Objective: The objective of the study was to compare mean Amniotic Fluid Index (AFI) in maternal oral hydration with routine hydration in third trimester oligohydramnios. Study design: Randomized control trial. Settings: Department of Gynea/Obs Faisalabad Medical University, Faisalabad. Duration of study: 6 months from 1 st June to 30 th November 2016. Methodology: A total of 80 cases (40 in each group), were included in the study, Group A was oral hydration group and was enquired about daily water intake. They are bound to take 2 liters of water in addition to their daily intake for 7 days. Group B was routine hydration group and continued to drink water determined by thirst and followed up on OPD basis according to the hospital protocol. Ultrasonography was done by radiology department and reported by radiologist after completion of 7 days and revised amniotic fluid index was noted. All the information was recorded on proforma. Results: In this study, (40 in each group), 65%(n=26) in Group-A and 57.5%(n=23) in Group-B were between 18-30 years and 35%(n=14) in Group-A and 42.5%(n=17) in Group-B were between 31-45 years of age, mean+sd was calculated as 27.88+5.40 years and 28.80+5.72 years respectively, pre-treatment mean AFI volume was in-significant between the two groups. Post-treatment mean AFI volume was recorded as 6.83+0.81 in Group-A and 5.05+0.75 in Group-B, p value was calculated as 0.001 which shows significant difference between the two groups. Conclusion: We concluded that oral hydration appears to be significantly increased in mean AFI as compare to routine hydration in third trimester oligohydramnios, this therapy can be used instead of expectant management or invasive techniques in patients of third trimester oligohydramnios.

Aim To clarify the status of minimally invasive gynecologic surgery (MIGS) in the Asia/Oceania region. Methods Survey questionnaires were sent out to the representative of AOFOG countries. They consisted of questions on the general status of MIGS, the clinical indication of MIGS, cost coverage, company support, training and certification for MIGS, patient preference for MIGS and requirements for the AOFOG. Results Developmental stage of MIGS in this region was roughly divided into three categories: fully developed countries, countries in the developmental stage and countries in the rudimentary stage. Clinical indication of MIGS and training opportunity of young doctors were correlated with the developmental stage. Conclusion Support by AOFOG should be considered according to the developmental stage of each country. Collecting updated information on MIGS in each member country is important to provide adequate support.

Background: Post-partum hemorrhage is one of the most common obstetric emergencies. However, Tranexamic acid (TXA) is a medication used to treat or prevent excessive blood loss due to trauma, surgery and medical conditions including hemophilia and heavy menstrual bleeding. Objective: To determine the role of intravenous tranexamic acid before elective caesarean section in preventing postpartum hemorrhage at tertiary care hospital. Study Design: Randomized control trial. Settings: Obstetrics & Gynecology Department, Allied Hospital Faisalabad Pakistan. Duration: 6 months from March 02, 2019 to August 01, 2019. Methodology: After taking demographic information and informed consent, all the patients were randomly divided into two groups by using random number table. Group A patients received tranexamic acid (1gm/10ml TA diluted with 20ml of 5% glucose) and group B patients not received tranexamic acid (placebo). Blood loss was noted by measuring the total blood collected in kidney tray of 10" size during delivery of placenta till completion of caesarean section. All this information was recorded through study proforma. Data was entered and analyzed on SPSS version 21. Results: In our study the mean age of the patients was 29.90±6.06 years. The mean blood loss value of the patients was 387.27±89.56 ml. Statistically highly significant difference was found between the study groups with blood loss of the patients i.e. p-value=0.000. Conclusion:It has been proved in our study that the tranexamic acid is useful and effective drug to control the mean blood loss before delivery in females undergoing elective caesarean section as compared to placebo group.

Primary postpartum hemorrhagic, rightly called as obstetrician’s nightmare,refers to excessive blood loss of more than 500ml during the third stage of labour or in the first24 hours after delivery. It continues to be one of the leading causes of maternal mortality andmorbidity all over the world including Pakistan where it is responsible for 21-31% of maternalmortality and morbidity. Objectives: Objective of study was to determine the efficacy of balloontamponade in the management of primary PPH, so that a low cast, easy to use technology isavailable for conserving future fertility by treating postpartum hemorrhage. Settings: Departmentof Gynae & Obs, Allied Hospital, Faisalabad. Study Design: Descriptive cross sectional study.Study Period: 6 months from 1st Oct, 2015 to 31st March, 2016. Material & Methods: All patientsdelivered vaginally at term (after 37 completed weeks of gestation) who developed PPH due touterine atony after failure of conventional medical therapy were included in this study. Patientselection was based on inclusion and exclusion criteria. Their demographic profile and efficacyof balloon tamponade was checked in terms of time required to control hemorrahage andneed of laparotomy. Results: During study period total no. Of vaginal deliveries were 3000.Out of these 298 developed PPH, 220 had PPH due to uterine atony and did not respond toconventional medical therapy. The age of patients ranged between 22 and 40 years with meanage of 30 year (±4.88SD). The parity of the patients ranged between 1 and 14 with the meanparity of 4 (±2.26SD). The condom catheter was introduced in all the selected 80 patients andwas successful in 73 patients. Conclusions: In developing countries such as Pakistan wherethe maternal death rate from PPH is very high, this safe, in expensive and easy procedure (itdoes not require any expertise) can be applied in any situation to save a life and to save theuterus in young patients to conserve reproductive capacity and prevent them from surgery andits morbidity. This will protect the patients from irreversible shock and even death with a successrate of 85-95%.