Background: Obstructed labour is one of the most common preventable cause of maternal and prenatal morbidity and mortality in developing countries. Objective: The purpose of the present study was to determine the risk factors as well as to asses the outcome of obstructed labour. Method: This cross sectional study was conducted in the Department of Gynecology & Obstetrics at Shaheed Ziaur Rahman Medical College Hospital, Bogra during the period from January 2007 to December 2007. One hundred and five cases with features of obstructed labour were selected as per inclusion and exclusion criteria in a consecutive method. A detailed history included sociodemographic feature, obstetric history, features of obstruction, intrapartum events were recorded to detect risk factors. Condition of patients, mode of delivery, preoperative and post operative complications, maternal and fetal outcomes were recorded. Results: A total number of 3171 deliveries were conducted during this period and 132 cases of obstructed labour were found constituting an incidence of 4.2%. The highest frequency was found among the unbooked, primigravid patients that were illiterate or only having primary education level. The commonest cause was cephalo-pelvic disproportion (47.5%) followed by fetal malpostion (25.7%) and malpresentation (24.8%). The majority of the patients were between 25-29 years, caeserean section was the most common mode of delivery (78.09%). Maternal morbidity due to different complication accounted for 76.19% of the case while the fetal morbidity was 51.31% of the cases. The maternal mortality was 1% and prenatal mortality was 24.76%. Conclusion: In this study the incidence of obstructed labour was very high. The commonest cause was cephalo-pelvic disproportion followed by fetal malpostion and malpresentation. DOI: http://dx.doi.org/10.3329/jssmc.v4i2.14401 J Shaheed Suhrawardy Med Coll, 2012;4(2):43-46

Background: GDM is a public health issue, affecting mostly the South East Asian region, as well in Bangladesh (prevalence 9.7% - 12.9%). It has a significant adverse impact on maternal and foetal outcome. So it needs to be addressed energetically to avoid maternal and foetal morbidity and mortality. Also it will contribute a lot to the pool of Type II Diabetes as substantial number of GDM mother and their offspring may develop type II DM in near future. Self-management of GDM is well-known globally but there is still lacking in adequate handling of diabetes by the patients themselves. Nevertheless the lacking can be minimized through ‘Patient Empowerment’ by clear understanding of the disease and its consequences along with intense learning, training, monitoring and evaluation of the clients involved. Also it will help in emotional stability of the client which is an essential component of diabetes management during pregnancy. The innovative strategy may contribute significantly in GDM management at low cost in a resource constraint setting. Objective: To find the effectiveness of ‘patient empowerment’ promoting better self-management of GDM. Methodology: This quasi experimental study was done on 96 cases (48 in each group) by purposive sampling technique at Shaheed Suhrawardy Medical College Hospital (ShSMC) as study group & Rajshahi Medical College Hospital (RMCH) as control group, from August 2012 – August 2015. Both group were matched of age, parity, education and income. Ethical clearance was taken from ethical committee of both ShSMC and RMCH Result: In the study group good glycemic control achieved with diet & exercise (75%) and Insulin required in only 25% cases, while in control group Insulin given in 75% cases. In the study group NVD (67%) were more than control group (33.3%). There were no obstructed labour in study group but control group (12.50%). Majority of the study group (74.6%) had no or minimum antenatal complication, in comparison to control group (74.66%). Regarding Neonatal outcome, neonatal resuscitation required none in study group but 12 (25%) in control group. So, overall adverse outcome observed less in study group than control group Conclusion: Patient empowerment can be an effective tool to manage GDM cases with an outcome of good control of blood sugar; less antenatal, intrapartum and post natal complications, good foetal and neonatal outcome and low requirement of insulin. J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 91-94

Background: Birth preparedness and complication readiness is an imperative intervention which has proven to reduce delays in care seeking behavior in case of obstetric emergencies. Although, many pregnant women and their families do not take the suggested steps to prepare for childbirth, despite of being known of them. Additionally, marked disparities often have been observed between rural and urban areas, with more maternal and neonatal deaths occurring in the rural areas owing to the unpreparedness. This study thus set out to assess and compare the knowledge, practice and factors associated with birth preparedness and complication readiness among women from rural and urban areas in Bangladesh. Methodology: A cross-sectional comparative study design have been undertaken among 250 rural and 240 urban women in the Department of Obstetrics and Gynecology, Shaheed Suhrawardy Medical College and Hospital, Dhaka, Bangladesh and Shaheed Sayed Nazrul Islam Medical College and Hospital, Kishoreganj, Dhaka over a period of 6 months from 1st October 2020 to 30th March 2021. All pregnant women who attended in the antenatal clinic of SSNIMCH and SSMCH for the first time during the study period was include in the study. Quantitative data was collected by the use of semi structured questionnaires adapted from the safe motherhood questionnaire, developed by maternal and neonatal Programme of Johns Hopkins Programme for International Education in Gynaecology and Obstetrics (JHPIEGO) an affiliate of John Hopkins University. Result: Birth preparedness and complication readiness was evident in 34.17% of the urban and 30.4% of the rural respondents. Urban women were statistically significantly more aware of the danger signs of pregnancy, labour and postpartum period (p<0.001). Selection of place of delivery, arrangement of transportation, emergency fund and blood donor was the most important actions taken as part of birth preparedness both in rural and urban respondents. Null birth preparedness was observed among 28.0% of the rural respondents compared to 2.50% of the urban respondents. The decision regarding the place of delivery was taken mostly by their husband both in urban and rural sub sets. Thus, this study findings showed low practice of BPACR both among urban and rural community while rural people showed more inaction than urban people. Bioresearch Commu. 8(2): 1100-1105, 2022 (July)

Endometriosis is a common gynaecological condition and presents mainly with involvement of the pelvic organs. However umbilical endometriosis is uncommon. A correct differential diagnosis can be difficult and the use of epiluminescence and MRI is suggested for the accuracy of preoperative diagnosis. This case report was experienced at a tertiary care hospital at Dhaka city. The patient was 39 years old multigravid woman presented with umbilical swelling and pain during menstruation for last 1year with cyclical bleeding from the umbilical region for last 4 months. The patient had regular menstrual bleeding since the time of menarche. The patient had no previous history of endometriosis, dysmenorrhea or dyspareunia. Physical examination showed a hyperpigmented tender paraumbilical swelling with bloody discharge through umbilicus. An accurate anamnesis and clinical examination together with the use of high resolution ultrasonography and fine needle aspiration cytology led to an accurate pre-operative diagnosis of umbilical endometriosis. The surgical approach to umbilical endometriosis represented an important step in achieving a satisfying result. The lesion to be excised and adequate umbilical repositioning was done. The patient was asymptomatic at the follow-up visit (12 months after surgery), however, nevertheless warned of the risk of recurrence. A natural-looking umbilicus was observed in cases with minimal visible scars.

Objectives: The purpose of this study was to evaluate the long term safety and efficacy of postpartum IUCD at a tertiary level hospital. Materials & Methods: This cross sectional study was carried out in Shaheed Suhrawardy Medical College & Hospital (ShSMCH) from March 2019 to December 2019. International Federation of Gynecology and Obstetrics (FIGO) in collaboration with Obstetrical and Gynecological Society of Bangladesh (OGSB) have been launched a project in Bangladesh to foster family planning activities by postpartum IUCD insertion since July 2015 in this hospital. All patients who were inserted PPIUD following delivery under FIGO- PPIUD project since 1st January 2017 to 31st December, 2017 were included in this study. Phone number of those PPIUD inserted women were collected from the register book. Clients were evaluated after 2 years of insertion. The outcome measures analyzed were safety measures – menstrual irregularities, vaginal discharge, pelvic infection, perforation and efficacy measures – continuation, removal, expulsion and failure rate. Result: Total number of patients delivered at ShSMCH in 2017 were 2,593. Out of them deliveries, 329 (12.70%) were introduced PPIUD. Among 329 PPIUD users, after about 2 years, 175 (53.20%) could be traced for follow up and rests couldn’t be reached by repeated attempts on phone call. After telephone call they attended our hospital and thorough interview and examination was done. All the informations were collected in a predesigned data collection sheet. Among 175 study population, 25 (14.28%) IUCD introduction were following vaginal delivery and 150 (85.71%) were during cesarean section operation. Those who are continuing PPIUD, 100 (82.0%) had no complications and few, 22 (18.0%) had some minor complaints for which they received treatment. The most common adverse event was the menstrual irregularities. There was no case of perforation. By the end of 2 years, out of 175 PPIUD inserted clients, missing string was found in 85 (69.7%) cases, continuation rate of PPIUD was 122 (69.7 %), spontaneous expulsion was 10 (5.7%), removal was 43 (24.6%) and failure rate was 3 (1.7%). Conclusion: PPIUCD is a safe, effective and convenient method of contraception and should be encouraged after both vaginal and Cesarean deliveries. Bangladesh J Obstet Gynaecol, 2020; Vol. 35(2): 81-89

Background: Polycystic ovarian syndrome (PCOS) is a condition characterized by menstrual abnormalities (oligo/amenorrhea) and clinical or biochemical features of hyperandrogenism and may manifest at any age. It is a common cause of female subfertility. All the dimensions of PCOS have not been yet completely explored. Methods: It was a cross sectional comparative study carried out at-GOPD of Shaheed Suhrawardy Medical College & Hospital from January, 2016 to December 2016 on 162 subfertile women. Among them 54 were PCOS group and 108 were non PCOS group. PCOS was diagnosed by (Rotterdam criteria 2003) (i) Oligo or anovulation (ii) hyperandrogenism (iii) Polycystic ovaries. Study was done to evaluate and compare the demographic characteristics, clinical, biochemical and ultrasoundgraphic features of sub-fertile women with and without PCOS. Results: A total of 162 sub-fertile women aged 16-36 years. Mean age was 29.5±5.4. There were significant differences between the two groups in terms of (oligo/amenorrhea), hirsutism, WHR and ovarian ultrasound features. There were no significant differences between two groups in correlations between the level of obesity with the incidence of anovulation, hyperandrogenism or with hormonal features. Conclusion: PCOS is one of the important factors causing Infertility. It is an ill-defined symptom complex needed due attention. There is a need to increase awareness regarding. The clinical features of PCOS are heterogenous thus can be investigated accordingly of selection of appropriate treatment modality. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 17-23

Background: Gynaecological malignancies are not uncommon in Bangladesh. Objective: The purpose of the present study was to see the histopathological pattern and post-operative surgical outcomes of gynaecological malignancies. Methodology: This clinical trial was conducted in the Department of Gynaeoncology at Dhaka, Medical College, Dhaka, Bangladesh from July to September 2019 for a period of three months. All the women presented with gynaecological malignancies with the age group of more than or equal to 18 years were selected as study population. The different patterns of gynaecological malignancies were diagnosed by histopathological examination after surgical operation. The immediate post-operative outcomes were measured. Result: A total number of 105 cases of gynaecological indoor patients were performed of which ovarian tumor was found in highest number which was 53(50.5%) cases followed by carcinoma of cervix (22.8%), endometrial carcinoma (5.7%) and vulval carcinoma (1.9%). The most common ovarian cancer was serous type carcinoma which was 14(26.4%) cases. In this study 101(96.2%) cases were survived and the rest 4(3.8%) cases were died. Conclusion: In conclusion most common cause of gynaecological operation has been performed due to ovarian tumor, carcinoma of cervix and endometrium. Journal of Current and Advance Medical Research 2020;7(2): 60-63

Background: Stillbirth is a disastrous event faced by the obstetrician. Each stillbirth is a tragedy having devastating implications for mothers, their families and the health personnel. Globally it remains a significant public health issue, particularly in developing countries like Bangladesh. An understanding of the risk factors associated with stillbirth will facilitate optimum quality of maternal and child health services; which leads to reduce the burden of death. Objective: To determine the factors associated with stillbirth in a tertiary care hospital. Methodology: A descriptive type of cross sectional study was conducted in the department of Obstetrics and Gynecology of Shaheed Suhrawardy Medical College Hospital from 1st January 2019 to 31th December 2019. Total 32 pregnant women who had stillbirth occurred during the study period were included in this study. Non probability purposive sampling technique was followed as per inclusion and exclusion criteria. Result: Total stillbirth reported were 32 (3.37% of total births). Maximum cases were primigravida (65.62%) with illiterate (71.87%), low socio-echonomic status (68.75%) and lack of Ante natal care(56.25%). Main causes of stillbirth were hypertensive disorders(15.6%), labour abnormalities(6.25%), other medical disorders(9.37%), infections(3.12%), Antepartum haemorrhage (12.5%), prematurity (12.5%), cord accidents(3.12%), IUGR(6.25%),birth asphyxia (6.25%) and post maturity(6.25%). Conclusion: Hypertension and other medical disorders, Antepartum haemorrhage, labour abnormalities, prematurity, post maturity, IUGR and birth asphyxia were identified as the highest risks for stillbirth which can be reduced by early recognition of the problem with regular antenatal check-up, colour Doppler ultrasound to diagnose fetal growth restriction and cord abnormalities, anomaly scan, intrapartum use of CTG to know fetal distress and use of partograph to prevent prolongation of second stage of labour and timely obstetric intervention will help in reduction of stillbirth. J Shaheed Suhrawardy Med Coll 2021; 13(1): 15-19