Objectives: To determine the prevalence, risk factors with maternal and fetal outcomes of hypertension in pregnancy. Type of Study: Retrospective cross-sectional study. Place of Study: Gynae A ward,Qazi Hussain Ahmed Medical Complex, Nowshera. Duration of Study: 1 year from 1st Jan,2019 to 31st Dec, 2019. Methodology: 552 patients who had hypertensive disorders in pregnancy were recruited. Self- administered and structured questionnaire was used for data collection. The risk factors in patients and the fetomaternal outcomes were manually extracted from the history sheets and evaluated. SPSS version 22.0 was used for data analysis. Results: The prevalence of hypertensive disorders in pregnancy was 13.9% in this study. Pregnancy induced hypertension was the most frequent hypertensive disorder with a prevalence of 57.97%. 61% of the total hypertensive patients had no antenatal booking making it the most common risk factors in pregnant hypertensive patients.38% of patients had high blood pressure in previous pregnancies as well. 56.5% of patients admitted had normal vaginal delivery,4.5% of patients had instrumental deliveryand 39% had lower segment caesarean section. 17.75% of the total patientsdeveloped maternal complications and among them the most frequent maternal complication was post-partum hemorrhage (7.4%).49.3% newborns developed neonatal complications where the most common neonatal complication was preterm deliveries (21.9%). Conclusion: The prevalence of hypertensive disorders was relatively high in our cohort. However, to reduce the feto-maternal morbidities and mortalities, awareness regarding hypertensive disorders should be increased at the community and hospital level and screening of this disorder should be proposed at early gestation. Keywords: Hypertension, Pregnancy induced hypertension, Pre-eclampsia, Eclampsia, maternal complications, fetal complications.
Background: Short pregnancy interval after caesarean section increases the risks of morbidity, mortality and surgical interventions. This can be easily avoided by post placental insertion of IUCD during caesarean section. Immediate post placental IUCD insertion is defined as insertion of IUCD within 10 minutes of delivery of the placenta. It is a very promising an appealing approach as patient does not have to come for a separate postpartum visit. Objectives: To determine the outcome (safety, complications, failure and continuation rate) of post placental IUCD insertion during caesarean section. Materials and Methods: Our study was a prospective cross-sectional study, carried out in the Department of Obstetrics and gynecology at Qazi Hussain Ahmad Medical Complex, Nowshera. All the pregnant women willing for post placental intrauterine contraceptive device were included in the study. Women who had postpartum hemorrhage, chorioamnionitis, structurally malformed uterus and fibroid uterus were excluded from the study. Follow up visits were scheduled at one month, 3 months and 6 months. Results: 156 women were included in this study. Majority(35.2%) belonged to 31- 35 years age group. 46.7% of them were illiterate and 30.7% have just primary education. 40.38% of women belonged to low socio-economic group. 26.2% of women were para 4. 26.9% had previous 3 caesarean section. The most common adverse events during follow up of 6months were vaginal discharge, menstrual irregularities and pelvic pain. At the end of 6 months there were 9expulsions, 12 removals and 2 pregnancies with the gross cumulative expulsions, removal, failure and continuation rate of 5.7%, 7.6%, 1.28% and 85.2% respectively. The incidence of undescended strings at the end of 6 months was high (32.4%). Conclusion: Post placental intra uterine Copper T 380 A insertion is a safe, effective and easy reversible method of contraception with low expulsion and high continuation rates. Keywords: Intrauterine device,Intra-cesarean section, Post placental insertion
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