Antenatal screening for hepatitis B and C virus infection in pregnant women in a tertiary care hospital of Rawalpindi

To determine the frequency of Hepatitis B and C virus infection in pregnant women and to assess whether it is more common in multigravida as compared to primigravida. A Descriptive Cross Sectional study carried out in the out patient department of Gynaecology and Obstetrics department of Military Hospital, Rawalpindi from August to October 2010. An open and close-ended questionnaire was self designed for this purpose. Data relating to medical, surgical, gynaecological and obstetric history, with particular references to hospital admissions and intravenous interventions was collected through convenience sampling. One hundred and forty pregnant women were questioned. The age of patients varied from 21 to 45 years [mean 28.66 years]. Out of 140 females, 44 [31.4%] females were primigravidas while 96 [68.6%] were multigravidas. Eight [5.7%] females were found positive for HBsAg and 18 [12.8%] were found positive for HCV antibodies by third generation ELISA. It was observed that 0% primigravida and 8.3% cases of multigravida were HBsAg positive cases [p = 0.049]. Frequency of HCV was 4.5% in primigravidas and 16.7% in multigravidas [p = 0.047].Various risk factors like, history of blood transfusion 27.1%, and IV injection 91.4%, were identified. The hepatitis B vaccination rate was only 24.3%. The frequency of Hepatitis B and C infection was 5.7% and 12.8% respectively in pregnant females as compared to the general population. The multigravidas were at a higher risk of HBV and HCV exposure than primigravida

effect of hyoscine butylbromide on 1st stage of labour in term pregnancy

To determine the effect of hyoscoine butylbromide in shortening active phase of 1st stage of labour without adverse effects in mother and fetus. Randomized, double-blinded placebo controlled trail. Labour ward of PNS SHIFA hospital for duration of 06 months from 1st Jan 2008 to 30 June 2008. One hundred pregnant women both primigravida and multigravida in active phase of spontaneous labour [an active phase is defined as 3 cm or more cervical dilatation with regular uterine contraction] were included in the study. Either drug or placebo was given intravenously once the women entered active labour. Progress of labour was plotted on partogram student 't' test was applied for comparison for two groups. The duration of 1st stage of labour was main outcome. Secondary outcome measures included duration of second and third stages of labour, blood loss at delivery, and apgar score in neonates between the two groups. In patient receiving hyocscine butylbromid the active phase of 1st stage of labour was 194.8 +/- 87.3 mins as compared to placebo group where active phase 1st stage of labour was 282.3 +/- 92.3. There was significant difference in duration of active phase 1st stage in both groups of [87.5 mins], there was no significant change in duration of second and third stage of labour, no difference in blood loss, and apgar score in both groups. Hyoscine butybromide is effective significantly in reducing duration of 1st stage of labour in primigravida and multigravida with term pregnancy and it is not associated with any adverse out come in mother or neonate

study of the etiology and management of post partum haemorrhage, at Nishtar medical college and hospital, Multan

The main objectives of present study were to determine the incidence and to identify the various etiological factors of primary post partum hemorrhage [PPH] at Nishtar Hospital Multan. We also aimed to review various management options for better outcome and to compare the results with international literature. Descriptive study. The study was conducted at the department of obstetric and gynaecology, Nishtar Medical College from October 2000 to September 2001. The study included all the cases presented with primary admitted at Nishtar Hospital Multan either delivered at Nishtar hospital Multan or outside. All the patients who suffered from PPH were thoroughly interviewed and examined according to the study protocol. A total of 3000 cases admitted in Nishtar Hospital Multan during the study period. Out of these 2100 [70%] were vaginal deliveries and 900 deliveries were caesarean section out of these 117 [3.9%] patients developed PPH. Among the etiological factors most common were; uterine atony 48%, and retained placenta 34%. Most successful management strategy was early use of uterotonic agents [68%]. Despite good antenatal care, better health services, early detection of problem, availability of new pharmacological agents and introduction of different surgical options, PPH is still, a major complication of third stage of labour responsible for a high maternal morbidity and mortality