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

Low birth weight (LBW, <2500g) is an important indicator of reproductive health and general health status of population. LBW is considered as the single most important predictor of infant mortality, especially of deaths within the first month of life. This is a prospective case control study carried out in the Department of Obstetrics & Gynaecolgy, Faridpur Medical College Hospital, Faridpur, during the period of August 2015 to July 2016 to find out the risk factors associated with low birth weight babies and to know modifiable risk factors. Total 300 samples were included in this study. All pregnant women who delivered a LBW baby during one year of study period were selected. One hundred mothers who delivered babies having birth weight <2500 gram were selected as cases and 200 mothers who delivered babies having birth weight 2500 gram and above were taken as control. This study shows most frequent maternal age group was 18-25 years in case group and 26-35 years in control group. Fifty four percent were female and 46% were male babies in case group where as 39% were female and 61% were male babies in control group. In LBW babies mothers, having regular antenatal care were only 23.8%. Maternal factors including maternal height, maternal weight, pre-eclampsia, PROM, chronic hypertension & PPH, heart disease and DM were associated with low birth weight. Fifty six percent mothers had average food intake and 34% had poor food intake in mothers of low birth weight baby. The status of antenatal check-up and poor socio economic condition also strongly influence birth weight of baby. There is a need for national prospective research project to study the low birth weight problem at the national level.Faridpur Med. Coll. J. Jan 2018;13(1): 31-34

Abstract:Hysterectomy is the commonest gynaecological operation. It is still considered as the treatment of choice for benign lesion such as leiomyoma, adenomyosis, extensive pelvic infection or adhesions, dysfunctional uterine bleeding and obstetric complications. A Cross-sectional observational study was done in the Department of Obstetrics and Gynecology during the period from 1 st January to 31 st December 2015 at Faridpur medical college and hospital, Faridpur. This study was done to correlate the indications of abdominal hysterectomy to histopathological findings thus, determining histologically confirmed preoperative clinical diagnosis. One hundred patients undergoing abdominal hysterectomy were studied. Data were recorded on structured proforma, including demographic characteristics, clinical features and indications of the procedure. In this study, leiomyoma of the uterus was found to be the major indication of hysterectomy in 35% of total cases, followed by dysfunctional uterine bleeding (DUB) in 26%, and pelvic inflammatory disease (PID) in 6%. Histopathological confirmation of pre-operative diagnosis was 100% for malignancy, 85.71% for fibroid and 65.38% for DUB. Hysterectomy is currently the most widely performed major operation in gynecology and histopathology is mandatory for ensuring diagnosis and management of malignant diseases.

This Study was done to assess safety and feasibility of non-descent vaginal hysterectomy for benign gynecological disease. A prospective observational study was conducted over a sample size of 50 patients at the department of Obstetrics and Gynecology of Faridpur Medical College Hospital from 1 st January 2017 to 31 st December 2017. All patients requiring hysterectomy for benign gynecological disorders who did not have any uterine descent were recruited for this study. Non-descent vaginal hysterectomy was performed in cases where uterus was mobile with size not exceeding 16 weeks gestation and with adequate vaginal access. Morcellation techniques like bisection, myomectomy, wedge debulking or combinations of these were employed in bigger sized uterus. A total of 50 cases were selected for non-descent vaginal hysterectomy. Among these, 47 cases successfully underwent non-descent vaginal hysterectomy. Majority (44%) of the patients were in age group of 41-45 years. All patients were parous. Uterine size was <10 wks in 30 cases and >10 wks in 20 cases. Commonest indication was leiomyoma of uterus (46%). Mean duration of surgery was two hours. Mean blood loss was 200 ml. Reasons for failure to perform nondescent vaginal hysterectomy was difficulty in opening pouch of douglus in two cases because of adhesions and in one case there was difficulty in reaching the fundal myoma which prevented the uterine descent. The most common complication was post-operative pain in 22% of cases. Febrile morbidity was present in 4% of cases. Blood transfusion was required in 7 cases. Average duration of hospital stay was three days. Vaginal hysterectomy for benign gynecological causes other than prolapse safe, feasible and patient friendly.

Abstract:Miscarriage, particularly recurrent mid-trimester miscarriage is a distressful condition. This form of miscarriage and preterm birth appear to have some etiologies. An important etiology is cervical incompetence that describes a disorder in which painless cervical dilatation leads to recurrent second trimester pregnancy losses. Every year more than 10 million preterm birth occurs and more than 1 million baby die from this common complication of pregnancy. The incidence of true cervical insufficiency is estimated at less than 1% of the obstetric population. In the index pregnancy, findings indicative of possible cervical insufficiency include cervical funneling, cervical shortening, and overt cervical dilatation. The main objective of the study was to explore the benefit from cervical cerclage in pregnant women with cervical incompetence. This is a retrospective observational study conducted over a period of twelve months. All cases delivered in Central Hospital were assisted by consultant obstetricians, in which 16(61.5%) out of 26 cases were delivered by caesarean section. Miscarriage rate was 11.53%. Out of the caesarean deliveries 2(12.5%) were at term and 14(87.5%) were at preterm. In this study 3(21.42%) babies born at 32 nd and 33 rd weeks, 6(42.85%) at 34 th week and 2(14.28%) were at 35 th week. There was no fetal loss. Extreme low birth weight was only one, 7(43.75%) of the babies had normal body weight for the area of study, 8 babies (50%) had low birth weight. The cervical cerclage procedure therefore should be available more widely to benefit those patients with proven or strongly suspected cervical incompetence.