Objectives: To evaluate the frequency of gestational diabetes in pregnant women with hepatitis C who presented at civil hospital Karachi Subject and Methods: This cross-sectional study was done at the Gynae and OBS department of Civil Hospital Karachi during the period of one year from December 2019 to December 2020, after obtaining approval from the IRBD of DUHS, DMC Civil Hospital, Karachi. Pregnant women with singleton pregnancies aged 16 to 45 years with positive HCV antibodies according to Elisa method tests were included in the study. Eligible patients were tested for glucose tolerance by performing an OGTT. The serum glucose level was measured using a glucometer. A study proforma was used to collect the information, and the data was analyzed using SPSS version 26. Results: A total of 197 HCV positive pregnant women were studied; their average age was 28.83±3.77 years and their average gestational age 25.95±1.45 weeks. The frequency of gestational diabetes among pregnant women with hepatitis C was 35.53% (70/197). The rate of gestational diabetes was associated with age groups (p = 0.020), while the frequency of gestational diabetes was statistically insignificant according to gestational age and duration of HCV (p > 0.05). Conclusion: As per the study conclusion, the frequency of gestational diabetes was observed to be frequently high among HCV positive pregnant women. Based on these findings, pregnant women who have HCV are at an increased risk of developing gestational diabetes. Keywords: HCV, pregnancy, Gestational diabetes

Objective: To find out the frequency of secondary  postpartum  haemorrhage  (pph)  as  well  as  its  causes and management in women presenting in a tertiary care hospital Methods: It was a descriptive case series study conducted  from  1st  January  2016  to  31st  December 2016 at the Department of Gynaecology and Obstetrics, Dr. Ruth K.M.Pfau Civil Hospital, Karachi.   All     the patients presenting with secondary postpartum haemorrhage in the specified  time  period  were  included in the study. The patient's age, parity, booking status,  mode  of  delivery,  place  of  delivery,  cause of secondary postpartum haemorrhage and management done was noted on a predesigned proforma. Results:  The average age of the women was 30.62 ± 4.37 years. Postpartum haemorrhage was ob- served in 130 patients, out of these 27 patients had secondary postpartum haemorrhage  with  a  fre- quency of 20.67%. Majority of the women with secondary pph were multiparous 17 (62.96%) with 21 (77.77%) being delivered vaginally compared to 6 (22.22%) who had caesarean section. Most of the women 16 (59.25%) presented with secondary pph around 10-14 days post-delivery. Retained placen-       tal pieces was identified as the commonest cause in 19 (70.37%) women, antibiotics was given to all       the patients, evacuation done in 19 (70.37%)  cases,  2  (7.40%)  women  had  obstetrical  hysterectomy and 1 (3.70%) woman had repair of uterus while 5 (18.51%) cases were managed conservatively. No maternal death was recorded. Conclusion: Secondary postpartum haemorrhage though less common but  is  found  to  be  associated with significant maternal morbidity which  require  timely  diagnosis  and  management  so  as  to  prevent life threatening complications.

Objective: To determine the frequency of gestational trophoblastic diseases and gestational  tropho-  blastic neoplasm, its risk factors and prognosis. Methods: This was a descriptive,  cross-sectional  study  conducted  at  Civil  Hospital,  Karachi  from  March 2015 to September 2015. All cases of gestational trophoblastic disease after necessary inves- tigations like tumour marker b-hCG, ultrasound with classical picture of "bunch  of  grapes"  or  "snow  storm" pattern and X-ray chest (for lung metastases) under went suction evacuation.  In  all  cases  specimen was sent for histopathology to confirm gestational trophoblastic disease. After primary treat- ment, cases were followed with  b-hCG till complete remission was achieved. During follow-up, cases     were labelled as gestational trophoblastic neoplasm on the basis of International Federation of Gyne-  cology and Obstetrics (FIGO) criteria. After risk scoring on World Health Organization (WHO) criteria, chemotherapy was given. Results: Out of 497 pregnant ladies, 40 were cases of gestational trophoblastic disease (8.05%). Frequency/obstetric case was 1.7% and frequency/delivery was  2.1%.  Out  of  40  cases  13  (32.5%)  were cases of gestational trophoblastic neoplasm. Out of 13 cases  of  gestational  trophoblastic  neo-  plasm 9 (69.23%) were labelled as low-risk and 4 (30.76%) as high-risk cases. All cases  achieved  complete remission. One case of high-risk group expired. Conclusion: All women with gestational trophoblastic disease must  be  followed  as  per  recommenda- tion with serum b human chorionic gonadotropin  measurement  until  the  levels  are  undetectable,  for early diagnosis and optimum treatment of gestational trophoblastic neoplasm.

Objective: To determine the different grades of meconium-stained liquor and association of fetal outcome (still birth, poor Apgar score, NICU admissions) among meconium-stained liquor patients according to their grades. Subject and Methods: This prospective case series study was conducted at the department of obstetrics and Gynaecology, civil Hospital Karachi, for 6 months from April 2019 to September 2019. After per vaginal examination meconium-stained amniotic liquor and grades of meconium-stained liquor were confirmed and these patients were monitored by auscultation of fetal heart sounds by pinard stethoscope and cardiotocography performed and when patients delivered, the frequency of fetal outcome according to grades noted and was documented on pre-designed proforma. Results: A total of 150 patient women were studied, their average age was 28.62±4.19 years and mean gestational age was 38.38+1.00 weeks. There 56% multiparous women. Of all meconium-stained liquor, grade II was commonest 40%, grade I 30% and grade III 30%. Still birth was 2.0%, poor Apgar score was 24.7% and rate of NICU admission was 28.0%. Maternal age, parity and gestational age effects were statistically significant on grade of liquor (p-<0.05). Conclusion: Meconium-stained liquor grade II was observed to be high. The adverse fetal outcomes in terms of still birth, low Apgar score and neonatal intensive care unit admission were observed to the significancy associated with meconium-stained liquor grades II and III. Meconium-stained amniotic fluid as a serious problem so early decision should be taken to improve the fetal outcome. Keywords: Meconium-stained amniotic fluid, still birth, poor Apgar score

Background: Depression is among the most prevalent psychiatric disorders affecting women. Depressive disorders are predicted to be the second leading cause of global disability burden by 2020. The risk of depression increased significantly during pregnancy and clinically significant depressive symptoms are common in mid and late trimesters. The purpose of present study is to determine the frequency of antenatal depression, so that better strategies and early management was recommended in such patients to reduce frequency of depression. Objectives: To determine the frequency of antenatal depression among pregnant women presenting to a tertiary care hospital. Study Settings: This Cross sectional Study was conducted at the Department of obstetrics and Gynaecology unit I of Civil Hospital Karachi for the duration of six months from January, 2019 to June, 2019. Subject and Methods: A total of 150 pregnant women attending the antenatal clinic were included in this study. EPDS is the most widely used screening questionnaire for postpartum depression and has been widely validated for not only this condition but also antenatal depression. We chose to regard an EPDS score ≥12 as indicating depression. All information was recorded in predesigned proforma. Results: The average age of the patients was 25.85±4.49 years. Frequency of antenatal depression among pregnant women was 46.67% (70/150). Conclusion: The prevalence of antepartum depression among pregnant women was high and the greatest contributor is the thought of harming herself. We therefore recommended that pregnant women be routinely screened for depression during antenatal care. The necessary psychological care for pregnant women, especially those with risk factors for antenatal depression, should be provided by PCH centers. Keywords: Antenatal depression, psychiatric disorders, psychological care.

Background: The commonest criteria used for diagnosis of Polycystic ovary syndrome (PCOS) are the “Rotherdam criteria” which includes any two among 1:Oligo/anovulation(O), 2:clinical and/or biochemical hyperandrogenemia (H), and 3:polycystic ovaries on ultrasound (P). Aim of the study was to determine the frequency of PCOS diagnosed on clinical findings and the frequency of phenotypes of PCOS in tertiary care hospital. Study Setting: This Cross sectional study was conducted in the Department of Gynaecology & Obstetrics, Unit 3, Civil hospital, Karachi from January, 2018 to July, 2018. Material and Methods: Total 292 patients of age 18-45 years were included. A pelvic ultrasound for status and morphology of ovary was done. After receiving laboratory and ultrasonography results diagnosis for PCOS and phenotypes was made on the basis of different combination of chronic anovulation (O), hyperandrogenism (H) and polycystic ovaries(P). Descriptive statistics were calculated. The stratification was done using chi-square test. P value ≤0.05 was considered as significant. Results: Mean age of patients was 31.37±5.72 years. 67.3% were multiparous. Mean irregular period days and number of follicles were 152.05±29.11 days and 12.66±2.46 while mean OV and mean testosterone was 11.20±6.86 cm3 and 4.36±1.51 Nmol/L. 74.3% females were found with PCOS. Among them Oligo-ovulation was 75.1%, Polycystic Ovary was 83.4%, and Hyperandrogenism was 85.35%. Phenotype A was the most common type. Conclusion: Total 74.3% females were found with PCOS. Hyperandrogenism was the highest followed by Polycystic Ovary and Oligo-ovulation. While Phenotype A was found most common phenotype. Keywords: Frequency, PCOS, Clinical Findings, Phenotypes