Background: The elevated risk of premature delivery should be discussed with polyhydramnios patients. It is advisable to measure the cervical length to evaluate whether or not it is necessary to administer steroids to encourage foetal lung maturity. Patients should also be made aware of the dangers associated with unstable labour necessitating caesarean delivery, umbilical cord prolapse, abruptio placentae, and postpartum haemorrhage. Aim: To determine the frequency of polyhydramnios among patients with preterm delivery presenting to Lady Reading Hospital Peshawar. Study design: Cross-sectional study. Place and duration of study: Department of Obstetrics & Gynaecology, Lady Reading Hospital Peshawar from 1st November 2019 to 25th April 2020. Methodology: One hundred and eighty one women with preterm delivery, gestation age of 24-36 weeks and age between 18-45 years were included. The obstetrical records of these patients were evaluated for the presence of polyhydramnios using AFI they were classified as mild, moderate, and severe polyhydramnios based on AFI. Results: The mean age was 30.39±3.53 years, mean weight of 68.33±7.52 Kg and mean height of 1.59±.0.07 meters, mean BMI 27.07±3.71 kg/m2, mean gestational age 32.30±1.89 weeks and mean AFI was 18.38±6.85 cm. Polyhydramnios was seen in 17.7% of patients. Mild polyhydramnios was 28.1%, moderate 40.6%, and severe was 31.3%. Conclusion: Preterm labour appeared to be influenced more by the underlying aetiology of polyhydramnios than by the relative excess of amniotic fluid as identified by this investigation Keywords: Preterm delivery, Polyhydramnios, Severity
Background: Primigravida and eclampsia still have not been well studied. This research intends to lighten risk factors and therapeutic care by examining the prevalence of first pregnancies in eclamptic patients. It is essential to comprehend the effects of primigravida in eclampsia to provide better treatment for this vulnerable population.Objective: To determine the frequency of primigravida in patients with eclampsia.Material and Methods: This Cross-sectional study was conducted in the Department of Gynaecology and Obstetrics, Lady Reading Hospital, Peshawar from 06 august 2020 to 06 February 2021.A total of 151 pregnant women with Gestational age > 20 weeks were included in the study. All Basic demographics like age, gestational age, and weight (kg) were recorded. Data regarding eclampsia was noted by the researcher herself and analyzed with a statistical analysis program (SPSS v22). Frequencies and percentages were computed for categorical variables like age groups, history of hypertension and primigravida. Mean, and SD ratios were calculated for quantitative variables like age, gestational age and BMI.Results: The results showed that the mean age was 25.814±2.71 years, the mean gestational age was 32.344±2.94 weeks, and the mean BMI was 24.476±2.24 Kg/m2. A history of hypertension was seen in 9.9% of patients. Primigravida with eclampsia was observed in 33.8% of patients.Conclusion: The study concluded that most pregnant women with eclampsia were primigravida. These results highlight the significance of considering primigravida as a possible risk factor for the onset of eclampsia. Keywords: Eclampsia, Pregnancy, primigravida.
BACKGROUND: In recent times, the incidence of multiple pregnancies has significantly increased dueto medication for induced ovulation and other reproductive technologies. The present study is designedto see the maternal complication of multiple gestations in pregnancy.OBJECTIVE: To determine the maternal complications associated with multiple gestation in secondand third trimester of pregnancy.METHODOLOGY: This descriptive study was carried out in the department of obstetrics andGynaecology unit at Lady Reading Hospital Peshawar. Duration of the study was 06 months from 1stJanuary 2012 to 1st July 2012. All patients with twin gestations, triplets and high order multiples visitingobstetrics and Gynaecology unit at Lady Reading Hospital Peshawar and who were admitted in wardwere included in the study and after taking informed consent their characteristics were recorded byfilling proforma.RESULTS: Sixty patients with multiple gestations were included in the study. Fifty four (90%) of themhad twin pregnancy and 06 (10%) had triplet pregnancy. The antenatal complications detected in thesepatients were preterm labour 23(32.3%), anaemia 18(30%), pregnancy induced hypertension, preeclamptic toxaemia, eclampsia 13(21.7%), Malpresentation 13(21.7%), Antepartum Haemorrhage 5(8.3%), 5 patients (8.3%) had PROM, 4 (6.7%) had polyhydramnios, 3(5%) had miscarriages, 5 (8.3%)had postpartum haemorrhage, 44(73.3%) patients had spontaneous vaginal delivery and 15(25%)underwent caesarean section. In 28(46.7%) patients cephalic/cephalic was the most commonpresentation.CONCLUSION: Multiple gestation is a high risk pregnancy and is associated with both maternal andfetal complications. Patient needs to be educated about the importance and advantages of early antenatalbooking and regular antenatal follow-up to reduce the risks to the mother and the babies.KEY WORDS: Twin pregnancy, Triplets, High-order multiplets; Complications-Second Trimester,Third trimester.
BACKGROUND: Family planning helps couples to attain their desired number of children and proper timings of their births (1). It is best achieved with different contraceptive methods. Immediate postpartum intrauterine contraceptive device (IPPIUCD) is an excellent contraception providing safe, effective and long term reversible contraception in women after both normal delivery and c/section(2). It reduces postpartum undesired pregnancies and thus induced abortions (3). It is coitus independent, easy to insert and does not affect breastfeeding. Both care provider and client are available in the same setting, securing time and cost of interval IUD insertion. PPIUCD is associated with primary complications like pregnancy and secondary ones as irregular vaginal bleeding, abdominal pain, infection, expulsion and uterine perforation. PPIUCD counselling services regarding its common side effects and complications are important. There is minimal research comparing follow up outcomes between vaginal and caesarean insertions. The objective of study is to compare outcomes of IPPIUCD as a factor of route of insertion. METHODS: In this prospective comparative study 200 patients in whom postpartum IUCD was inserted within 10 minutes of delivery of placenta after normal vaginal delivery or c/section were included. About first 100 cases of vaginal and first 100 cases of intra-cesarean PPIUCD insertions formed study groups. Record of clients was maintained and analysis at 6 weeks to 12 weeks post insertion follow up visit was done at gynae and obstetric unit of Lady Reading Hospital Peshawar. RESULTS: Of total 1005 IPPIUCD inserted during the study period, about 156( 15.5%) were inserted intra-cesarean and 849 (84.4%) after vaginal delivery. Follow up of 200 (19.9%) clients i.e. about 100 intra-cesarean and 100 vaginal insertions was recorded. Complications rate was low. No life threatening complication such as perforation was recorded. Most common complications observed between vaginal vs intra-cesarean insertions were irregular vaginal bleeding in (11% vs 5%), abdominal pain(6% vs 9%), vaginal discharge(8% vs 5%),spontaneous expulsions (8% vs 2%) and lost strings (14% vs 1%). Statistically significant difference was found between two groups with respect to lost strings (P=0.0006). CONCLUSION: IPPIUCD is an acceptable, safe (in terms of complications) and effective contraceptive option after both vaginal and intra-cesarean insertions. Early follow up examinations are helpful in identifying spontaneous expulsions and dealing common problem.
Introduction: Toxoplasma gondii (TG), Rubella virus (RV), Cytomegalovirus (CMV), and Herpes simplex virus (HSV) 1 and 2, globally most neonatal and infant deaths are reported due to this group of infections. Purpose: The objective of this research study is to estimate the Prevalence of TORCH infections. Methods: This research study was carried out at the Hi-Tech clinical laboratory Shewa Adda Swabi KPK Pakistan for a duration of 4 months from April 2022 to July 2022. Data statistics looking at the clinical characteristics of Toxoplasma gondii, CMV, RV, and HSV were filled from n=371. All samples were qualitative and quantitative tested by using Immune chromatographic (ICT) and Chemiluminescence Microparticle Immunoassay (CMIA) techniques. Results: Out of n=317 pregnant women, n=131 (35 %) women were found positive while n=240 (65 %) women were found negative. Prevalence of Toxoplasma gondi 32 %, RV 28 %, CMV 27 %, and HSV 13 % in Swabi, KPK, and Pakistan. Among them, a high-frequency fraction of co-infection was detected for CMV and Rubella 17 (58 %), followed by CMV, Herpes, Rubella virus, and Toxoplasma gondii combined 7(25 %). The highest number of infected individuals 37 % we found in the age-group 21-25 years, followed by the 15-20 years age group 23 %, 26-30 years age group 17 %, 31-35 years age group 23 % while the lowest number of positive individuals found in >36 age group. Conclusion: In brief context, TORCH pathogens have potentially shocking clinical manifestations. Hence, screening before pregnancy, and timely diagnosis of TORCH can reduce disease and death in both kid, and the mother. Moreover, knowing the epidemiology survey is a significant aspect to develop strategies and implementation for the prevention of disease. Keywords: Pregnancy, Prevalence, TORCH, Swabi, Infections.
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