Objective: To observe the effect of abnormal Cardiotocography to delivery interval on perinatal outcome in terms of Apgar score. Study design: Descriptive case series study. Place and duration of study: Baqai Medical University department of obstetrics and gynecology Fatima Hospital Karachi from Jan 2011 to July 2011. Material and method: One hundred patients were registered who had pathological Cardiotocography. Bishop’s score was noted and decision to deliver the patient was made according to the abnormality, and bishop’s score. If bishop’s score was good and vaginal delivery was imminent, then her second stage was shortened by operative vaginal delivery. Fetal distress was managed by left lateral position, O2 inhalation and hydration. If delivery was not imminent then decision of urgent LSCS was made, meanwhile fetal distress was managed. Decision – delivery interval was recorded, and fetal outcome was noted in terms of Apgar score and resuscitation needed. Results: During this period one hundred pregnant women at term had pathological CTG for which they were delivered urgently. Among them 12% of parturients were delivered within 30 min ,68% delivered within 30-60 min , 12% delivered in 60-90 min and only 8% were delivered in 90-120 min. Seventy four (74%) of parturients were delivered by emergency lower segment caesarean section and 26% of parturients were delivered by instrumental vaginal delivery. Fetal outcome in terms of 1 min Apgar score ,38% of neonates had Apgar score of <7 ,46% had >7 and 16% had Apgar score of <5. This group of neonates required resuscitation and 5 min Apgar was good. No neonate was admitted in Neonatal unit. Conclusions: In this study it is concluded that with fetal heart rate abnormality, if fetus is delivered within 60 min, it is not associated with poor fetal and neonatal outcome, provided fetal distress is managed while preparing for emergency lower segment caesarean section.
Objective: To audit indications and outcome of hysterectomies in Fatima HospitalBaqai Medical University Karachi so as to improve the quality of care provided to patients. StudyDesign: Descriptive observational study. Place and Duration of Study: Department ofObstetrics and Gynaecology, Fatima hospital, Baqai Medical University Karachi from November2009 to November 2011. Patients and Methods: All patients undergoing hysterectomy forgynaecological conditions from 2009 to 2011were included in the study. Results:Hysterectomies for gynaecological conditions accounted for184 cases during the study period.Mean age of patient was 49 (range 30-60 years). Mean parity was 6 (range 0-11). The mostcommon indication for hysterectomy was fibroid uterus56(30.4%) cases, dysfunctional uterinebleeding 38 (20.6%) cases, and uterovaginal prolapse 10 (5.4%) cases. Abdominal hysterectomyaccounted for 174(96.6%) and vaginal hysterectomy accounted for 10 (5.4%) cases. Twenty six(14%) patients were found to be suffering from hypertension,6(3.3%)patients were suffering fromdiabetes mellitus. Wound infection occurred in 11 (6%) cases. No mortality was associated withhysterectomy during the study period. The duration of hospital stay was less in vaginal route ascompared to abdominal. Conclusions: An audit should be carried out every year to improve thelevel of care of patients and also the expertise of surgeon should be checked. The study hasshown that hysterectomy is a safe procedure but the high morbidity associated with thisprocedure is bothersome. The other options like endometrial ablation, intrauterine hormonaldevice like mirenaetc should also be considered. More efforts should be made on vaginalhysterectomies as it is economical and morbidity is less with it.
Hyperglycemia in pregnancy (HIP) is an important component of primary prevention of diabetes both globally and in Pakistan. To ensure that the opportunity of primary prevention is not missed it is important to diagnose hyperglycemia early in pregnancy. Universal screening in pregnant women at booking is recommended with its implementation at primary, secondary and tertiary levels of health care settings. These guidelines by Society of Obstetricians and Gynecologists (SOGP) are pragmatic addressing screening methodology, preconception care screening & diagnosis, antenatal care plan, intrapartum and postpartum management & follow up, neonatal care, breastfeeding, contraception, counseling for future pregnancy, lifestyle modification, nutritional recommendations and proper techniques for insulin injection, management of diabetic ketoacidosis (DKA) and recommendations for future research. There are many available guidelines for the screening, diagnosis and management of HIP. The SOGP GDM guidelines recommendations are simple, tailored to the local context especially for the busy health care providers; medical as well as nurse practitioners, for whom it is confusing to choose the recommendations from different available guidelines. These guidelines are meant to standardize clinical practice at all health care levels across the country. In order to ensure its practical utilization, a national GDM registry has been proposed and designed so as to observe its applicability in the clinical practice by health care providers.
Schwannoma or neurilemmoma is a rare benign nerve sheath tumor, usually presenting as a solitary, painless, slow growing, fleshy mass. It is located subepidermally, but produces skin swelling, depending on the size and exact location in the skin.1 It usually arises from schwann cells of peripheral, cranial and autonomic nerve sheaths, and rarely affects female external genitalia.2 All schwannomas are positive for S-100 protein, and almost all are benign with less than 1% risk of malignancy.
Objective: The study aimed to compare the CS between 37 and 38 weeks gestational weeks and those performed between 39-40 weeks gestational weeks in order to determine the neonatal outcome and complications. Study design: comparative cross-sectional. Place and Duration of study: The study was conducted on 200 pregnant women in the Department of Obstetrics and Gynecology, Baqai Medical University, Fatima Hospital, Gadap Karachi from January 2021 to December 2022. Methodology: Women with term singleton pregnancies scheduled for elective cesarean section at 37 - 38 weeks and 39-40 weeks of gestation without medical comorbidities were enrolled.. All the patients were distributed into two groups: Group-A composed of pregnant women with gestational age 37-38 weeks and Group-B pregnant women with gestational age of 39-40 weeks. Data such as maternal age, gestational age, parity, and neonatal complication neonatal weight were collected. Transient tachypnea of the newborn (TTN), sepsis, NICU admission, respiratory distress syndrome (RDS), and neonatal outcomes were noted. Repeat C-Section, malpresentation, Cephalopelvic Disproportionation (CPD), maternal request were different causes for elective cesarean section. Data was collected from those patients who were admitted in ward for elective cesarean section through a pre designed proforma. Data analysis was done in SPSS version 27.
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