Background: Every day more than 220 women around the world die from severe bleeding after childbirth. Globally post-partum hemorrhage is the number one direct cause of maternal mortality. Most postpartum hemorrhages are caused by uterine atony and occur in the immediate postpartum period. Most of these tragic deaths can be prevented by active management of third stage of labour. Active management of the third stage of labor should be practiced routinely to decrease the risk of postpartum hemorrhage. Oxytocin is used for enhancing uterine contraction after delivery. But oxytocin has some limitations like shorter half- life, less contraction time and more side effects, whereas carbetocin has prolonged duration of action which ensures more contraction time and less adverse effects. This study was done to see the efficacy and safety of carbetocin over oxytocin for prevention of PPH after vaginal delivery. Methodology: A randomized controlled clinical trial was conducted in the Department of Obstetrics and Gynecology, Shaheed Suhrawardy Medical College and Hospital, Dhaka, Bangladesh over a period of 9 months from January 2015 to September 2015. Ninety four patients undergoing vaginal delivery at term were randomized into two groups receiving either 10IU oxytocin or 100 μg carbetocin. Outcome measures such as primary PPH, massive blood loss, need for additional uterotonic drug, additional blood transfusion as well as adverse effects were documented. Results: In this study, massive blood loss did not occur none of patients in carbetocin group. But massive blood loss occured 6.4% women of oxytocin group. Further fundal massage , immediate blood transfusion and additional uterotonics didn’t need any patient in carbetocin group. In oxytocin group, fundal massage required in 8.5% of women, blood transfusion needed in 10.6% patients and additional uterotonics needed in 10.6% women. Average amount of blood loss was 88 ml less in carbetocin group and adverse effects of drugs were almost similar in both group. Primary PPH developed in oxytocin group 8.5% but none of patients had developed PPH in carbetocin group. Conclusion: Carbetocin is an effective new drug than oxytocin for prevention of postpartum hemorrhage in vaginal delivery. Bioresearch Commu. 7(1): 927-931, 2021 (January)
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.
Polycystic ovary syndrome (PCOS) is a frequently encountered problem affecting 6-11% women of reproductive age.1 Purpose of the study was to determine whether serum AMH level can be used to diagnose PCOS. Methods: It was a cross sectional study conducted among 55 sub-fertile women of reproductive age (18-35 year) in a tertiary level hospital during the period of January 2018 to December 2018. The study subjects were divided into group I (PCOS patient with subfertility by Rotterdam Criteria 2003) and group II (non PCOS subfertile patients of reproductive age). Menstrual history, obstetrical history, physical examination, clinical assessment of androgenesis, ovarian ultrasound assessment and level of AMH, FSH, LH were collected. Result: Twenty five PCOS & 30 non PCOS sub-fertile patients were recruited. Mean age in PCOS & non PCOS were 25.24±4.03 years and 27.8±5.01 years respectively. The mean serum AMH in PCOS was 11.03±3.78 ng/ml and in non PCOS was 3.93±1.92 ng/ml, their difference was statistically significant. Conclusion: AMH can be used as a diagnostic aid for PCOS. J Shaheed Suhrawardy Med Coll, December 2019, Vol.11(2); 142-146
Background: Hyperemesis gravidarum (HG) is the severe form of the nausea & vomiting in pregnancy and is associated with weight loss, ketonemia ,ketonuria ,electrolyte imbalances and profound volume depletion. Increased accumulation of fluid caused by elevated steroid hormones in pregnancy, a shift in pH and change of pH in the gastrointestinal tract could result in the manifestation of subclinical Helicobacter pylori (H. Pylori) infection. We therefore examined whether seropositivity for IgG antibodies to H. Pylori may be related to hyperemesis graviderum. Objective: To determine the association of H-pylori infection in hyperemesis graviderum patients. Methodology: A cross sectional study was conducted in the department of obstetrics and gynaecology, Dhaka medical college hospital from January 2007 to December 2008. Total 82 pregnant patients, 40 were hyperemesis gravidarum patients (Cases, group A) and 42 were normal pregnancy without hyperemesis graviderum (Control, group B) for admission and attending for routine ANC in OPD were selected. Purposive sampling method was followed as per inclusion and exclusion criteria. Evaluation of the patients was based on history, physical examination and investigation. Serum IgG antibody response to H.pylori antigen by ELISA were measured from every patients and analysed for its association with HG.
Introduction: Umbilical cord blood is blood left over in the placenta and in the umbilical cord after the birth of the baby. Umbilical cord blood saving consists of the collection, processing and cryopreservation of the remaining blood within the umbilicus and placenta following the birth of a child. Within this left over blood, traditionally discarded with the placenta as medical waste, lies a rich source of haematopoietic stem cells same as bone marrow. Cord blood stem cells have advantages over bone marrow in transplants and have been used in more than 30,000 transplants to regenerate healthy blood and immune systems1. Today, stem cell therapies continue to evolve, bringing new hope to patients and their families.Objective: To aware regarding use of stem cells of babys umbilical cord blood in future.Methods: A review of relevant articles and documents and some world standard stem cell banking protocol were undertaken.Conclusion: When these cord blood stem cells are processed and stored, the cells are not only a perfect match for the baby, but it could also provide life saving benefits for siblings and other family members.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(2) : 79-82
The single fetal death in multiple pregnancy is not rare. Death of one fetus in multiple pregnancy increases the risk of mortality and morbidity of the surviving fetus. This might pose management challenge to the obstetrician. It is a cause of great concern and psychological stress to the parents. Proper diagnosis and intervention in appropriate time can improve the maternal and neonatal outcome. Adequate counseling, psychological support and close follow up are mandatory. There are potential complications to the mother and the surviving twin.Bangladesh Med J. 2016 Sep; 45 (3): 172-174
Background: Adjunctive therapies to have a baby and widespread perception is that dietary supplementation such as myo-inositol are associated with only benefit, not with harm in case of PCOS women. The use of 2×1000mg myo-inositol +2×200microgram folic acid per day is a safe and promising tool in the effective improvement of symptoms and infertility for patients with a PCOS. Objectives: To evaluate the effectiveness and safety of oral supplementation of inositol for reproductive outcomes among subfertile women with PCOS who are trying to conceive. Materials and methods: Using questionnaire an observational study was performed in ShSMCH of outdoor infertility clinic and routine clinical practiced. In this observational study Thirtyfive PCOS women of childbearing age with oligo or amenorrhea were enrolled in the study. Ovulatory disorder due to PCOS was apparently the only cause of infertility; no tubal defect or deficiency of male semen parameters was found. Myo-inositol combined with folic acid 2g twice a day was administered continuously. During an observation period of 6 months from July,2018 to December, 2018, ovulatory activity was monitored with ultrasound scan and hormone profile and the number of spontaneous menstrual cycles and eventually pregnancies were assessed. Results: Twenty eight out of 35 (80%) patients restored their spontaneous menstrual cycle during treatment. A total of 10 singleton pregnancies (28.5% of patients) were obtained. Nine clinical pregnancies were assessed with fetal heart beat at USG scan. One pregnancies evolved in spontaneous abortion. Conclusion: Myo-inositol is a simple and safe treatment that is capable of restoring spontaneous ovarian activity and consequently fertility in most patients with PCOS. This therapy did not cause multiple pregnancy. J Shaheed Suhrawardy Med Coll, December 2019, Vol.11(2); 115-118
Background: Both oral and injectable hormonal contraceptives are the most popular type of birth control measures used in Bangladesh. Objective: The purpose for the present study was to see the effects of hormonal contraceptives on serum lipid profiles. Methodology: This was case-control study which was carried out in the Department of Obstetrics & Gynaecology at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2004 to December 2005 for eighteen (18) months. Women of reproductive age group who had given the history of taking low-dose OCP containing 30 meg EE plus 150 meg LNG were included as case group and women who were presented without the history of hormonal contraceptives use were included as control group. Blood was collected from each woman in fasting state and serum was sent for estimation of serum lipids profiles like serum triglycerides, total cholesterol, LDL and HDL. Result: The study included 40 women (control) who were not using OCP and 40 women (case) who were using OCP for more than one year. Comparison of age between control (31.75±4.85 years) and case (30.43±5.44 years) groups showed no significant difference (p>0.05). No significant difference with raised cholesterol levels (207.50±3.54 and 254.71± 45.54 mg/dl) was reported. Comparison of normal (136.16±39.46 and 154.05±35.33 mg/dl) and raised (229.00±24.52 and 246.32±35.98 mg/dl) triglyceride levels between control and case groups did not statistically significant. Comparison of normal and raised HDL levels did not show statistically any significant difference in control (32.07±3.02 mg/dL) and case (32.48±1.76 mg/dL) groups. Mean (±SD) of normal and raised levels of LDL was significantly high in case group. Normal LDL level was 82.71±26.82 and 111.05±15.40 mg/dl and raised LDL level was 138.55±3.03 and 188.82±40.37 mg/dL. Conclusion: In conclusion use of low-dose OCP containing 30 meg EE plus 150 meg LNG significantly increases serum cholesterol, serum triglyceride and LDL-cholesterol levels but not HDL-cholesterol. Journal of Science Foundation, January 2020;18(1):19-24
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