Fetal biophysical profile; as a tool to predict fetal outcome

To evaluate fetal Biophysical Profile as an effective technique for the assessment of fetal condition and to improve fetal outcome by early detection of fetal hypoxia. Co relational study: The study was carried out for a period of one year from Oct 2004-Oct 2005 at Obstetrics and Gynecology Department of Fatima memorial hospital Lahore. All patients with history of sluggish fetal movements and clinical suspicion of IUGR, were underwent BPP from 32-42weeks. 100 patients were selected and their BPP score was recorded and were followed till delivery. Those who went into spontaneous labor and who were induced monitored during labor and at any sign of fetal distress immediate caesarean section performed. APGAR score of newborn was noted at one and five minutes and those having poor APGAR score were resuscitated and were followed till one week after delivery. APGAR score was compared with BPP score, During this study 100 BPP were performed. 34patients were primigravidas and 66 were multigravidas. Among 100 patients 73hada BPP score of 9-10/10,21 patients had a score of 7-8/10 and 6 patients had 4-6/10. In 2 patients with 4/10 score emergency caesarean section led to the delivery of neonates with APGAR score of 8 at 5 minutes. Majority of patients with normal BPS of 8-9/10 had good APGAR score of 7-8/10.0nly 8 patients having BPP of 9-10/10 had poor APGAR score 6/10 or <6/10. The fetal BPP appears to be an effective technique for assessment of fetal condition

Wound infection; prevalence in anaemic women after cesarean section

To evaluate the effects of the anaemia in wound infection after cesarean section. Prospective study. Setting: Department of Obstetric-Gynaecology in Sir Ganga Ram Hospital / Fatima Jinnah Medical College Lahore. Sep 2008 to Sep 2009, The study comprises of 1 00 pregnant women with moderate to severe anaemia. Selected cases underwent cesarean section due to different indications. The rate and frequency of wound infection was observed in all these women. Results were analysed and tabulated. 100 cases with moderate to severe anaemia who underwent cesarean section were included. Moderate aneamia was recognized in 55% of cases and 19% with severe anaemia. Wound discharge was seen in 44% of cases and wound dehiscence was found in 56% cases. Culture was positive in 41% patients and majority of these were unbooked. Non elective cesarean delivery was performed in 99% of cases. The rate of wound infection was very high in moderate to severely anemic women who underwent non elective / emergency cesarean section

Preterm labour; comparison of efficacy of glyceryl trinitrate patch with salbutamol for prolonging gestation for more than 48 hours, 7 days and upto 37 weeks of gestation

To compare the efficacy of Glyecryl trinitrate patch for prolonging gestation for more than 48 hours, 7 days or up to 37 weeks of gestation with Salbutamol in preterm labour. Compartive descriptive study. Fatima Memorial Hospital Lahore. Dec 2003 to Jan 2005. The study was carried out on 60 pregnant patients admitted in hospital with the symptoms and signs of preterm labour. The results were statistically analyzed using SPSS version 8.0. Two groups [Transdermal Glyceryl Trinitrate group and Salbutamol] comprising 30 patients each were made. In Glyceryl Trinitrate group, transdermal patch was applied and in Salbutamol group, Intravenous infusion titrated according to frequency, duration and intensity of uterine contractions. All the patients in each group were evaluated for prolongation of gestation for 48 hours till 37th week of gestation. The mean prolongation of pregnancy was 26 days in GTN group and 32 days in Salbutamol group. The decrease in frequency of uterine contractions by 67.51 +/- 7.74% in first 48 hours of applying transdermal Glyceryl Trinitrate patch and by 80.14 +/- 8.43% in Salbutamol group which was statistically significant. Trinitrate appears to be a safe, well tolerated and non-invasive but less effectives method of suppressing uterine contraction in preterm labour as compared to Salbutamol

Termination of pregnancy; comparison of sublingual and vaginal misoprostol in second trimester

To compare the efficacy of vaginal misoprostal with that of sublingual misoprostol in 2nd trimester of pregnancy by comparing the induction-expulsion interval between two groups of patients induced with vaginal and sublingual misoprostol. Interventional, quasi experimental study. Obstetrics and Gynaecology Unit 1, Sir Ganga Ram Hospital, Lahore. Thirteen months form October 2006 to November 2007. Sixty women at 12-26 weeks of gestation which were selected for termination of pregnancy were assigned into two groups. Thirty women received sublingual misoprostol and thirty women received vaginal misoprostol. Dosage regimen was tablet Misoprostol 200 micro g 4 hours apart till expulsion of fetus [maximum 5 doses]. Main outcome measures were: 1. Induction-expulsion intervals 2. Maternal side effects 3. Fever 4. Nausea/vomiting 5. Diarrhea. Mean induction-expulsion interval in vaginal group was 11.8 +/- 8.3 hours and in the sublingual group was 12.8 +/- 8.5 hours. Percentage of complete expulsion was 53.3% in both groups. Cases of failed induction in vaginal group were 10% and in sublingual group were 13.3%. One case [3.3%] of fever and two cases [6.6%] of vomiting were observed in sublingual group and one case [3.3%] of vomiting was observed in vaginal group. Both routes appear to be equally efficacious for mid trimester pregnancy termination, without significant side effects

Risk factors for hepatitis C virus; obstetrics patients

To find out risk factors for hepatitis C infection in obstetric patients in a teaching hospital. Observational study. At Sir Ganga Ram Hospital, Lahore during a period of one year. Cases of hepatitis C infection, diagnosed on the basis of screening for antibodies for Hepatitis C were included in the study. A proforma was designed and details of each case including maternal demographics and associated risk factors were entered. Fifty three obstetric patients were positive for Hepatitis C virus antibodies in one year of study period. Majority of women were among 25-29 years of age, belong to low socioeconomic status, illiterate and among parity range of 2-5. Previous history of surgical procedures was in 66% of subjects while 62% had history of injections. Ear piercing in unsterilized conditions by non skilled person was also present in significant number [43%] while 17% had history of blood transfusions. Hepatitis C infection is linked to surgical procedures, injections and ear piercing in this study. However, to identify all associated maternal risk factors, larger studies at multiple centres will be required and strategies should be made to prevent its' transmission

Maylard incision in gynecology: report of 30 cases

The choice of incision in gynaecologic surgery is a very critical one and has a profound influence of surgical outcome. [i] To highlight that Maylard incision is under used in gvnaecologic surgery [ll] Maylard incision is a safe and effective alternative to Pfannenstiel incision with minimal complications. Design: Case study. Setting: Gynaecologic unit of DHQ Hospital Faisalabad between September 1993 and May, 1995. Objects and Thirty patients in whom Maylard incision was used when entering the abdomen for various gynaecologic procedures. A good outcome with no complications was noted in all cases