Summary:Objective: To determine the level of serum ionized magnesium in eclampsia patient before and 24 hours after giving the loading dose of magnesium sulfate and if low, to determine the relationship between levels of ionized magnesium in serum and occurrence of eclamptic convulsions.Methods: Fifty eclampsia patients received a loading dose of 4 gm of magnesium sulfate, which was diluted with 12 ml of distilled water and then was given intravenously over a period of 10-15 minutes and it was followed by 3 gm of magnesium sulfate deep intramuscular injection in each buttock. Patient's venous blood samples were obtained before and 24hours after loading dose of magnesium sulfate and analyzed for ionized magnesium, sodium, potassium, and calcium level.

The present study aimed at exploring the causes of re laparotomy following Caesarean section and to find out the pathway how to avoid these complications. This is a hospital based prospective study conducted in the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh from August 2007 to August 2008. Bangladeshi pregnant women are at risk of serious complications during pregnancy and labor due to lack of antenatal, intra natal and postnatal care. DMCH is the largest referral hospital in Bangladesh and more than ten thousand patients admitted here each year with different pregnancy and child birth related complications. Among them, 54 puerpera needed re laparotomy after Caesarean section within 6 weeks of Caesarean Section. Of the 54 cases, 28 had primary PPH, 14 patients had secondary post-partum hemorrhage (PPH), 4 cases had puerperal sepsis and 3 women had wound dehiscence, and 5 cases had sub rectus hematoma. Irreversible hemorrhagic shock (12cases), cardio genic shock (1 case), not reversed from anesthesia (1 case), acute renal failure (3cases) and puerperal sepsis (1 case) were causes maternal death. It gave the overall case fatality rate was 33.33%. Obstetric patients who return to the operation theater face potential death. This study will help us to identify the risk situations where re laparotomy may be needed and due precautions and prevention may be taken as far as possible to avoid this complications following caesarean section and thereby reduce maternal mortality and morbidity. Key word: Cesarean section; laparotomy; maternal morbidity; maternal mortality; case fatality. DOI: http://dx.doi.org/10.3329/jdmc.v20i1.8583 J Dhaka Med Coll. 2011; 20(1) :57-62

Objective: To examine the obstetric outcome in grand multi-parous and the effect of high parity among young women, aged 18-34 years vs. older women, aged 35years and above. Methods: This is a retrospective study done in DMCH from 1st August 2007 to 31st August 2008. For study purpose 98 patients were selected randomly whose gravidity 6th and more. To see peri-natal outcome, the cut-off point of 28 weeks was taken. Results: Mean age of the study group was 32(22-45) years. Mean gravidity and parity of the study group was 6.7 (6-11) and 4(1-8) respectively. Ninety percent pregnancy affected by different complications. Hypertensive disorder of pregnancy (14.3%) and ante-partum hemorrhage (14.3%) was more common. Bad obstetric history (12.35%), mal-presentation (11.23%) and intra-partum complications were also common. Twenty two percent (22.46%) pregnancies complicated by gestational diabetes, maternal medical disease and multi-fetal gestation. Regarding fetal outcome, peri-natal loss was 10(14%). Preterm delivery, ante partum hemorrhage, bad obstetric history, gestational diabetes and mal presentation were the cause of peri natal loss. Lack of reproductive knowledge, unmet need for contraception, poor obstetric performance and too early marriage are the main cause of grand multi-gravidity and multi-parity Conclusion: Diabetes mellitus, hypertension, ante partum hemorrhage, mal-presentation was more common in grand multi-parous irrespective of age. There was no significant difference in the incidence of obstetric complications and in perinatal outcome among both groups. DOI: http://dx.doi.org/10.3329/jdmc.v22i1.15629 J Dhaka Medical College, Vol. 22, No. 1, April, 2013, Page 67-71

Objective: To demonstrate the value of iron sucrose complex in the treatment of anemia in  pregnancy.Methods: It is a prospective clinical study, of 35 consecutive pregnant women suffering from  anemia in pregnancy. The study was conducted over a period of twelve months. Hemoglobin  concentration was measured three times during pregnancy. All women consumed timed release iron from 17 weeks onward up to birth of the baby. If hemoglobin level is (8.5 - 9) gm/dl, parentral Iron sucrose complex 2 doses (400gm of iron) were given intravenously and hemoglobin  level was checked after 15 days.Results: There were 35 women who completed the treatment and data was available for  analysis. Their mean age was 27.5(range21-35) years. Fifty six percent were 2nd gravid. Twenty eight (28%) percent women in 1st half of pregnancy, 53% in 2nd trimester and 16% in 3rd trimester suffering from moderate anemia and treated with iron sucrose complex (ISC). The average Hemoglobin concentration before treatment was 8.47gm/dl and after treatment  was 9.67gm/dl. There was a statistically significant improvement in hemoglobin concentration. Three women developed side effects and did not get 2nd dose.Conclusion: Intravenous iron therapy is safe, convenient and effective in treatment of iron  deficiency anemia during pregnancy. The intravenous iron therapy can replace blood transfusion in antenatal period in many patients. DOI: http://dx.doi.org/10.3329/bjog.v25i1.13728 Bangladesh J Obstet Gynaecol, 2010; Vol. 25(1) : 20-23

Thrombocytopenia in pregnancy has many common causes, including gestational thrombocytopenia, viral and bacterial infections, and preeclampsia complicated by hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome. The great concern for ITP during pregnancy is the risk of thrombocytopenia in the newborn infant. A 30yrs old 3rd gravid women was admitted in maternity unit 3, Dhaka Medical College Hospital with the complaints of 36weeks pregnancy, lower abdominal pain and less fetal movement. She had been suffering from severe thrombocytopenia for the last 8 months. She treated with Prednisolone during pregnancy period, platelet transfusion before and after delivery and Danazol in puerperium. Her baby was delivered by caesarean section .Her intra-operative and post operative period was uneventful. She delivered a healthy male baby weighted 2.5 kg and breast feeding established successfully. She was discharged on seventh post operative day. The aim of this case report to reveal pregnancy with ITP and its clinical presentation, investigation and management with review of relevant literatures. DOI: 10.3329/jbcps.v28i3.6516J Bangladesh Coll Phys Surg 2010; 28: 196-198