Objective: To determine the association of preterm delivery with maternal anemia in Tertiary Care Hospital, Karachi. Study Design: Prospective cohort study. Study Setting: Study was conducted at Department of Obstetrics and Gynecology of Aga Khan University Hospital Karachi, Pakistan. Duration of Study: Six months from 3rd September, 2018 to 3rd March, 2019. Subjects and Methods: Data was prospectively collected from 90 patients. 45 patients were in the anemic group and 45 patients were in the non anemic group. Quantitative data was presented as simple descriptive statistics giving mean and standard deviation and qualitative variables were presented as frequency and percentages. Effect modifiers were controlled through stratification. Post stratification chi square was applied and p-value of ≤0.05 was considered significant. RR > 1 was considered significant. Results: In the anemic group, mean age of the patient was 28.82±3.65 years, gestational age at delivery was 36.97±2.58 weeks, booking hemoglobin was 9.79±0.84 g/dl, and delivery hemoglobin was found to be 9.73±1.19 g/dl. In the non-anemic group mean age of the patient was 29.57±5.83 years, gestational age at delivery 37.08±1.91 weeks, booking hemoglobin was 10.76±0.99 g/dl and delivery hemoglobin was found to be 10.75±1.12 g/dl. Moreover, frequency distribution of preterm status showed that out of 45 patients in anemic and non-anemic group, 35.6% and 46.7% had preterm status respectively. RR was 0.76. Conclusion: Prematurity is major cause of perinatal mortality. The findings of this study although shows prevalence of preterm delivery in both anemic and non-anemic pregnant women however results were not significant to support our hypothesis. Further research is needed with strategies to address the anemia status of expecting mothers. Key Words: Maternal anemia, preterm, anemia and non-anemic group.

Objective: To determine the frequency of factors responsible to small for gestational age infants in primigravid women. Study Design: Cross Sectional Study Setting: This study was carried out in the department of obstetrics and gynaecology of Agha Khan University Hospital, Karachi Duration of Study: This study was conducted from 15th September 2018 to 10th January 2019. Subjects and methods: A total of 127 women with singleton pregnancy and gestational age 28-35 weeks by LMP with 0 Parity were included. Women with history of miscarriage, diabetes and family history of SGA babies were excluded. Ultrasound was done to all women and Small for Gestational age babies (as per operational definition) was recorded. All the women was interviewed regarding smoking and detailed history and examination was done to make clinical assessment and for ordering the proper investigations to establish medical disorder by the researcher herself. Venous blood was collected from all women and was immediately sent to laboratory. Hemoglobin < 10 g/dL was recorded as anemia. Ultrasound examination was done for oligohydroamnios as per operational definition. Patients BMI were calculated. Hypertension was also calculated as per operational definition. Data was recorded for factors. Results: Age range in this study was from 18-40 years with mean age of 27.968± 2.05 years and mean gestational age 31.692±2.40 weeks, mean weight 71.645±12.94 Kg, mean height 1.549±0.10 meters and mean BMI was 29.924±5.12 Kg/m2. Majority of patients were from 18-30 years age group (89.8%). As far as risk factors are concerned smoking was seen in 5.5%, overweight 65.4%, hypertension 13.4%, oligohydramnios 29.1%, anemia 12.6%, preeclampsia 15.7%, hypothyroidism 16.5%, hyperthyroidism 6.3%, antiphospholipid antibody syndrome 13.4% and diabetes mellitus was 8.7%. Conclusion: A variety of risk factors have been discovered for newborns deemed SGA by customized centiles. SGA is associated with a number of lifestyle factors, many of which are controllable, such as food, smoking, and exercise. Future research is needed to verify our findings. Keywords: Small for Gestational Age, Primigravid women, Factors

Aim: To determine the fetus and maternal outcome on the trial of vaginal delivery after a previous single Caesarean Section (CS). Study design: A cross-sectional study Place and Duration: This study was conducted at Bolan Medical Complex Hospital Quetta from January 2021 to December 2021 Methodology: A total of 108 cases were incorporated in the study who had a previous single CS. Patients' vital signs, fetal cardiac activity, pain and tenderness of the lower abdomen, and fetal distress were observed extensively during the labor. Data was collected with pre-designed Performa, and written informed consent was obtained on a consent form. The hospital committee was given authorization, and the data was analyzed for outcomes. Results: A total of71 patients (65.7%) had a successful vaginal delivery, while 37 (34.3%) required a repeat emergency cesarean section. Out of 71 vaginal deliveries, 47 (66.2%) were between the ages of 19 and 30 years, while 24 (33.8%) were between 31 and 45 years. Out of 37 instances, 22 (59.5 %) were between the ages of 19 and 30 years, while 15 (40.5 %) were between 31 and 45 years. The distribution of cases according to fetal distress in emergency cesarean section patients showed that 8 cases (21.6%) experienced fetal distress, and 29 (78.4%) did not develop any fetal complication. Conclusion: This study demonstrates the higher frequency of fetal distress in CS than vaginal delivery. Pregnant patients should be encouraged to have vaginal deliveries to reduce future morbidity related to CS. Keywords: Caesarean Section, Emergency cesarean delivery, Feto-maternal, vaginal delivery

Maternal height influences obstetric effects, especially the delivery outcome. It is crucial to identify and anticipate potential CPD at every birth in order to avoid the detrimental effects of an undiagnosed imbalance. Maternal height is closely associated with women's ease of vaginal delivery. Objective: To assess the impact of maternal height on the delivery outcome. Methods: The study included nulliparous women aged between 19 to 35 years, with a height between 140-155 cm, and a singleton pregnancy with cephalic presentation. Data were collected through a predesigned questionnaire. The pregnant women were categorized concerning their heights, and the delivery outcomes and complications were compared. The main outcome was the manner of delivery (vaginal delivery or CS). Secondary outcomes were a composite of newborn morbidity, including infant distress, mechanical ventilation, neonatal intensive care unit hospitalization, perineal injury, postpartum hemorrhage, and puerperal fever. Results: A total of 383 cases were included in the present study. The range of the patient’s height was from 140 to 155 cm. The age of pregnant women was between 19-35 years. Women of ≤ 145 cm had a higher cesarean section (CS) rate than the group of 150-155 cm. No significant correlation was observed between maternal and neonatal mortality concerning maternal height. Conclusion: Females with short stature have higher chances of Cesarean Section than vaginal delivery. As a result, these women should deliver in a health-care institution where their labor may be thoroughly watched and a prompt choice about delivery mode made. Clinical examinations during prenatal visits should include maternal height.