ABSTRACT… Objectives:To compare the obstetric outcomes in adolescent and adult primigravida. Study Design: A comparative, cross sectional study. Setting: Gynae unit 3, Jinnah hospital, Lahore. Period: One year from Jan-Dec 2014. Methodology: Study population was adolescent primigravida (<19 years) and adult primigravida between the ages 20-29 years, 250 in each group who were > 24 weeks of gestation. Obstetric complications were recorded as percentages of anaemia, pre-eclampsia, antepartum hemorrhage, postpartum hemorrhage, gestational diabetes mellitus, preterm delivery, instrumental delivery, cesarean section rate, low birth weight, Apgar score <7 at 5 minutes and NNU admission. Data was entered into SPSS 16. Chi square test applied and a p-value of<0.05 was considered significant. Results: The mean age of adolescent group was 18.4+ 0.56 years while it was 24+2.47 years in adult primigravida. The data revealed that the adolescent mothers are at higher risk of certain obstetric risks when compared to adult primigravida .These include anaemia ( 41.2% VS 17.6%), pregnancy induced hypertension (14.4% VS 1.6%), preterm delivery (21.6% VS 13.6% ), instrumental delivery (6.4% VS 1.6%), cesarean section rate (24% VS 12%), low birth weight (20.4% VS 8%), Apgar score <7 at 5 minutes (4% VS 2%) and NNU admission (19.2% VS 8%). The risk of antepartum hemorrhage (1.6% VS 1.2%), postpartum hemorrhage (0.8% VS 1.6%), gestational diabetes mellitus (1.2% VS 2%) and malpresentation (1.6% VS 2%) were not different in two groups. Conclusion: Adolescent pregnancy is associated with a higher rates of certain obstetric risks like anemia, preterm delivery, pregnancy induced hypertension, instrumental delivery, cesarean section and poor neonatal outcome However the risk of antepartum hemorrhage, postpartum hemorrhage and malpresentation is no greater than adult pregnant mothers. Key words:Adolescent pregnancy, outcome.

Objective: To determine the association of intrapartum CTG with fetomaternal outcome Material and Methods: A total number of 120 pregnant females who presented in the department of obstetrics and gynecology with labour pain were included in this cross-sectional analysis. A written informed consent was taken from all patients. The study was conducted in the department of Obstetrics & Gynaecology at Islam Teaching Hospital, Sialkot from January, 2021 to September, 2021. At presentation in the labor room, 20 minutes CTG was performed and patients were divided into two groups, those having abnormal trace including suspicious and pathological trace (Group A) and normal cardiotocography (CTG) pattern (Group B). After that the patients were followed till delivery to determine the feto-maternal outcomes e.g. APGAR score, NICU admission, perinatal mortality and caesarean section rate. Results: The mean age was 26.9±4.12 years in group A and 27. 1 ± 3.9 years in group B (p-value 0.78). On comparison of maternal outcomes, caesarean section was done in 38 (63.3%) patients in group-A and in 17 (28.3%) patients in group-B (p-value <0.0001).Regarding neonatal outcomes, NICU admission was needed in 9 (15%) patients in group A, versus in 4 (6.7%) patients in group B (p-value 0.14). Perinatal mortality occurred in 03 (5.0%) patients in group A and in no patient in group B (p-value 0.07). APGAR score at 5 minutes was >7 in 46 (76.7%) patients in group A versus in 52 (86.7%) patients in group B (p-value 0.18). Conclusion: The intrapartum abnormal CTG cannot be used as the only tool to identify fetal hypoxia during labor. It may lead to increased caesarean section rate because of high false positive rate of abnormal CTG. Keywords: Cardiotocography, Fetal Distress, Cesarean section

Objectives: To compare the obstetric outcomes in adolescent and adultprimigravida. Study Design: A comparative, cross sectional study. Setting: Gynae unit 3,Jinnah hospital, Lahore. Period: One year from Jan-Dec 2014. Methodology: Study populationwas adolescent primigravida (<19 years) and adult primigravida between the ages 20-29 years,250 in each group who were > 24 weeks of gestation. Obstetric complications were recordedas percentages of anaemia, pre-eclampsia, antepartum hemorrhage, postpartum hemorrhage,gestational diabetes mellitus, preterm delivery, instrumental delivery, cesarean section rate, lowbirth weight, Apgar score <7 at 5 minutes and NNU admission. Data was entered into SPSS 16.Chi square test applied and a p-value of<0.05 was considered significant. Results: The meanage of adolescent group was 18.4+ 0.56 years while it was 24+2.47 years in adult primigravida.The data revealed that the adolescent mothers are at higher risk of certain obstetric risks whencompared to adult primigravida .These include anaemia ( 41.2% VS 17.6%), pregnancy inducedhypertension (14.4% VS 1.6%), preterm delivery (21.6% VS 13.6% ), instrumental delivery (6.4%VS 1.6%), cesarean section rate (24% VS 12%), low birth weight (20.4% VS 8%), Apgar score<7 at 5 minutes (4% VS 2%) and NNU admission (19.2% VS 8%). The risk of antepartumhemorrhage (1.6% VS 1.2%), postpartum hemorrhage (0.8% VS 1.6%), gestational diabetesmellitus (1.2% VS 2%) and malpresentation (1.6% VS 2%) were not different in two groups.Conclusion: Adolescent pregnancy is associated with a higher rates of certain obstetric riskslike anemia, preterm delivery, pregnancy induced hypertension, instrumental delivery, cesareansection and poor neonatal outcome However the risk of antepartum hemorrhage, postpartumhemorrhage and malpresentation is no greater than adult pregnant mothers.

Objectives: To compare the obstetric outcome between primigravida andmultigravida presenting in labor at term. Study Design: Cross sectional study. Period: Sixmonths from Jan 2013 to Jun 2013. Setting: Obs/Gynae unit III, Jinnah hospital, Lahore.Patients and methods: 800 patients were included in the study which comprised 400of primigravida and 400 of multigravida. Patients having single, alive fetus with cephalicpresentation at 37-41 weeks were included in the study. Those having recurrent miscarriages,parity >5, antepartum hemorrhage, previous uterine scars and significant medical illness wereexcluded from the study. The data was collected on specially designed proforma. Observationsmode of delivery including the indication of cesarean section or instrumental vaginal deliveryif applicable. Maternal complications such as postpartum hemorrhage along with its cause,retained placenta and uterine inversion were also recorded. Fetal and neonatal observationsincluded CTG abnormalities, oligohydramnios, low birth weight, macrosomia, Apgar score < 7at 5minutes, NICU admission, fresh still birth and early neonatal death. Results: Mean age was25.57+ 3.46 years in primigravida women while it was 25.75 + 3.44 years in multigravida group.CTG abnormalities (15.5% VS 4.25%), instrumental deliveries (9.75% VS 1%), cesarean section(15.25% VS 1%) and postpartum hemorrhage (5.7% VS 1.75%) were commoner in primigravidawomen. In addition, NICU admissions, low birth weight babies and a low Apgar score at5-minute were also commoner in primigravida women. Conclusion: Nulliparous women areat greater risk of labor abnormalities, fetal distress, instrumental deliveries, cesarean section,postpartum hemorrhage and neonatal morbidity. These adverse factors should therefore belooked for and treated well in time.

Objective: To determine the association of intrapartum CTG with fetomaternal outcome Material and Methods: A total number of 120 pregnant females who presented in the department of obstetrics and gynecology with labour pain were included in this cross-sectional analysis. A written informed consent was taken from all patients. The study was conducted in the department of Obstetrics & Gynaecology at Islam Teaching Hospital, Sialkot from January, 2021 to September, 2021. At presentation in the labor room, 20 minutes CTG was performed and patients were divided into two groups, those having abnormal trace including suspicious and pathological trace (Group A) and normal cardiotocography (CTG) pattern (Group B). After that the patients were followed till delivery to determine the feto-maternal outcomes e.g. APGAR score, NICU admission, perinatal mortality and caesarean section rate. Results: The mean age was 26.9±4.12 years in group A and 27. 1 ± 3.9 years in group B (p-value 0.78). On comparison of maternal outcomes, caesarean section was done in 38 (63.3%) patients in group-A and in 17 (28.3%) patients in group-B (p-value <0.0001).Regarding neonatal outcomes, NICU admission was needed in 9 (15%) patients in group A, versus in 4 (6.7%) patients in group B (p-value 0.14). Perinatal mortality occurred in 03 (5.0%) patients in group A and in no patient in group B (p-value 0.07). APGAR score at 5 minutes was >7 in 46 (76.7%) patients in group A versus in 52 (86.7%) patients in group B (p-value 0.18). Conclusion: The intrapartum abnormal CTG cannot be used as the only tool to identify fetal hypoxia during labor. It may lead to increased caesarean section rate because of high false positive rate of abnormal CTG. Keywords: Cardiotocography, Fetal Distress, Cesarean section

Patients and methods: 800 patients were included in the study which comprised 400 of primigravida and 400 of multigravida. Patients having single, alive fetus with cephalic presentation at 37-41 weeks were included in the study. Those having recurrent miscarriages, parity >5, antepartum hemorrhage, previous uterine scars and significant medical illness were excluded from the study. The data was collected on specially designed proforma. Observations mode of delivery including the indication of cesarean section or instrumental vaginal delivery if applicable. Maternal complications such as postpartum hemorrhage along with its cause, retained placenta and uterine inversion were also recorded. Fetal and neonatal observations included CTG abnormalities, oligohydramnios, low birth weight, macrosomia, Apgar score < 7 at 5minutes, NICU admission, fresh still birth and early neonatal death. Results: Mean age was 25.57+ 3.46 years in primigravida women while it was 25.75 + 3.44 years in multigravida group. CTG abnormalities (15.5% VS 4.25%), instrumental deliveries (9.75% VS 1%), cesarean section (15.25% VS 1%) and postpartum hemorrhage (5.7% VS 1.75%) were commoner in primigravida women. In addition, NICU admissions, low birth weight babies and a low Apgar score at 5-minute were also commoner in primigravida women. Conclusion: Nulliparous women are at greater risk of labor abnormalities, fetal distress, instrumental deliveries, cesarean section, postpartum hemorrhage and neonatal morbidity. These adverse factors should therefore be looked for and treated well in time.