Caesarean section (c-section) is one of the important risk factor to placenta praevia. There is significant association between placenta praevia and previous c-section pregnancy. It is a leading cause of APH and it affects approximately 0.5% of all labour. This cross sectional type of observational descriptive study based on non- probability technique was done in Faridpur Medical College Hospital from July 2015 - June 2016. A total of 150 pregnant women were studied. Pregnant women with H/O previous c-section once or more beyond 28 weeks gestation were included. Those who were primigravidae or pregnant women without previous c-section were excluded. The data were subjected to chi-square test with SPSS software version 20.0. In our study women with previous c-section were selected; out of which 16 patients (10.67%) were found to have placenta praevia and 134 patients (89.33%) were not found. The mean age of the study subject was 27.25 ± 3.43 years with maximum number of patients having age between 25 to 29 years. Among the study population other placental positions were anterofundal 90(60%) and posterofundal 44 (29.33%). The frequency of placenta praevia out of 16 women who had one c-section was 11 (10%), two c-section was 4 (11.4%) and three c-section was 1 (20%).There was significant association (p-value < 0.05) between number of c-section and placenta praevia. There was found significant relation between placenta praevia and lower segment caesarean section (LSCS) in our study.Faridpur Med. Coll. J. Jul 2017;12(2): 75-77
Maternal As exposure was positively associated with IgGmat but not IgGcord . Elevated IgGmat may have implications as regards maternal morbidity and the placental transfer of specific IgGs. Further studies are required to better understand how As may affect maternal and child health by modifying the humoral immune system.
To explore a suitable biochemical marker to predict the future development of preeclampsia (PE), total 119 pregnant women at their 10-14 weeks of pregnancy were selected. Urinary albumin was measured in these subjects and they were followed up to the term for the possible development of PE. The data were analyzed by grouping the subjects into the PE group and control group. Out of 119 subjects 56 were primigravida and 63 were multigravida. From the total subjects 10 developed PE (04 primigravida and 06 multigravida), which shows a prevalence of about 8.4%. The PE group showed a relatively higher value of Albumin Creatinine Ratio (ACR) as compared to control. 63 subjects had microalbuminuria out of which 8 developed PE. The sensitivity of ACR in predicting the development of PE was 80%, specificity 49.54%, Positive pridictive value (PPV) 12.69% and Negitive pridictive value (NPV) 96.42%. It may be concluded that early pregnancy levels of microalbuminuria can be used as predictors of preeclampsia with high negative predictive value.
Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder responsible for subfertility in young women. The aim of the study was to compare the efficacy of Letrozole over Clomiphene citrate (CC) for ovulation induction in patients with PCOS. It was a prospective randomized trial in a private practice setting. The study period was 3 years, which includes 240 sub fertile patients with PCOS. Patients were divided into two groups. Group-A: 120 patients got Letrozole (2.5 mg) tab, 2 tabs once daily from D 2 -D 6 for 3 cycles. Group-B: 120 patients took tab. Clomiphene citrate (50mg), 2 tabs once daily from D 2 -D 6 for 3 cycles. Trans-vaginal ultrasound was done on D 12 -D 13 to document number of follicles, measurement of dominant follicle and endometrial thickness. Ovulation and pregnancy rate was measured. Results showed that Letrozole have significantly better effect on endometrial thickness (Let 9.2 mm vs CC 8.1 mm) and pregnancy rate (Let 44% vs CC 24%). In CC, multiple follicles were found (CC 44% vs Let 30%). Ovulation occurred in 65% with Letrozole group and 64% in CC group without a significant statistical difference. The study concluded that Letrozole have better effect for induction of ovulation in PCOS patient in comparison to CC.
A uterine malformation is the result of an abnormal development of the Mullerian duct(s) during embryogenesis. The arcuate uterus is a type of congenital uterine malformation where the uterine fundus displays a small midline indentation towards the uterine cavity. A 25 years old woman with history of two abortions was diagnosed as a case of arcuate uterus during her first caesarean section. With proper antenatal care and counseling she has been able to give birth to 2nd baby successfully. No correctable surgery was essential for her. The literature regarding the diagnosis, management, and reproductive outcomes for arcuate uterus is limited and conflicting. A woman with an arcuate uterus can carry a baby to full term pregnancy. However, this condition is associated with a higher risk for miscarriage and premature births. Arcuate uterus is usually managed similarly to septate uterus, and only selected patients who fulfill poor reproductive performance criteria are recommended for surgical correction.
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