Objectives: To determine relationship between immediate postpartum umbilical cord pH, fetal distress and neonatal outcome Methods: This descriptive cross-sectional study was conducted in the department of Gynaecology, Lady Reading Hospital Peshawar, Pakistan, from January 2019 to July 2019. This study included 27 full-term pregnant women who had abnormal CTG during the active or latent phase of labour. Data were analyzed by IBM SPSS Statistics for Windows, Version 23.0. Results: Out of 27, most patients 13 (48.14%) were in the age group 20-25 years,11 (40.74%) to 26-30 years and 3 (11.11%) belonged to 31-35 years of age group. CTG abnormalities were severe bradycardia, late deccelerations and persistent variable deccelerations with loss of baseline variability. Of all delivered babies, 21 (77%) babies had birth weight<3.5 kg and 6 (22%) had >3.5 kg birth weight. 20 (74.07%) had acidosis (pH <7.2) at the time of birth, of which one had severe hypoxemia and acidosis with pH 6.85. APGAR score at 0 minutes showed a strong positive correlation (r=0.818, p= <0.001) with cord pH, while APGAR at five minutes was also strongly correlated (r= 773, p=<0.001). Of all babies 18(66.66%) with PH less than 7.2 were admitted in NICU while only 2 babies with PH more than 7.2 were admitted. (p value= 0.005). Conclusion: Low umbilical cord pH values of babies born by cesarean section (for fetal distress) are strongly correlated with low APGAR score at birth and higher rates of NICU admission. doi: https://doi.org/10.12669/pjms.36.7.2536 How to cite this:Syed W, Liaqat N, Qazi Q, Yasmeen S. Relationship between immediate postpartum umbilical cord pH, fetal distress and neonatal outcome. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.2536 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.
Background & Objective: Placenta previa and its accompanying fetomaternal complications are increasing day by day because of globally increasing rates of cesarean deliveries, trends of assisted reproductive techniques, and delaying pregnancies to later ages. Placenta previa is an important contributor to iatrogenic and mostly emergent preterm deliveries, which add to increased neonatal morbidity and mortality. The predictors of preterm deliveries can help clinician make necessary preparations for optimal fetomaternal outcome. The aim of the current study was to determine relationship of placental edge thickness and cervical length with gestation at delivery in patients having placenta previa. Methods: It was a descriptive case series study conducted in the department of obstetrics and gynecology, Medical Teaching Institute Lady Reading Hospital Peshawar from January 2020 till January 2021. Seventy five patients fulfilled the inclusion criteria and were included in the study. Already diagnosed cases of placenta previa, with singleton alive pregnancies and gestation of 28 weeks or more were enrolled. Trans vaginal ultrasound was done to determine placental edge thickness and cervical length. Patients data on gestation at delivery were collected from hospital records. Results: A significant negative correlation between the placental edge thickness and gestational age at delivery was seen (r= -0.566, P= 0.001). The correlation between length of cervical canal and gestation at delivery was positive (r= 0.362, P=0.001). Also thick placental edge of > 2cm had significant association with birth before 37 weeks (P=0.023). A short cervix of less than 2.5 cm had also statistically significant association with birth before 37 weeks (P=0.022). Conclusion: There is linear inverse relationship of placental edge thickness with gestation at delivery. The relationship of cervical length with gestation is positive linear. Patients with thick placental edge are more likely to deliver preterm than those having thin placental edge. doi: https://doi.org/10.12669/pjms.38.5.5097 How to cite this:Syed W, Liaqat N, Naseeb G, Khattak SM. Relationship of placental edge thickness and cervical length to gestational age at delivery in patients with placenta previa. Pak J Med Sci. 2022;38(5):---------. doi: https://doi.org/10.12669/pjms.38.5.5097 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.
The study aimed at examining the effect of reciprocal teaching strategy on students’ academic achievement in the subject of general science at elementary level. The objectives of the study were; (i) to investigate the effect of using reciprocal teaching strategy on academic achievement of 5th grade students, (ii) To investigate the effect of reciprocal teaching strategy on high achiever and low achiever of 5th grade, (iii) To observe the participation of the students in reciprocal teaching strategy. Sample of the study was consisting of 40 students studying general science in class 5th. A Pre-test Post- test equivalent group design was used to conduct the study. For collection of data teachers made test and observation sheets were developed. Statistical techniques such t-test, percentage, S.D and mean were used to analyze the collected data. The study is equally significant for students, teachers, curriculum developers and future researchers. It was found that the participation of students was significant in reciprocal teaching strategy during treatment. The participation of students in reciprocal teaching strategy reported an increasing trend after the first week to week 6.With the help of reciprocal teaching strategy students readiness to learn, their attention to reading and listening, their ability to generate questions from the text, their activeness during the discussion and their confidence about sharing their ideas in a group increased hundred percent. Reciprocal teaching had great effect on student’s academic achievement.
Background and Objective: Obesity with its growing prevalence is a major public health problem influencing gestational age at delivery. Raised Body Mass Index (BMI) has been shown to be associated with significantly increased risk of prolonged pregnancy; which is an important contributor to perinatal morbidity and mortality. Obesity needs modified antenatal, intrapartum and postpartum care by obstetrician. Limited data is found regarding association of obesity with prolonged pregnancy and the same fact led us to search for this association. Methods: This cohort study was carried out in Gynecology and Obstetrics department, MTI Lady Reading Hospital Peshawar from March 2020 to April 2021. Patients were enrolled in third trimester at 37 weeks of gestation with primary exposures of interest being either self-reported pre-pregnancy weight or obtained from first trimester antenatal record. Patients were divided into two classes based on BMI i.e., one with BMI <25 and other with BMI ≥ 25. Patients in both classes were followed till their delivery to determine outcome of gestational age at delivery. Results: Statistically significant difference between the two groups was seen at lower age range of 18-21 years(p-0.04) and higher age range of 39-42 years (p-0.0001). Statistically significant association was found between high pre pregnancy BMI and postdates pregnancy (OR:4.93 ;95%CI:1.98-12.26, p-0.001). Association of induction of labor with high pre pregnancy BMI was not significant. (OR 0.56, 95%CI:0.21-1.48, P < 0.001). Higher rates of Instrumental deliveries(p-0.0005) and cesarean sections (p-0.0001) were seen in higher BMI group. Conclusion: Higher pre-pregnancy BMI is associated with increased risk of postdates pregnancy. doi: https://doi.org/10.12669/pjms.38.5.4815 How to cite this:Qazi Q, Liaqat N, Hussain SS, Syed W. Association of high Body Mass Index and postdates pregnancy. Pak J Med Sci. 2022;38(5):---------. doi: https://doi.org/10.12669/pjms.38.5.4815 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.
Background: Primary postpartum haemorrhage (PPPH) is the leading cause of maternal morbidity and mortality in low resource countries like Pakistan. The objectives of this study were to determine the frequency, distribution by place of delivery and parity, causes, management options and outcome of PPPH in postpartum women of District Peshawar, Pakistan. Materials & Methods: This cross-sectional study was conducted in Department of Gynaecology & Obstetrics, Lady Reading Hospital, Peshawar, Pakistan from 1st January 2019 to 30th June 2019. Sample size of 4,034 was with 0.39342 % margin of error, 95% confidence level, prevalence of PPPH 2% and a population of 23,607 postpartum women. All postpartum women were eligible. Those with secondary PPH, surgical management for PPPH done at some other hospital, with known bleeding disorders and on anticoagulants were excluded. All these patients were managed according to standard protocols. Data was collected for following variables; presence of PPPH (yes/ no), place of delivery (in-hospital deliveries/ referred cases), parity (primipara/multipara/grandmultipara), causes of PPPH (uterus atony/retained placenta-RPOC/ruptured uterus/genital tract tears), management options of PPPH (conservative management/laparotomy with repair of ruptured uterus/laparotomy with uterine artery ligation and B-Lynch/repair of genital tract tears other than ruptured uterus/removal of retained placenta & RPOC/hysterectomy) and outcome of PPPH (uneventful recovery/maternal near miss/maternal mortality). Frequencies and percentages with confidence intervals were calculated for these variables. Results: Out of 4034 postpartum women, frequency of PPPH was 400 (9.92%). Out of 4034 women, distribution of 400 cases of PPPH by place of delivery was 222 (5.50%) in-hospital deliveries and 178 (4.42%) referred cases and by parity it was primipara 79 (1.96%), multipara 243 (6.03%) and grandmultipara 78 (1.93%) cases. Out of 400 cases of PPPH, frequency of uterine atony was 254 (63.50%) and conservative management 245 (61.25%). Out of 400 cases, frequency of uneventful recovery was 352 (88%), maternal near miss 40 (10%) and maternal mortality eight (2%) cases. Conclusion: Primary postpartum haemorrhage (PPPH) continues to be a common and serious complication of delivery with uterine atony being its most predominant cause.
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