Objective:To determine the frequency of placenta Previa in patients coming to a tertiary care unit with previously scarred and non-scarred uterus.Methods:A descriptive cross sectional study was carried on 114 cases who underwent caesarean sections (37 cases out of 645 cases with non scarred uterus and 77 cases from 721 cases with scarred uterus) in the department of obstetrics and gynecology Lady Willingdon Hospital from January 2008– December 2011.Results:Most patients (47.36%) were between 26-30 years age group, presented with gestational age between 36-40 weeks (70.17%), were mostly G2-4, while frequency of placenta Previa in non-scarred uterus was 32.45% (37 cases), and frequency in previously scarred uterus was 67.54% (77 cases). Major degree Previa was found in 88 cases (77.19%). There were 5.70% cases of placenta Previa from non-scarred uteruses and 10.67% cases of placenta Previa (10.67%) from already scarred uteruses. Stratification revealed a higher trend of the morbidity with the increase in number of previous caesarean sections.Conclusion:A significantly higher frequency of placenta Previa was found among patients coming to a tertiary care hospital with previously scarred uterus.
Objective: The objective was to compare the effectiveness of vaginal versus intramuscular progesterone to prevent preterm delivery in patients with history of preterm labor in previous pregnancy. Patients and Methods: It was a Randomized Control Trial carried out in the Gynecology Unit in a Public sector Hospital, Lahore from March to December 2015. A total of 800 patients were enrolled through Antenatal OPD and were randomly divided into two groups by draw method. In Group-A, patients were administered 200mg of vaginal progesterone pessary once daily and in Group-B 250 mg of intramuscular progesterone was injected weekly. Treatment was continued until 37 completed weeks of gestation. The patients were followed up through their contact numbers and on routine follow up. This practice was abandoned if premature rupture of membranes occurred and the fetus was delivered before 37 weeks. All the parameters were recorded by the researcher on proforma. The data was analyzed using Statistical Package for the Social Sciences (SPSS) version 16.0. Chi Square test was applied to draw the comparison. Results: The mean age of patients was 26.16 ± 5.36 years (18 -35 years). The 296 patients were Para 1, 290 were Para 2, 142 were Para 3, 51 were Para 4 and 21 females were Para 5. In all females, the mean gestational age at time of presentation was 22.00 ± 1.47 weeks, whereas, at time of delivery, mean gestational age was 36.05 ± 2.38 weeks. In vaginal progesterone group, the mean gestational age at time of delivery was 36.67 ± 1.92 weeks while in IM group, mean gestational age at time of delivery was 35.43 ± 2.62 weeks. The difference between both groups was statistically significant (P < 0.05). Effectiveness (delivery ≥ 37 weeks) was achieved in 379 (47%) cases, out of which 228 (57%) cases belonged to vaginal progesterone group and 151 (37.8%) cases belonged to IM progesterone group (P < 0.05). Post stratification with age and parity also showed that vaginal progesterone is more efficacious than IM progesterone (P < 0.05). Conclusion: We concluded that vaginal progesterone is more effective than intramuscular progesterone for the prevention of preterm labor in patients with history of preterm labor in previous pregnancy.
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