Rupture of a gravid uterus is a surgical emergency. Predisposing factors include a scarred uterus. Spontaneous rupture of an unscarred uterus during pregnancy is a rare occurrence. We hereby present the case of a spontaneous complete uterine rupture at a gestational age of 35 weeks 01 day in a 25 years old patient. The case was managed at the Civil Hospital Bahawalpur. She had past history of one uterine curettage for endometrial polyp one year back. She presented with mild abdominal pains of sudden onset. After conservative management for 10 hours in hospital she suddenly developed severe abdominal pains with P/V bleeding. On ultrasound scan, uterine rupture was diagnosed and an emergency laparotomy was done. The ruptured amniotic sac with baby and placenta were found in the peritoneal cavity with rupture of the uterine funds. Spontaneous uterine fundus rupture usually occurs when there is an upper segment uterine scar. This case report shows that past history of curettage is a risk factor for the presence of uterine scar.

Rupture of a gravid uterus is a surgical emergency. Predisposing factorsinclude a scarred uterus. Spontaneous rupture of an unscarred uterus during pregnancy is arare occurrence. We hereby present the case of a spontaneous complete uterine rupture at agestational age of 35 weeks 01 day in a 25 years old patient. The case was managed at theCivil Hospital Bahawalpur. She had past history of one uterine curettage for endometrial polypone year back. She presented with mild abdominal pains of sudden onset. After conservativemanagement for 10 hours in hospital she suddenly developed severe abdominal pains with P/Vbleeding. On ultrasound scan, uterine rupture was diagnosed and an emergency laparotomywas done. The ruptured amniotic sac with baby and placenta were found in the peritoneal cavitywith rupture of the uterine funds. Spontaneous uterine fundus rupture usually occurs whenthere is an upper segment uterine scar. This case report shows that past history of curettage isa risk factor for the presence of uterine scar.

Objective: It is to compare neonatal morbidity in terms of birth trauma, respiratory distress syndrome, APGAR score in Primigravida with breech presentation delivered vaginally and emergency cesarean section. Design: Cross-sectional comparative study. Place and Duration of Study: Obstetrics and Gynaecology Unit-I, Bahawal Victoria Hospital, Bahawalpur from 1-5-2007 to 30-4-2008. Patients and Method: The study was carried out on all Primigravida with breech presentation reported through emergency in labour deliveredvaginally and by emergency cesarean section. The variable analyzed were birth trauma, respiratory distress syndrome and APGAR score at 1 and 5 minutes. Students-t test was used for comparison between means and chi square test for comparison between percentages. Significance was taken at P<0.05. Results: It was found that mean APGAR score at 1 and 5 minutes is 7.31 and 9.066 in vaginal and 8.533 and 9.644 incesarean group. Respiratory distress syndrome is more in cesarean (4.4%) than vaginal group (2.2%). Observed neonatal trauma is more in vaginal group (6.7%) than cesarean section (2.2%). Conclusion: Neonatal morbidity appears to be more in vaginal breech delivery than cesarean section for Primigravida with breech presentation at term.

Objective: It is to compare efficacy of Oral Misoprostol with intravenous oxytocin in the management of primary post partum hemorrhage. Design: Quasi experimental study. Place and Duration of Study: Obstetrics and Gynaecology Unit-I, Bahawal Victoria Hospital, Bahawalpur. From 1st December, 2006 to 1st December, 2007. Patients and Method: The study was conducted on 90 patients who went into post partum hemorrhage during the study period. Cases were divided into two groups each having 45 patients fulfilling the inclusion criteria. Group ‘A’ had those who received oral misoprostol 600μg and group ‘B’ those who received 5 UNITS intravenous oxytocin. The variables analyzed were failure of drug, time taken to control bleeding and side effects of drugs. Students t-test was used for comparison between means and chi-square test for comparison between percentages. Significance was taken at P<0.05. Results: It was noted that failure rate of oral misoprostol was 11.1% and that of oxytocin was 22.2%. Mean time taken to control bleeding by misoprostol was 16.6 minutes and 1.311 minutes by intravenous oxytocin. Side effects was observed in 35.5% cases of misoprostol group and 2.22% cases of oxytocin group. Conclusion: The time taken to control bleeding and side effect profile is more better in intravenous oxytocin as compared to oral misoprostol in the menagemnt of primary postpartum hemorrhage, but number of patients responded to oral misoprostol are more, so it can be used as in combination of oxytocin where oxytocin alone failed to work.