Objective: To determine the Incidence of Placental Abruption and the morbidity / mortality associated with it. Design:Prospective and Observational case Study. Setting & Duration: Department of Obstetrics & Gynecology, Liaquat University of Medicaland Health Sciences Hyderabad, for a period of 15 months from January 2007 to March 2008. Patients & Methods: Among all theantenatal patients delivered during the period under review, those suffering from Placental abruption were entered into this study bycompleting a proforma for each patient. After history, examination and initial management, investigations were carried out. These patientswere managed on case to case basis depending on the progression of abruption and delivery. After delivery whether spontaneous or bycesarean section the condition of mother and subsequent complications were recorded and results analyzed on SPSS version 10.Results: During the period 15 months, 2760 patients were admitted to labour room /labour ward and delivered. Among these, 100patients had abruption making an incidence of 2.89% per year. According to the degree of abruption 33 had mild, 50 had moderate and 17had severe abruption. 42% had spontaneous vaginal delivery, and 52% underwent cesarean section. 36% of Abruptio patients, developedcomplications like shock, PPH and DIC. One (1%) patient died in severe abruption. Conclusions: The incidence of Abruptio Placentae inthis study is comparable to local studies and studies from developing countries, but is high in comparison to studies from developedcountries. The maternal morbidity and mortality rate is not as high as in other studies.

The training of junior doctors in the UK is undergoing an evolution to ensure that those concerned are adequately trained and specialised for current and future consultant practice.The implementation of this training evolution is currently widespread at the foundation level (SHO-equivalent) and will expand to specialty training programmes as foundation programme trainees complete their training in 2007. Urology has led the change to the specialty training, with three-year trainees having entered the specialty in 2005. The emergence of urology as the lead specialty for change originated in part from a meeting in 1998 that addressed the future of urology and training, the summary of which was published later that year. The urology consultant workload is undoubtedly changing with the expansion of diagnostic services and the decrease in surgical in favour of medical treatments. The proportion of patients currently referred for surgery after an outpatient consultation has decreased and trainees are exposed to 50% of the operative experience of a decade ago.

Objective: To determine the frequency of risk factors associated with Placental Abruption. Design: Prospective andObservational Case Study. Setting & duration: Department of Obstetrics & Gynecology, Liaquat University of Medical and Health SciencesHyderabad, for a period of 15 months from January 2006 to March 2007. Patients & methods: All the antenatal patients/ pregnant ladiesadmitted to labour room /ward and delivered during the above mentioned period were scrutinized and those suffering from Abruptio Placentaewere entered into this study by completing a proforma for each patient. The risk factors studied were; Age of Patient, Parity, past history ofabruption, rural belonging, history of trauma, association with diabetes, hypertension, smoking and anemia. Results were analyzed on SPSSversion 10. Results: A total of 100 patients suffering from placental abruption were studied during 15 months period. The commonest age groupwas 30 years (47%). Majority (54%) was multiparous, 66% belonged to rural population and among these, 2/3 were unbooked. Only one patientgave history of trauma. 5 patients had history of previous abruption. History of diabetes was present in only one patient, whereas 38% werehypertensive. Only 4 patients gave positive history of smoking. Anemia was the single most common factor present in 83% ladies.Conclusions: Age around 30 years, multiparity, hypertension, presence of anemia, rural belonging and previous abruption are the risk factorsfor placental abruption as per this study. No association of abruption has been found with trauma, diabetes or smoking in this study.

Background: Trial of labour is a clinical test to assess the adequacy of pelvis andability of fetus and mother to withstand labour. If progressive changes in dilation and station donot occur, a cesarean delivery is performed. Objective: Feto-maternal outcome after trial oflabour in women with gestational age b/w 37 to 42 weeks. Study Design: Cross sectional study.Setting: Department of Obs/ Gyn unit-I Liaquat University Hospital Hyderabad. Duration ofStudy: One year from 01-02-2009 to 31-01-2010. Subjects and Methods: 100 pregnant women,with gestational age between 37-42 weeks, who underwent trial of labour at labour ward,Obs/Gyn Unit-1 Liaquat University Hospital, after fulfilling the inclusion criteria were included inthe study. Detailed history and examination including abdominal and pelvic examination as wellas Ultrasound for fetal well being was performed. Fetal monitoring was done by auscultation andCTG. Partogram was maintained to observe the progress of labour. Those who progressed withtrial either delivered normally or with the help of instruments and those who did not progress weredelivered by C-section. After delivery, mothers were watched for any postpartum complicationand condition of neonates was assessed by APGAR score. Results: Out of 100 women includedin this study 58% delivered vaginally, 31 % delivered by cesarean section and 11 % hadinstrumental deliveries. Labour was induced in 34%, augmented in 34% and 32% hadspontaneous labour. 77.0% babies had apgar score > 5(7.1±0.72), 16% < 5(3.68±2.18) and 6%were still birth. 81% mothers had no complication during or after delivery, whereas 19 developedcomplications and these were 12 Genital tract traumas, 5 postpartum haemorrhage, one uterinerupture and one retained placenta. There was no statistically significant difference (P=0.42)when mode of delivery was compared with the trial of labour. However augmentation of labourwas associated with increased rate of maternal complications when maternal outcome wascompared with the type of labour (P=0.03). Conclusions: Trial of labour in carefully selectedwomen with high probability to deliver their babies vaginally decreases the rate of LSCS, therebyreducing the maternal morbidity and mortality associated with it. However augmentation oflabour is associated with increased rate of maternal complications as compared to spontaneousor induced labour.

Background: To determine the association of primary subfertility in Polycystic Ovaries with BMI and waist circumference. Methods: This cross-sectional study was performed from 01-08-2018 to 01-08-2019 at the Department of Obstetrics & Gynecology, Indus Medical College, Tando Muhammad Khan on (n=245) diagnosed with polycystic ovaries in the age group of 18 to 49 years. The study population, having diabetes mellitus, increased prolactin levels, disturbed thyroid function, congenital adrenal hyperplasia, and the couples with contraceptive measures were not included. Mean ± SD was computed for numerical data, frequencies and percentages were computed for qualitative data. Chi-square was used as a test of significance with a P-value <0.05 as significant. Results: The mean ± SD age of these women was 33.46±6.71 years with a range from 18 to 45 years. The proportion of subfertility in PCOS was 40.41%. The frequency of subfertility in PCO increases from normal weight to obesity significantly. (P-value <0.01) Additionally; women presenting with PCOS and increased waist circumference had a higher frequency of subfertility. (P-value <0.01). Conclusion: A much higher proportion of women with PCOS who present with obesity, overweight, and higher waist circumference were subfertile. With early screening and treatment for PCOS, weight control also is necessary to prevent the big issue of subfertility. Keywords: Obesity, Polycystic Ovarian Syndrome. Subfertility.