Determine the frequency of peripartum hystrectomy in placenta previa

Background: Peripartum hysterectomy is one of the life saving procedure performed after vaginal delivery or caesarean birth or in the immediate postpartum period in cases of intractable haemorrhage due to uterine atony, rupture uterus and placental disorders and it is usually reserved for the situations where conservative measures fail to control the haemorrhage. The objective of the study was to determine the frequency of peripartum hysterectomy in placenta praevia.Methods: The study was cross-sectional. It was conducted at the Department of Obstetrics and Gynaecology, Punjab Medical College and affiliated Hospital, Faisalabad. Study was carried out over a period of six months from October 2010 to March 2011. Total 130 cases of placenta praevia undergone caesarean section were included in this study. In cases of primary postpartum haemorrhage conservative management was done first in the form of intramuscular syntometrine (Oxytocin 5 IU/ergometrine 0.5 mg). Intravenous infusion syntocinon (40 IU in 500ml 0.9% saline over 4-6 hours).Results: Mean age of the patients was found to be 30.9±6.7 years. Distribution of cases by gestational age shows, 52 (40.0%) patients had gestation of 28-36 weeks and 78 (60.0%) patients had gestation of 37-41. Mean gestational age was observed 37.5±3.4 weeks. Parity distribution was as follows: 76 (58.5%) patients had parity 0-3, 34 (26.1%) patients had parity 4-6 and 20 (15.4%) patients had parity > 6 with mean parity of 3.2±1.9. Conservative management was done in 129 patients (99.3%). Peripartum hysterectomy was found to be in 1 patient (0.7%).Conclusions: Placental pathology is the leading cause of postpartum hemorrhage and the main indications of peripartum hysterectomy. Timely operation minimizes the morbidity and mortality

Psychological complications of polycystic ovarian syndrome and women’s health

Background: Polycystic Ovarian Syndrome (PCOS) affects approximately 5-10% females of reproductive age worldwide. Recent research shows that this syndrome is associated with psychological upset and devastating effects on women′s mental health and wellbeing.  Lack of clinicians′ awareness of adverse psychological effects is a major concern in developing countries to provide standard care and to improve overall health outcomes.Purpose of study was to determine the frequency of anxiety and depression among women with PCOS in order to promote awareness among clinicians about psychological complications of disease.Methods: Present study was conducted in the department of Obstetrics and Gynaecology/ University Medical and Dental College, from October 2018 to March 2019. Sixty patients with diagnosis of PCOD and sixty participants without this disease were included in the study. Participants having other endocrine or metabolic disorders were excluded from study. Hospital anxiety and depression scale was used to detect anxiety and depression among both groups. SPSS version 16 was used for data analysis. Chi- square test was applied to compare prevalence of anxiety and depression in both groups, p-value ˂0.05 was taken as statistically significant.Results: Women having PCOD exhibited statistically significant prevalence of anxiety (78.3% vs 35%) and depression (60% vs 30%) with p value of 0.0001 and 0.001 respectively.Conclusions: It is highly recommended that initial evaluation of these patients should include assessment of psychological domain of disease to provide more comprehensive treatment to improve overall health related quality of life

Oral versus intravenous maternal hydration in isolated third trimester oligohydramnios

Background: To study the effect of oral and intravenous maternal hydration in patients with isolated oligohydramnios in terms of mean change in amniotic fluid.Methods: A total number of 38 patients included in the study which fulfill the selection criteria.  Patients were randomly divided in two groups. Amniotic fluid index (AFI) of all patients was measured before the hydration therapy according to the method of Phelan et al.  In maternal oral hydration (Group A), every patient was instructed to drink two liters of water over two hours daily for 1 week. In intravenous hydration (Group B), every woman infused two liters of 0.9% normal saline in two hour daily for 1 week. After 48 hours and 1 week of oral and intravenous hydration, the AFI was reassessed by the same observer. Patients were monitored closely for sign and symptoms of fluid overload. Data was stratified for mean difference in improvement in amniotic fluid index.Results: After oral hydration therapy AFI was 5.926±0.4593 after 48 hours and 8.286±0.6000 after 7 days in Group A. In Group B AFI was 5.784±0.4622 after 48 hours and 7.868±0.2810 after 7 days of intravenous hydration. P value after 48 hours is 0.348 and p=0.014 after 7 days means oral hydration therapy significantly increase amniotic fluid index.Conclusions: Oral maternal hydration significantly increase the amniotic fluid index in patients with isolated oligohydramnios. It is simple, safe and non-invasive method

Vitamin D supplementation reduces the risk of preeclampsia in high-risk pregnant females

Background: Maternal vitamin D insufficiency has been linked with increased risk of preeclampsia. Despite this, the evidence regarding the efficacy of vitamin D supplementation in preventing preeclampsia is controversial. The aim of study was to collate the incidence of preeclampsia in high-risk females with vitamin D supplementation versus placebo.Methods: The present study was a randomized controlled trial. The study was conducted in the department of obstetrics and gynecology, Madinah Teaching Hospital affiliated with University Medical and Dental College Faisalabad. The study was collected over one year from July 2019 to June 2020. Patients were randomly assigned to two groups. Patients in group-A were given vitamin D supplementation of 600 IU daily. The control group (group-B) was given placebo. If blood pressure (BP) ≥140/90 mmHg and proteinuria found positive in urine, then preeclampsia was labeled (as per operational definition). Both groups were compared for preeclampsia by using Chi–square test. P value <0.05 was taken as significant.Results: The incidence of preeclampsia was 4% (n=2/150) in group A and 8% (n=6/150) in group B developed preeclampsia. The difference was (p value=0.3) insignificant difference.Conclusions: Vitamin D addition in pregnancy did not demonstrate a statistically significant effect of vitamin D on the prevention of preeclampsia