Objective:To compare neonatal outcomes between Category-1 and Non-Category-1 Primary Emergency Cesarean Section.Methods:This was a retrospective analysis, conducted at Aga Khan University Hospital Karachi from January 1st 2016 till December 31st 2016. Non-probability purposive sampling technique was used. A sample size of 375 patients who had primary Emergency Caesarean Section (Em-CS) was identified by keeping CS rate of 41.5% and 5% bond on error. Data was collected from labor ward, operating theatre and neonatal ward records by using structured questionnaire.Results:In the current study, out of 375 participants who underwent primary Em-CS; majority (89.3%) were booked cases. Two-hundred-eighty-two (75.2%) were primiparous women. Two hundred and thirty (61.3%) were at term and 145(38.7%) were preterm. The main indication among Category-1 CS was fetal distress (15.7%). For Non-Category-1 CS, non-progress of labour (45.1%) was the leading cause of abdominal delivery. Except for APGAR score at one minute (p value = 0.048), no other variables were statistically significant when neonatal outcomes were compared among Category-1 and Non-Category-1 CS.Conclusion:In this study, fetal distress and non-progress of labor were the main indications for Category-1 and Non-Category-1 CS respectively. We did not find statistically significant association between indications of Em CS and neonatal outcomes. However further prospective studies are required to confirm this association.
Objective: To determine the association of adolescence pregnancy and adverse pregnancy outcome. Study Design: Prospective Cohort study. Setting: Department of Gynae and Obs, HBS General Hospital Islamabad. Period: June-2018 to April-2019. Material & Methods: A total of 226 pregnant females with singleton pregnancy of 20-24 weeks gestational age and 16 to 30 years of age were included in the study. Patients with known diabetics, h/o chronic hypertension, known smoker and any renal disease etc. were excluded. Women included were divided into two groups. All women between 16-20 years of age were included in adolescence group (group A) and age >20-30 years in adult group (group B). All patients were followed till delivery and outcome variables like adverse pregnancy outcome in terms of preeclampsia and small for gestational age infants were noted. Results: The mean age of women in group A was 18.15 ± 0.79 years and in group B was 25.42 ± 2.08 years. The mean gestational age in group A was 21.54 ± 1.46 weeks and in group B was 21.98 ± 1.07 weeks. Frequency of small for gestational age infants in adolescence group was 7.96% while in adult group was 1.76% with p-value of 0.030 and relative risk of 4.5 which is significant. Frequency of pre-eclampsia in adolescence group was 21.24% while in adult group was 4.42% with p-value of 0.000 and relative risk of 4.8 which is significant. Conclusion: This study concluded that the frequency of pre-eclampsia and small for gestational age infants in adolescence pregnancy is higher compared to adult pregnancy which shows adolescence pregnancy as a risk factor for pre-eclampsia and small for gestational age infants.
Introduction: Peripheral infarcts on maternal side are relatively common and are not thought to be clinically significant. However those that occupy more than 5% of the placental mass or are more than 3cm in diameter in size are associated with perinatal mortality and morbidity. Objectives: To determine the frequency of placental infracts and its different severity grades among women with severe placental abruption. Study Design: Cross sectional descriptive study. Setting: Department of Obstetrics & Gynaecology, Postgraduate Medical Institute, Lady Reading Hospital Peshawar. Period: January 2016 to July 2016. Material and Methods: Patients admitted in hypovolemic shock or intrauterine fetal death was considered as severe abruption. Placenta of the subject was collected from labour room of the wards and was fixed in 10% formalin. Gross examination of placenta performed and then the section of placenta was stained with hematoxylin & eosin stain. The consultant pathologist reviewed the slides. All the data was recorded on predesigned Performa and analyzed through SPSS version 11.0. Results: Among 124 cases, majority of women (41.93%) were in the age group 30-40 years and presented at gestation age more than 37 weeks. 21.77% of patients were having placental infarcts of less than 3 cm and 18.54% of cases were having placental infarcts of more than 3 cm. 79.03% of babies born alive, 41.12% were preterm and stillbirth was a finding in 20.96% of cases. Overall frequency of placenta infarcts in patients was 40.32%. Conclusion: Placental infarcts were seen in about 40.32% placentae of women with placental abruption. Association between placental infarcts and preterm babies and stillbirths was also significant.
Objectives: To assess the overall survival of pregnant women diagnosed with cancer during pregnancy or became pregnant thereafter. Methods: A retrospective medical record review of 90 patients who were diagnosed with cancer when pregnant or who became pregnant thereafter between 1996 and 2015 in Aga Khan University Hospital, Karachi. Results: A total of 90 patients were analyzed. The malignancies that expectant mothers had were, breast cancer 38 (42.2%), hematological cancers 29 (32.2%), brain cancer 10 (11.1%), and other malignancies 13 (14.4%) that included thyroid cancers, gestational trophoblastic disease and synovial tumor of foot. We observed only four deaths out of 90 patients and mean survival time in pregnant patients with malignancies was 17.98 years [CI 16.35-19.31]. Conclusions: The diagnosis of most cancer types before or during pregnancy does not influence on overall survival of patients. doi: https://doi.org/10.12669/pjms.37.2.3525 How to cite this:Dur-e-Shahwar, Irfan S, Islam ZS, Sheikh L. Impact of pregnancy on cancer survival: Experience at a tertiary care hospital. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3525 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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