Background: Foetal outcome is a great concern among the primigravida women presented with fetal head engagement. Objectives: The purpose of the present study was to see foetal outcome among the women presented with fetal head engagement. Methodology: This descriptive cohort study was carried out in the

Background: Caesarean Section is now a common surgical practice during child birth.Objective: The purpose of the present study was to see the indication of emergency caesarean section.Methodology: This descriptive type of cross sectional study was conducted in the Department of Gynaecology & Obstetrics at Dhaka Medical College Hospital during the period from July 2006 to December 2006 for a period of 6 months. The pregnant women who were selected for emergency caesarean section during the mentioned period of study were included as study population. The details of the indication of the caesarean section were recorded.Result: A total number of 100 cases were recruited in this study. Among the all indications of emergency caesarean section history of previous caesarean section was the most common which was found in 25(25.0%) cases. Foetal distress was the second common indication of emergency caesarean section which was 18(18.0%) cases. Obstructed labour was also reported in 11(11.0%) cases. Antepartum haemorrhage (8.0%) was another indication of emergency caesarean section. Considering the hypertensive disorder preeclamptic toxaemia (7.0%), eclampsia (5.0%) and pregnancy induced hypertension (1.0%) were the reported as the indications of emergency caesarean section. Some other indications of emergency caesarean section were recorded which were mal-presentation (7.0%), prolonged labour (6.0%), cephalopelvic disproportion (4.0%) and failed trial labour (4.0%).Conclusion: In conclusion history of previous caesarean section is the most common indication for emergency caesarean section obstructed labour, antepartum haemorrhage as well as foetal distress, malpresentation and cephalopelvic disproportion.Journal of Science Foundation 2017;15(2):36-40

Background: Surgical management of vesico-vaginal fistula is very crucial regarding the outcomes among the women. Objectives: The purpose of the present study was to see the surgical outcomes of vesico-vaginal fistula. Methodology: This cross-sectional study was carried out from July 2013 to December 2013 for a period of 6 months in the National Fistula Centre in the Department of Obstetrics & Gynaecology at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh. All patients who underwent surgical repair for iatrogenic VVF in National Fistula Centre of the department of Obstetrics and Gynaecology of Dhaka Medical College Hospital were included in this study. Patients who got themselves admitted to Obstetrics & Gynaecology department of DMCH with the complaints of fistula. An interview usually lasted for an hour. The entire selected patients were interviewed for detailed history. Thorough physical examination was done. The surgical outcomes were recorded among the women. Result: A total number of 51 cases of VVF were recruited for this study. The mean age was 46.02 (±SD 6.104) years. Regarding the causes of iatrogenic vesico-vaginal fistula most of the cases (88.2%) were abdominal hysterectomy. In 4(7.8%) patients lower segment caesarean section caused the situation. Vaginal hysterectomy was responsible for 3.9% (2/51) cases of iatrogenic VVF. In more than 90% cases (46/51) the surgical outcome was successful; while in 5 patients’ fistula recurred 5 to 7 days following surgery. They were treated by re-operation later on. Conclusion: In conclusion abdominal hysterectomy is the most common cause of iatrogenic vesico-vaginal fistula with a very good surgical outcomes. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 29-32

Background: Maternal outcome is an important issue among the primigravida women presented with fetal head engagement. Objectives: The purpose of the present study was to observe the maternal outcome of among the primigravida women presented with fetal head engagement. Methodology: This descriptive cohort study was carried out in the Department of Gynecology and Obstetrics at Sir Salimullah Medical College and Mitford Hospital, Dhaka from June 2006 to December 2006 for a period of sic (6) months. Primaigravida women with 38 or more weeks of pregnancy having single foetus with cephalic presentation were selected as study population. Maternal outcome was measured in terms of incidence of post-partum hemorrhage, injury to the birth canal, wound infection and puerperal sepsis. Result: A total number of 1440 pregnant women were recruited for this study. Maximum number of patients was in the age group of 21 to 24 years which was 897(62.29%). Post partum hemorrhage (PPH) was reported in 7(2.67%) cases in engaged group and 17(1.44%) cases in non-engaged group. Birth canal injury was recorded in 4(1.53%) cases and 12(1.02%) cases in engaged and non-engaged group respectively. Wound infection was found in 8(3.05%) cases and 81(6.88%) cases in engaged and non-engaged group respectively. Regarding puerperal sepsis it was found in 3(1.15%) cases and 11(0.93%) cases in engaged and non-engaged group respectively Conclusion: In conclusion PPH, birth canal injury, wound infection and puerperal sepsis are commonly found in non-engaged group Journal of Science Foundation 2018;16(2):34-37

Objective: This prospective study was carried out to see the effect of engagement of foetal head at term in primigravidae women. Materials and Methods: The study was conducted in the Department of Obstetrics & Gynaecology, Sir Salimullah Medical College & Mitford Hospital (SSMC & MH), Dhaka from June, 2006 to December, 2006. The study included 1440 women who were admitted in the hospital during the above mentioned period. All women were examined to see the engagement of foetal head by the rule of 5 at or after 38 weeks pregnancy. Of them, 262(18.2%) presented with engagement of foetal head and 1178(81.8%) without foetal head engagement. Main outcome measure was the effect of engagement of foetal head at term in primigravidae women. Foeto-maternal outcomes were recorded by clinical observation. Result: No significant differences were found in terms of demographic and anthropometric characteristics (like age, height and weight) between primigravidaewomen who had engaged foetal head and women who did not have foetal head engaged (p = 0.969; p = 0.258 and p = 0.139). Three-quarters (74.96%) of the patients at presentation were in labour and the rest were not in labour. Duration of labour was significantly higher in non-engaged group compared to those who had foetal head engaged.The incidence of non-engagement of foetal head in nulliparous women at or after 38 weeks of pregnancy was 81.8%; but only 11.5% of them had cephalo-pelvic disproportion (CPD). The incidence of vaginal delivery in the non-engaged and engaged group was 36.9% and 66.1% respectively. Most of the patients underwent caesarean section due to foetal distress and indications other than CPD. Conclusion: The findings of the study suggest that the obstetricians should take a conservative attitude and a non-engaged foetal head at term in a primigravid woman should not by itself be an indication for caesarean section. Ibrahim Card Med J 2016; 6 (1&2): 62-66