Objective: To determine the complications (infection, perforation and expulsion rate) of immediate postplacental insertion of intrauterine contraceptive device (Multiload Copper375) in postnatal patients. Methods: A case series study was conducted between October 28, 2014 to April 30, 2018 in obstetrics and gynaecology department, Civil Hospital Karachi,-+ Informed consent was taken. Intrauterine contraceptive device (Multiload) was inserted immediately within 10 min after delivery of placenta. These women were observed to determine outcome (infection, perforation and expulsion) at the time of discharge and 6 weeks postpartum. Absence of all these were taken as satisfactory outcome. Results: A total of 435 women were included in this study. 165 (38%) were delivered through cesarean section and 270 (62%) were delivered through vaginally. There were 36 (8.3%) cases of infection. The cumulative rate of expulsion and perforation at the end of sixth week of post insertion was 39 (9%) and 0% respectively and 360 (82.8%) had satisfactory outcome. Post-placental placements during cesarean delivery are associated with lower expulsion rates than post-placental vaginal insertions without increasing rates of postoperative complications like perforation, slightly increase infection rate following vaginal delivery. Conclusion: Immediate postpartum insertion of IUCD is an effective, safe and easily reversible method of contraception. Rates of the complications (Infection, expulsion and perforation) are remarkably low.

Objective: To compare effect of Omega 3 fatty acid supplementation versus no supplementation in high risk pregnant females from 20 weeks gestation in terms of frequency of preterm delivery. Methods: We conducted a prospective randomized controlled clinical trial in department of Obstetrics and Gynecology and, Railway Teaching Hospital Islamic International Medical College Trust, from January 2015 to Jan 2017. Women with a history of prior spontaneous singleton preterm birth and a current singleton gestation were divided into two groups A and B by computer generated random numbers. Omega 3 fatty acid supplementation was given to group A patients from 20 weeks to 36 weeks gestation and patients in group B was received no such treatment. Frequency of preterm delivery was compared among patients of both groups. Results: A total of 500 women with singleton pregnancy with history of one or more preterm deliveries were included, and none was lost to follow up. The mean duration of pregnancy at delivery between the omega3 supplemented and control groups [38.2 (SD, 0.6) weeks and 36.6 (SD, 0.9) weeks, P<0.0001 respectively] was statistically different. The data were also analyzed for birth weight and statistically significant difference of the weights were found in the two groups [3.2 (SD, 0.233) and 2.8 (SD, 0.259) controls P <0.0001]. Conclusion: In this study we found that gestational age and birth weight, both are significantly improved with oral administered omeg-3 in high risk pregnancy when compared with controls.