Eclampsia is responsible for 34% of maternal mortality in Pakistani tertiary care hospitals among women admitted for delivery. Objective: To evaluate risk factors associated with eclampsia patients as well as the perinatal maternal effects in patients. Methods: Overall, 250 patients were involved in this research who were diagnosed with eclampsia. The data were collected from the medical records of the patients. The medical records contained information related to the patient's pregnancy history, characteristics, medical history, obstetric history, information related to admission to the hospital, maternal outcomes, and treatment provided at the hospital. For statistical analysis, SPSS version 21.0 was used. Results: There were 21689 women who gave birth in the hospital during the research process and 250 patients (1.15%) were diagnosed with eclampsia out of which 4 women died and had a case fatality rate of 1.6 %. The major risk factors associated were young age, already existing medical conditions, education level being low, low antenatal attendance, and nulliparity. HELLP syndrome was the most common consequence with a percentage of 15.6. All patients were provided with medication of magnesium sulfate. However, there was an absence of parenteral antihypertensive therapy. A total of 46 women (18.4 %) gave birth through vaginal delivery. Conclusions: According to our findings, eclampsia is still a key risk to maternal survival. Poor socioeconomic status, lack of education, and inadequate antenatal care were found as major risk factors

Aim: To determine the risk factors for postpartum hemorrhage. Study design:A retrospective case-control study Place and duration: This study was conducted at Bolan Medical College and Hospital Quetta from January 2021 to January 2022. Methodology: A total of 115 patients with PPH were identified in the given data.A case was categorized based on blood loss of more than 1500 mL or needing the transfusion of blood due to excessive postpartum blood loss. According to the exclusion criteria, those women who were transfused blood due to anemia were not included in the present study. A total of 225 cases were randomly chosen as controls. Those women did not report having PPH. Results: According to the data collected in our study, a total of 4695 babies were delivered in the given duration of time. Out of those, 115 were identified as cases and 225 were considered as random controls. The frequency of PPH was 2.45%. The commonest etiology of PPH was atony of the uterus (60%) and complications related to the placenta (36%). The risk factors determined to cause PPH was a positive history of PPH, anticoagulant drugs, anemia, severe pre-eclampsia, fibromas in the uterus, multiple pregnancies, and the use of assisted reproduction technologies. Conclusion: Patients having a positive history of PPH are most likely to develop severe PPH. It is the most significant risk factor. The most significant risk factor to cause severe PPH was a positive history of PPH, anticoagulation drugs, severe pre-eclampsia, anemia, multiple pregnancies, and uterine fibromas Keywords: Case-control study, postpartum hemorrhage, Risk factors, High-risk, Obstetric interventions

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Objective: To determine the frequency of the second stage intervention and maternal outcome among those undergoing 2nd stage intervention (forceps versus vacuum) at Liaqat University hospital Hyderabad. Material and methods: This cross-sectional comparative study was conducted at the gynecology and obstetrics department of Liaquat University Hospital Hyderabad during one year from October 2014 to September 2015. Cases having a singleton pregnancy with cephalic presentation as per fresh fetal well-being ultrasound, gestational age 36 weeks or more, undergoing instrumental vaginal deliveries (vacuum or forceps) of either age or parity were included. The position of the head and pelvis and the status of the cervical dilatation were assessed. In the Labor Room, all instrumental forceps and vacuum-assisted deliveries were performed. The time of instrument application, the time of delivery, the type of instrument used, the number of pulls, the number of detachments in the case of ventouse, and the analgesia/anaesthetic provided were all recorded. The consultants who delivered the patient assessed the level of maternal trauma right away. Perineal tears, extension of episiotomy, ulceration of the vagina, cervical tears, and other maternal outcomes were measured. The data were entered and analyzed in the statistical program SPSS version 26.0. Results: During the study period, 2135 pregnant women were identified, with 265 receiving second-stage intervention (14.70%). These women were 27.84+5.13 years old on average. 52.83% women received ventouse/vacuum extraction and 47.16% received forceps assistance. The majority of females 73.58% were un booked. The interval decision-to-delivery was substantially shorter in patients of the forceps group than in the vacuum patient’s group (p-0.0001). Maternal trauma of soft tissues was the most common complication among 58 cases and out of them vaginal tears were significantly higher 18.4% in the Forcep group compared to vacuum group 7.14%, while cervical tear 4% in the Forcep group and 3.57% in the vacuum group and 3rd degree perineal in 8% of the Forcep group and 3.57% in the vacuum group. Findings regarding cervical tear, 3rd degree perineal, PPH, LSCS and other maternal complications were statistically insignificant according to both procedures (p->0.05). Conclusion: It was concluded from this study that maternal outcomes in assisted vaginal deliveries suggested that ventouse application is associated with less maternal complications than with forceps. The frequency of the second stage interventions was observed to be 14.70% and no adverse maternal outcomes were observed. Keywords: Vacuum extractor, Obstetric forceps, maternal morbidity

Objective: To determine the frequency of pregnancy induced hypertension in teenage pregnancy, presenting in a tertiary care hospital. Design of the Study: It’s a descriptive case series Study Settings: This study was done at Department of Gynaecology & Obstetrics, Ziauddin Hospital, Karachi from January 2021 to June 2021. Material and Methods: Total 163 women with gestational age 20 and more weeks, age 10 to 19 years, singleton pregnancy, and with any parity were included in the study. On the basis of clinical examination, pregnancy comprised hypertension was diagnosed. If any patient had BP equal or more than 140/90 on more than two separate occasions, then it was considered as hypertensive. Patients were followed at 24, 28, 34, 36, and 38 weeks till delivery to look for development of Pregnancy induced hypertension. If patient developed any complications, was admitted and managed accordingly. By using computer program SPSS-17, data was entered and analyzed. For post stratification Chi-square test was applied and p-value ≤0.05 was considered as significant. Results of the Study: The average maternal age was 16.53±1.94 years. The mean parity was 3.03±1.44 and mean gravidity was 2.80±1.44. The mean gestational age was 31.17±3.52 weeks, with range 16(21–37) weeks. Age of 49 women was ≤15 years and age of rest of the 114 women patients was >15 years. The parity of gravidity of 113 women was ≤3 and it was >3 in 50 women. The parity of 131 women was ≤3 and in the 32 women it was >3. The gestational age of 73 women was ≤30 weeks and gestational age of 90 women was >30 weeks. The pregnancy induced hypertension was found in 24(14.7%) females who are expecting involved in the research. Among women with PIH the mean age was 16.46±2.14 years and mean gestational age was 30.83±3.26 weeks. The results showed no statistically significant association of maternal age, gravidity, parity, and gestational age with pregnancy induced hypertension. Conclusion: For higher incidence of pregnancy induced hypertension, the younger maternal age is a significant risk factor. Keywords: Pregnancy Induced Hypertension, Teenage Pregnancy, Frequency