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OBJECTIVE: To assess the maternal morbidity and perinatal outcome in pre-term pre mature rupture of membranes between 24 to 37 weeks gestation. METHODS: This observational study was carried out in Gynaecology & Obstetrics Unit - I, at University Hospital Hyderabad, from October 2010 to October 2011. It included one hundred patients admitted through the outpatient department, as well as from casualty department of University Hospital Hyderabad. Detailed Clinical examination of the patient was done. Systemic review was also done to see any co-morbidity. All patients had laboratory investigations. Inclusion criteria were all patients gestational age between 24 to 37 weeks with preterm premature rupture of membrane (PPROM) confirmed by ultrasound and clinical examination regardless of their age. Exclusion criteria were patients with congenital anomalies, multiple pregnancy, pre-eclampsia & eclampsia, diabetes mellitus, polyhydramnios1 intrauterine growth restriction and placenta abruption. Data was collected using a proforma. Detailed workup including history, general physical examination, abdomen and pelvic examination and relevant specific investigations were noted. RESULTS: Out of 100 patients included in this study Primigravida were 17% and multigravida 83%. There was wide variation of age ranging from a minimum of 20to >40 years. The mean age was 30+ 3.1 years. Mostly patients belonged to the poor class in 72% cases followed by middle class in 21% and upper class 7%. Analysis shows that out of 100 mothers 26% had PROM of <24 hrs duration and 74% had >24 hrs of duration. Maternal outcome in 16 cases of Preterm Premature Rupture of Membrane findings revealed septicemia in 12% cases and Chorioamnionitis in 12% cases. Fetal outcome in 27 cases of preterm premature rupture of membrane revealed prematurity in 5% cases, fetal distress in 4% cases, cord compression in 5% cases, necrotizing enterocolitis in 2% cases, hypoxia in 9% cases and pulmonary hypoplasia in 2% cases. CONCLUSION: Low socioeconomic status is associated with increased neonatal morbidity due to fetal distress, cord compression, necrotizing enterocolitis, hypoxia and pulmonary hypoplasia at the time of delivery. An appropriate and accurate diagnosis of PROM is critical to optimize pregnancy outcome. It is suggested that the timely diagnosis and management of preterm PROM will allow obstetric care providers to optimize perinatal outcome and minimize neonatal morbidity.
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OBJECTIVE: To evaluate the effect of Body Mass Index and nutritional status on the menstrual pattern in adolescent girls Methods: Four hundred one adolescent girls who attained menarche were selected from five schools in Hyderabad. The data was collected by trained medical undergraduate and postgraduates by interviewing adolescent school girls using a pre-designed pre-tested questionnaire. BMI was calculated using the formula: BMI (kg/m(2)) = Weight (kg) / Height 2 (m(2)). Hb was estimated by Sahlis method using a haemoglobinometer. Data was analyzed using SPSS 11.0. Results : The mean age of the girls was 14.96 +/- 1.5 years. Three hundred and five (76%) of the girls had a normal menstrual cycle, twenty-eight (7 %) had frequent periods, fifty-two (13%) had infrequent periods and sixteen (4%) of the girls had totally irregular cycles and a pattern could not be determined. Three hundred and five (76%) of girls had a normal menstrual flow, sixty-eight (17%) had heavy flow and twenty-eight (7%) had scanty flow. One hundred fifty two (38%) of girls complained of premenstrual symptoms. Two hundred thirty one (60%) girls were clinically anemic. Two hundred and seventy seven (69%) had a BMI between 18.5 - 24.9 kg/m(2.) One hundred and eight (27%) were underweight with a BMI of 14 - 18.49kg/m(2), while sixteen (4%) were overweight with BMI 25 - 29.99 kg/m(2). A statistically significant relationship was found between BMI and social class (P<0.001) and BMI and menstrual pattern P<0.001). Conclusion : The study concludes that a majority of the girls had clinically obvious nutritional deficiency diseases. Out of the four hundred and one girls who were checked, two hundred thirty one were found to be anemic. Majority of the girls (84%) had a normal menstrual pattern, normal BMI and attained menarche before the age of 16. Overweight girls had infrequent periods.
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BACKGROUND AND OBJECTIVES: Pakistan is among the countries having high prevalence of HCV infection in the population but there is dearth of proper epidemiological data regarding acquisition of HCV infection in the pregnant population. Our objective was to determine the seroprevalence of HCV antibodies in healthy pregnant women and to assess the potential risk factors for HCV infection in HCV positive subjects and in the control group. METHODOLOGY: This cross sectional and comparative study was conducted from 1(st) January to 31(st) December 2010 in the Department of Obstetrics/Gynaecology Unit-I, Liaquat University Hospital Hyderabad. Sera were collected from all admitted pregnant women and tested for HCV anti bodies using Elisa kits (Abbott, USA). Data were analyzed using SPSS version 16.0 statistical package. RESULTS: The seroprevalence of HCV among pregnant population was found to be 4.7%. HCV positive women were more likely to have a history of blood transfusion (OR 1.99, 95% CI 1.26- 3.12), History of therapeutic injection use (OR 2.46, 95% CI 1.43-4.26), history of surgery (OR 1.72, 95% CI 1.12-2.66) and history of sharing household products (OR 1.81, 95% CI 1.14-2.87). CONCLUSION: HCV seropositive pregnant women were more likely to have a history of blood transfusion, therapeutic injection use, surgery and sharing household items.
