Aim: To determine the risk factors and prevalence of perineal tear in low-risk pregnant females. Study Design: A retrospective cross-sectional study. Place and Duration: In the Obstetrics and Gynecology department of Khawaja Muhammad Safdar Medical College, Allama Iqbal Memorial Teaching Hospital Sialkot for one-year duration from January 2020 to December 2020. Methods: The females with perineal tear after birth included in this study. A total of 400 females were selected for this study. Results are articulated as adjusted odds ratio (OR) and <0.05 of P value is considered significant. Results: 400 total females had singleton vaginal delivery and perineal tears were noticed in 140 females. The episiotomy frequency for the total of 1st and 2nd degree, and 3rd and 4th degree (OASI) were 16.3%, 25%, and 1.5%, correspondingly. The perineal tear risk-factors are young mothers (teenagers OR = 5.6, 21-25 years OR = 4.3), primiparous women (OR = 12.6), gestational age less than 32 weeks OR = 0.175), received antenatal care (OR = 0.42), correspondingly. Primiparous females were 12.4 times more probable to have an episiotomy (OR = 12.4, 95% CI, 1.48-104.8, p = 0.02). A birth weight between 2.5-3.0 kgs and less than 2.5 kg (OR = 0.012 and 0.084, respectively) protects against Obstetric Anal Sphincter Injury. Conclusions: The perineal injuries risk factors are comparable to those formerly described in other researches. There is an urgent need to train the gynae staff and doctors in proper selection for episiotomy and better perineal care in order to improve obstetric services in the Gynecology department. Identifying those at danger can decrease obstetric perineal injuries. Keywords: Low risk pregnancy, episiotomy, low-risk pregnancy and Obstetric Anal Sphincter Injury.

Hypertensive disorders in gestation are categorized as hypertension in pregnancy, chronic hypertension, eclampsia and pre-eclampsia. The World Health Organization states: “There are 529,000 maternal deaths annually worldwide due to pre-eclampsia and eclampsia. This study will help in determining pregnancy outcomes in early vs late-onset pr-eclampsia. Aim: To access the pregnancy outcomes of early and late onset pre-eclampsia. Study Design: A retrospective, descriptive and cross-sectional study Place and Duration: In the Obstetrics and Gynecology department of Allama Iqbal Memorial Teaching Hospital Sialkot and Islamic International Medical College, Rawalpindi for one-year duration form January 2021 to December 2021. Methods: A total 130 were admitted to the gynae ward with pre-diagnosis of pre-eclampsia were included. The cut-off value of the early and late onset PE was thirty-four weeks. Pre-eclampsia analysed < 34 weeks was labeled as early-onset pre-eclampsia and if diagnosed after 34 weeks will be labeled as late-onset pre-eclampsia. Obstetric and perinatal outcomes were assessed with version 21 of the Social Sciences Statistical Package. Results: A total 130 were admitted to the gynae ward with pre-diagnosis of pre-eclampsia were included. The severe pre-eclampsia was observed in 48(36.9%) pregnant women and 82 women (63.1%) had no symptoms of severe pre-eclampsia. In 38 (29.2%) cases; early-onset pre-eclampsia was detected and late-onset PE in 92 (70.7%) cases. The rate of severe PE in early-onset PE has been documented in 22 (57.8%) of 38 cases, and severe PE has been reported in late-onset PE in 29 (31.5%) of 92 cases. Adverse maternal outcomes occurred in 20 cases, including 7 cases of placenta abruptio and 3 cases of eclampsia with seizure disorders. Conclusions: The results indicate that in addition to intensive fetal monitoring in women with early-onset pre-eclampsia, attention should be paid to neurological, cardiopulmonary, and haematological parameters. Keywords: late onset, early onset; pregnancy outcome and preeclampsia.

Objectives: To comparison intravenous (IV) versus intra-umbilical oxytocin for blood loss and placental separation time for active management of third stage of labour (TSL). Methodology: This randomized controlled trial was done at “The department of Obstetrics & Gynaecology”, Sialkot Medical College, Sialkot, Pakistan from December 2021 to May 2022. A total of 100 women (50 in each group), aged 18-40 years with singleton cephalic pregnancy having active labour were randomly allocated to either Group-A (IV oxytocin) or Group-B (intra-umbilical oxytocin). Time of placental separation along with blood loss were noted in all women. Results: In a total of 100 women, mean age was 27.1±7.18 years. Mean gestational age was 38.12±1.3 weeks. Mean blood loss in Group-A (IV group) was 416.80±23.24 ml vs. 186.74±34.72 ml in Group-B (intraumbilical group), p<0.0001. Placental separation time was 4.84±1.22 minutes in Group-A versus 1.70±0.72 minutes min in Group-B (p<0.0001). Conclusion: Mean blood loss and time of placental separation were significantly less with intra-umbilical oxytocin in comparison to IV oxytocin for active management of TSL. Keywords: Blood loss, intraumbilical, intravenous, oxytocin

Background: As documented by the histopathology the recurrent pregnancy loss (RPL) is characterized as two or more miscarriages. The true prevalence of RPL is unknown, but is reported that two percent of women are affected by RPL per annum. A well-known risk factor for recurrent pregnancy losses is the high maternal age. Objective: This study was carried out to determine the risk factors and consequences of recurrent pregnancy loss. Study design: It is a prospective study Place and Duration: Conducted for the duration of one year from August 2021 to July 2022. The patients attended the obstetrician and gynecology department of Khawaja Muhammad Safdar Medical College, Allama Iqbal Memorial Teaching Hospital Sialkot. Material and Methods: This study was performed on 130 patients, admitted to tertiary care unit within the duration of one year. The written consent was taken from all the patients included in the study. The ethical and review board committee of the hospital approved the study. The women that had less than 2 miscarriages were excluded from the study. Results: The mean age of the mother at the time of admittance to hospital was 34 years and the mean of the miscarriages reported earlier in these patients were 2.9±1.3. The risk factors were found to be linked in most of the patients. The abnormality of the uterus and the thyroid dysfunction were some of the major risk factor in most of the patients with recurrent pregnancy loss. In case of thyroid dysfunction, the hyperthyroidism and hypothyroidism were studied and the results showed that the hyperthyroidism was present in case of 17% of the patients while hypothyroidism was found in 83% of the cases. Parental karyotype abnormality was also found in 4% of the cases. Conclusion: It was concluded that the patients suffering from recurrent pregnancy loss should underwent through the process of appropriate examination to clarify and conclude the risk factors involved in causing RPL. The protein S and factor XII deficiency may be playing a role in causing RPL, therefore LDA therapy can improve the rate of live birth in these patients. Keywords: recurrent pregnancy loss and protein S deficiency.