To examine the effect of timing at which women admitted either in active or latent phase of spontaneous labour on subsequent outcome. This cross-sectional study was conducted at labour ward, department of Obstetrics and Gynaecology, BSMMU hospital, Dhaka, Bangladesh, from August 2007 to November 2007, where data were collected prospectively. A total of 60 women with term, singletone pregnancy, cephalic presentation with spontaneous onset of labour admitted in labour either in active or latent phase were selected for evaluation. Patients with any medical or obstetric complications, rupture of membrane, antenatally diagnosed foetal anomalies or death and with prior caesarean section were excluded from the study. Patients with cervical dilatation at less than 4cm were categorized as latent phase and were in group I. On the other hand, patients with cervical dilatation of 4 cm or more were marked as in active phase and were allocated in group II. Baseline characteristics were compared. Outcome differences were compared using chisquare(X 2 ) test, t test, fisher's exact test, A 'p' value <0.05 considered significant. Duration of labour, mode of delivery, indication for caesarean section, need for oxytocin, labour analgesia, Apgar score <7, birth weight of baby, maternal PPH and postpartum hospital stay. A total of 60 patients were enrolled during the study period. Of them 35 patients (58.3%)were in group I and 25 patients (41.7%) in group II. Duration of labour was more in early admitted group compared to late admitted group (mean± SD 17.0 ± 2.8 vs 14.3 ± 2.4). Latent phase women needed more caesarean delivery than active phase women (62.9% vs 28.0%). Dystocia was the main indication for caesarean delivery in the present study which was 68.2% and 28.6% in early and late admitted group respectively. Second commonest indication for caesarean section was foetal distress (6 in group I and 5 in group II). Oxytocin for augmentation was used in 62.9% in group I and 56.0% in group II and nulliparae women were the one who needed more augmentation (40.0% in group I, 36.0% in group II). Mean foetal weight between two groups did not reach any significant difference (p>0.05). Apgar score <7 shows insignificant difference between two groups. PPH was found in 5.7% cases and all were from group I. Total postpartum hospital stay was significantly longer in group I than group II (p<0.05). t is shown that early admission to the hospital in low-risk women may negatively affect the outcome of labour and are at increased risk of prolonged labour, more need for analgesia, increased rate of caesarean section, increased PPH and postpartum hospital stay.

Ibrahim Cardiac Medical Journal 2011; 1(2): 15-19 DOI: http://dx.doi.org/10.3329/icmj.v1i2.13546

Background: Cervical cancer (CC) is the fourth most common cancer in women worldwidewith an estimated 569,847 new cases and 311,365 deaths in the year 2018. In Bangladesh,the incidence of CC was 8068 and 5214 women died from CC in the year 2018.1CC constitutesabout 12% of the female cancer in this country.1 Methods: The present situation of cervical cancer screening program is reviewed. Results: The Government of Bangladesh (GOB) adopted visual inspection of cervix withacetic acid (VIA) method for cervical cancer screening. The major strengths of VIA is itssimplicity, low cost, potential for immediate linkage with investigations/treatment, feasible inlow resource settings and the possibility of rapid training to the providers. The GOB hasextended the program to all districts and selected upazilas.The screening programme hasbeen implemented through capacity building of service providers of Medical College Hospitals(MCHs), District Hospitals (DHs), Mother and Child care Welfare Centers (MCWCs) andselected Upazila Health Compleses(UHCs) and several institutes.Serviceprovidersareperforming VIA for the women of 30 years and above at about 417 VIA centres at primary,secondary and tertiary level health care facilities of 64 districts of Bangladesh. Screen positivecases are being referred to the colposcopy clinics of 14 government MCHs and BSMMU,where evaluation and management are carried out. From January 2005 to June 2017,1647380VIA tests were performed at different facilities with 4.6%positivity.Among the VIA+ve women attending women at the colposcopy clinic of Bangabandhu Sheikh Mujib MedicalUniversity (BSMMU), 51% had precancerous or cancerous condition of the cervix, 3312(14.10%) were treated by local excision, 2428 (10.30%)by local ablative method and1413(6%) women with cervical cancer were referred to oncology. In Bangladesh, LEEPand thermalablation has acquired acceptability as a commonly used treatment method for selected CINand ‘see-and-treat’ approach for high grade diseases combining colposcopy and LEEP/thermal ablation has been adopted since the year 2010 to improve compliance to treatment. Conclusion: Bangladesh has established VIA as screening test for prevention of cervicalcancer in quiet a good number of facilities with wide coverage. But the program has to beexpanded readily to prevent cancer and reduce sufferings & untimely death of women dueto this devastating disease. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 63-73

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