Objectives: To compare the intraoperative hemorrhage between blunt and sharp expansion of uterine incision at lower segment caesarean delivery. Study Design: Randomized controlled trial. Study Duration: 03-02-2022 to 02-08-2022 (6 months) Setting: Department of Obstetrics and Gynecology, D.G Khan Hospital D. G Khan Material and methods: Total 74 patients undergoing C-section, age range 20-40 years, with singleton pregnancy and patients with >37 weeks gestation. (on ultrasound) were included. Intraoperative blood loss was compared between blunt and sharp group. Results: Mean age was 32.31 ± 6.246 years, in Blunt and Sharp group, mean age was 35.70 ± 4.122 years and 28.92 ± 6.202 years. In Blunt group, mean blood loss was 201.62 ± 60.794 ml while in sharp group was 782.03 ± 153.819 ml. Difference of mean blood loss between Blunt and Sharp group was significant (P= 0.000). Conclusion: Results of present study reflects that there is significant difference of intraoperative mean blood loss between blunt and sharp groups. Most of the patients were between 31-40 years of age. After stratification of age, gestational age, parity and type of C-section, it was found that there is significantly low mean blood loss in blunt group as compared to sharp group. Keywords: Blood loss, C-section, Blunt, intraoperative haemorrhage,
Objective: To compare domeperidone and metoclopramide to increase the milk production in lactating mothers. Study Design: Randomized Controlled Trial. Setting: Department of Gynecology and Obstetrics, Sheikh Zayed Hospital, Rahim Yar Khan. Period: February 2021 to August 2021. Material & Methods: A total of 190 lactating mothers within 1 month of delivery and milk production less than 160 ml/kg/day were included. Women in Group-A were given metoclopramide in a dose of 10 mg three times a day in oral form and those in Group-B were given tablet domeperidone in the same dose and protocol. These women were then followed up and assessed at day-10 regarding the milk production over the previous 24 hours. Treatment compliance was also noted. Results: In a total of 190 women, the mean age was 29.86±5.49 years ranging between 20-40 years. Majority of the women, 114 (65.3%) were aged between 31-40 years. The mean weight was 71.78±8.75 kg while the mean parity was 2.32±1.06. Pre-treatment mean milk production was 159.43±89.67 ml in metoclopramide group versus 157.98±78.59 ml in domperidone group (p=0.9058). After 10 days of treatment, mean milk production was noted to be 183.61±31.44 ml in metoclopramide versus 245.63±68.84 ml in domperidone and the difference was noted to be significant favoring domperidone group (p<0.0001). Treatment compliance was statistically similar in both treatment groups (58.2% vs. 64.4%, p=0.4617). Conclusion: Domperidone is better in increasing the milk production in lactating mothers as compared to metoclopramide.
Background: Hypertensive disorders are the second most common cause ofmaternal death worldwide. Eclampsia is the extension of pregnancy induced hypertension tothe point of conclusions, coma or both. Objectives: To find out the incidence of eclampsiaamong pregnant women and to identify the maternal and perinatal outcomes of eclampticpatients treated in a tertiary care referral hospital. Study Design: Discretional cross sectionalstudy. Setting: Department of Obstetrics & Gynecology, Sheikh Zayed Hospital, Rahim YarKhan. Period: January 2014 to December 2014. Methods: A total number of 96 patients out of10513 who were diagnosed as being eclamptic during the study period were included in thisstudy. While normal pregnant women and Patient’s with uncertain diagnosis was excluded. Allpatient variables were entered and analyzed using SPSS v20. Frequency and percentages wereused to express qualitative variables. Results: There were total ninety six patients (0.913%) outof 10,513 who presented with eclampsia. Most of eclamptic patients were of having age >21years. Among patients who developed eclampsia 52 (54.16%) were in Ante partum period and40 (41.66%) were in postpartum period. Out of 96, five patients died before delivery and thirteenafter delivery, seventy eight patients developed one or more complications during delivery.Out of total 91 deliveries, 54 (59.30%) were delivered by cesarean section (C/S). Main reasonfor C/S was unfavorable cervix. Out of total ninety one deliveries two were twins and eightynine singletons. Fifty eight (62.36%) babies were born at a gestational age <37 weeks. Birthasphyxia occurred in sixty one (65.60%) newborns. There were twenty two (23.65%) perinataldeaths, fourteen (63.64%) were stillbirths and eight (36.36%) were early neonatal deaths.Conclusion: Eclampsia is found to be associated with very high rates of maternal mortality andmorbidity as well as perinatal mortality. Early diagnosis of eclampsia and its timely managementcan reduce the risk of this mortality. This can be made possible by provision of basic facilitiesand improvements in the quality of basic care provided by our antenatal clinics.
Objective; To compare emergency vs elective LSCS for their various outcomes. Study setting; Sheikh Zayed Hospital, Rahim Yar Khan Duration; 01-09-2018 to 28-02-2019 Methodology: This was a randomized controlled-trial, in which pregnant females irrespective of their duration of gestation, gravida and parity having age equal more than 20 years were included. The cases were subdivided into 2 equal groups. The cases in group A were operative for emergency C section surgery and those, who were in group B underwent elective surgery. These cases were then followed to look for various surgical outcomes. Results: In this study total 150 cases of C section were included with 75 in each group. The mean age of the group A and B was 28.87±4.43 vs 29.54±5.13 years and mean duration of gestation at presentation was 37.13±2.56 vs38.67±1.39 weeks. SSI was seen in 3 (5.33%) cases in emergency group vs 2 (2.66%) in elective group with p= 0.07. PPH was observed in 2 (2.66%) of the cases each with p= 1.0 and both hysterectomy and maternal mortality was observed in 1 (1.33%) cases each in emergency group with p= 0.81 each. Conclusion; Complications are rate are relatively higher in emergency as compared to elective C section and SSI is nearly significantly high in this group.
Objective: To look for the association of raised CA 125/ CEA ratio and positive ascitic fluid cytology with the diagnosis of epithelial ovarian cancer in patients with an adnexal mass. Study Design: Comparative Cross-sectional study. Setting: Department of Oncology and Gynecology, Sheikh Zayed Hospital Rahimyarkhan. Period: September 2021 to February 2022. Material & Methods: A total of three hundred patients presenting with adnexal mass were recruited for the study. All patients underwent detailed evaluation, including CA 125 levels, CEA levels and ascitic fluid cytology. After complete staging workup, they underwent surgery and histopathological analysis of adnexal mass. A consultant histopathologist made the diagnosis of ovarian cancer. Association of various factors, including raised CA 125/ CEA ratio and positive ascitic fluid cytology with the diagnosis of ovarian cancer, was established. Results: Out of 350 patients of adnexal mass included in analysis, 273 (88%) were diagnosed with ovarian carcinoma, while 77 (22%) were not diagnosed with ovarian cancer after the surgery and had a diagnosis other than ovarian cancer. 179 (51.2%) patients were post-menopausal whereas 171 (48.8%) were pre-menopausal. It was revealed that raised CA-125/CEA ratio and positive ascitic fluid cytology had a statistically significant association with the diagnosis of ovarian carcinoma on histopathology (p-value<0.001). Conclusion: Most patients who presented with adnexal mass were diagnosed with ovarian carcinoma in our study. Raised CA 125/ CEA ratio and positive ascitic fluid cytology at baseline predicted a histopathological diagnosis of ovarian cancer in our study participants.
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