigravida, in active labour were selected for the study. An informed consent was taken from all the participants. Twin pregnancy and ante-partum haemorrhage were excluded Age, parity, type and degree of tear, mode of delivery, birth weight of baby, birth attendant, risk factors and complications were noted. There were 2563 deliveries, 256 patients had some degree of perineal injury giving a frequency of 9.9%. Out of them, 100 patients were selected, 37[37.0%] of multiparous and 63[63.0%] of primiparous sustained some degree of perineal injury. A higher incidence of first and second degree tears were noted and incidence was found to be more when vaginal delivery was conducted without episiotomy and fetal weight was more than 4kg. However duration of labour, perineal support, presence of perineal edema and experience of the birth attendant were important risk factors. Obstetric perineal tears are common as depicted by the high frequency in this study. Lack of perineal care, poor socio-economic conditions, poor intra-partum care with lack of experience were found to be contributing factors in the occurrence of perineal tears

Hysterectomy following tubal sterilization

In a study of two hundred patients undergoing hysterectomy for non-malignant conditions 58 patients [29%] had previous tubal sterilization. In most of these patients the gynecological problem necessitating hysterectomy antedated the sterilizing procedure. Proper counselling, through examination and investigation should be carried out prior to tubal sterilizatoin to exclude any underlying gynecological disorder. The aim of this study was to attempt to identify circumstances where two operations could have been avoided by consideration of any possible indication for hysterectomy at the time when initial sterilization was requested

Clinical experience in the use of prostin E2 [Dimoproston] vaginal tablet in obstetric department, Liaquat medical college hospital

Prostaglandins are now widely used in Obstetrics for terminating pregnancy at any stage of gestation. The efficacy and acceptability of protaglandin E and vaginal Tablet was assessed over a period of one year in 120 patients aged 1 4-42 years. The object was to achieve delivery, preferably vaginally. One hundred and ten patients delivered vaginally and 10 needed operative delivery. This preparation was well tolerated with minimum side-effects. The use of Prostin E2 vaginal Tablet is strongly recommended because of its high efficacy, acceptability and minimum patient interference

Perinatal mortality at Liaquat medical college hospital

Perinatal Mortality is a reflection of the standard of obstetric care available to the population. A retrospective study was carried out and perinatal deaths occurring over a period of one year were analyzed. Illiteracy, poverty. lack of antenatal care, poor transport facilities and inadequate treatment were the major factors found to be responsible. The perinatal mortality was found to be 145.24/1000 birth