Objective: To find the frequency of depression, anxiety and stress among Gynae residents during covid pandemic. Methodology: This Cross-sectional survey was carried out in different Teaching Hospitals of Khyber Pakhtunkhwa during the period of six months i.e from August 2020 to January 2021. After the ethical approval from the research community, data was collected from Post Graduate Gynae Residents of Teaching Hospitals. Sample size for the study was 405 participants. Depression, anxiety and gross scale shorten version DASS-21 containing 21 items was standard research to use in study i.e. depression, anxiety and stress was identified on the basis of their cutoff scores i.e. normal scores were ≥10, ≥8 and ≥15 for depression, anxiety and stress respectively. Result: In depression, 136 (34%) participants were normal followed by moderate level having frequency 121 (30.25%). In the anxiety category, 116 (29%) participants were normal followed by moderate level having frequency 101 (25.5). In the category of stress, 179 (44.75%) participants were normal followed by mild levels having frequency 106 (26.50%). Only COVID positive status was statistically significant with depression, anxiety and stress as their P-valve was 0.02 less than 0.05. Conclusion: Considerable number of post graduate Gynae trainees working in different tertiary care hospitals have varying degrees of depression, anxiety and stress due to COVID-19 pandemic. Keywords: COVID-19, Pandemic, Post graduate, Psychological impact, Trainee doctors, Gynae residents, Mental health, Obstetrics, Gynaecology.
Background: Cesarean section delivery causes major risk factors in terms of intraoperative performance and blood loss while blood transfusion is a promising factor in emergency care in case of blood unavailability. Women undergoing cesarean section routinely require blood cross-matching. Aim: The present study aimed to evaluate the pattern of blood transfusion among women who underwent c/section at the tertiary care center. Materials and Methods: This cross-sectional study was conducted on 745 pregnant women who underwent cesarean section at Obstetrics & Gynaecology department of Quaid-e-Azam International Hospital Islamabad and PAF hospital Masroor, Karachi for duration of six months from January 2021 to June 2021. The demographic details, incidence of cesarean section, blood transfusion indications and types were recorded. Antenatal intraoperative and pre-operative details were also noted. Complications regarding blood transfusion were analyzed using multivariable analysis and EPI-statistical software v 3.5.3. Results: Of the total 745 cesarean sections, the prevalence of blood transfusion was 10.1%. About 75 women transfused 216 units of blood with packed cells tailed by Fresh Frozen Plasma (FFP). The prevalence of emergency cesarean section was 61 (81.3%) while general anesthesia was utilized in 27 (44.3%) cases. Fetal distress and placenta praevia were the common indications of cesarean section. Placenta praevia Respiratory rate (RR) was 5.01 (p<0.001). Other obstetric complications and risk factors were anemia, antepartum hemorrhage, hypertension, and previous cesarean section. The cross-matched transfusion ratio was 9.93 while the transfusion index and probabilities were 0.078 and 10.1 respectively. Conclusion: Our study found a higher prevalence of blood transfusion risks among pregnant women who underwent cesarean section. It has been observed that the risk of blood transfusion increased with placenta previa, preoperative maternal anemia, placenta abruption, and second stage cesarean section. During the antenatal period, the need for blood transfusion might be reduced with an increased concentration of maternal hemoglobin. Keywords: Blood transfusion, Complications, Caesarean delivery, Transfusion index
Background and Aim: Postpartum intrauterine device (PPIUD) is a reversible, long-term and effective technique of contraception. The intrauterine device (IUD) is inserted within 48 hours of delivery. The immediate insertion of an intrauterine device causes certain complications. The present study aimed to assess the prevalence of complications after Interval Postpartum Intrauterine Device Insertion. Materials and Methods: This cross-sectional study was carried out on 147 women who underwent postpartum IUD (PPIUD) insertions during from January 2021 to June 2021 at Gynecology department, Mufti Mehmood Memorial Teaching Hospital (MMMTH), Dera Ismail Khan and Muhammad Teaching Hospital Peshawar. All the women who delivered and showed willingness for PPIUCD insertion were enrolled and continuously follow-up for 4 to 6 weeks after delivery. Demographic, obstetric, and clinical parameters were recorded on pre-designed medical proforma. PPIUCD insertion after 6 weeks of delivery were followed-up for the evaluation of complications. Uterine infection, medical removal of IUD, IUD expulsion, perforation, and method discontinuation were the outcome variables. SPSS version 20 was used for data analysis. Results: Of the total deliveries, 147 women inserted the postpartum intrauterine contraceptive device (PPIUCD). Of the total, about 122 (83%) women returned for follow-up after 6 weeks. All the women underwent transvaginal insertion of intrauterine contraceptive devices. The PPIUCD insertion related complications with prevalence were uterine infection 26 (21.3%), overall method suspension 17 (13.9%), perforation 20 (16.4%), interceptive uterine device expulsions 25 (20.5%), and intrauterine device removal 32 (26.2%). The severe uterine infection was in 2 (1.7%) cases who were hospitalized. Conclusion: The postpartum intrauterine device cumulative expulsion rate was higher among women compared to the expulsion rate of insertions. The longer duration of bloody lochia flow and delivery intrauterine device insertions were the key risk factors for expulsion of PPIUCD. Women can safely utilize intrauterine contraceptive devices with low complications beyond four week. Keywords: Postpartum intrauterine device; Complications; Intrauterine device expulsion
Objectives: To determine the frequency of placenta previa in women with previous caesarean section presenting at Obstetrics and Gynecology department. Study Design: Descriptive (cross-sectional) study Setting and Duration: The study was carried out in the Department of Obstetrics and Gynecology of Abbottabad Medical Complex, Abbottabad and Mufti Mehmood Teaching Hospital, D. I. Khan during from December 2020 to May 2021. Methodology: The study population included those who have had at least one or more caesarean section, whether emergency or elective and irrespective of the cause of previous caesarean section with age group of 20 to 45 years of age. Patients fulfilling the inclusion and exclusion criteria were enrolled in the study after taking the informed consent. The aims and objectives of the study were explained to the patients being enrolled and their relatives and assured about confidentiality of information. Women included in the study underwent complete history, physical and gynecological examination. Results: A Total of 147 patients were included in the study sample with placenta previa. Mean age of the patients was 28.69±6.086, ranging from 20 to 45 years. Mean value of the parity was 3.18±1.141 ranging from 2 to 7 in the descriptive analysis, and the mean of gestational age (weeks) was 39.029±1.5618 ranging from 36.4 to 41.0 weeks. Out of 147 patients, Placenta previa diagnosed by ultrasound was found in 26(17.7%) patients. Conclusion: The study concludes that the frequency of PP in this setting is in keeping with globally cited frequencies. Other findings such as causes of PP and maternal morbidity data also agree with most national and international studies on this topic. Key Words: Placenta previa, Previous Caesarean Section
Background and Aim: Globally, hypertension disorder is the most common disorder in pregnancy. It complicates 6–10% of pregnancies with a major contribution to the worldwide maternal mortality rate. The aim of the current study was to evaluate the pregnancy outcomes in women with Hypertension disorders. Materials and Methods: This cross-sectional study was carried out on women with hypertension disorders enrolled in the department of Gynecology, Mardan Women Hospital, Sheikh Maltoon Town, Mardan and Family Health Centre, Peshawar from March 2021 to August 2021. Demographic details such as age, gestational age, parity, intrapartum, early postpartum complications such as perinatal outcomes and mode of delivery, and antepartum were recorded from each individual. Chi-square test was used for comparing the composite adverse outcomes such as preterm birth, postpartum hemorrhage, abrupt placenta, and mortality rate. SPSS version 20 was used for data analysis. Results: Of the total 2357 pregnant women, about 146 (6.2%) women had hypertensive disorders of pregnancy. The mean age of 146 pregnant women was 29.45±4.67 years with an age range from 17 to 43 years. About 37 (25.3%) women had no perinatal and maternal complications. Out of 109 pregnant women, the prevalence of eclampsia, preeclampsia, and pregnancy-induced hypertension were 8 (7.3%), 44 (40.4%), and 57 (52.3%) respectively. Based on gestational age, preterm (24-36 weeks) and term (>37 weeks) were 35 (32.1%) and 74 (67.9%) respectively. Other maternal complications were Abruption Placentae, Postpartum hemorrhage (PPH), Renal Failure., Pulmonary Edema, Disseminated intravascular coagulation (DIC), and Maternal Death. Conclusion: Our study found hypertension disorders as a significant medical disorder in pregnant women. However, neonatal outcomes and pregnancy outcomes were significantly smooth in more than 50% of pregnant women. Keywords: Hypertensive disorders of pregnancy, Pre-eclampsia, Eclampsia.
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