Introduction: Obstetric Fistula is defined as direct communication between the vagina and the bladder (vesicovaginal fistula) and/or between the vagina and the rectum (recto-vaginal fistula). Each year 50.000 to 100.000 new cases of obstetric fistula are globally reported.  According to World Health Organization, more than 200 million young women live with unrepair obstetric fistula mostly in sub-Saharan Africa and southeast Asia including Afghanistan. Women with obstetric fistula suffer from frequent urinary or fecal incontinence which causes shame, social segregation, and other health problems. Obstructed labor (due to early marriage and inadequately developed pelvic) constitutes the most common cause of obstetric fistula. Therefore, the current study strived to assess teenage pregnancy on obstetric fistula among women in the fistula center of Malalai Maternity Hospital in Kabul, Afghanistan. Methods: A descriptive cross-sectional study was conducted over a period of one year (2019-2020) with 30 cases of obstetric fistula among women attended at Fistula Center of Malalai Maternity Hospital. Result: Among 30 women current aged with obstetric fistula 66.6 % were between20-37years, the mean age was 33.9±10.2 and the median was 30 years, the max and min range was between 20-56y. 66.6 % cases their marriage-age was between 16-20 y, while marriage age(mean) was 18.4±3.2, most women (60%) their ages in first delivery were between 15-19 y old, the height of the 40% women was less than 150 cm, and 46.7% women had 1-4 parity with mean of 5.2±3.1 and extreme (1-14), duration of labor in 90% were more than one day, majority of cases (60%) was Recto vaginal, 33% vesicovaginal and 7% with a compound type of fistula, 80% of cases were from remote and rural areas. Conclusions The teenage pregnancy and early marriage between (16-20 y old) was the vast majority of obstetric fistula formation, rectovaginal fistula, living in a remote area, short stature less than 150cm, and duration of more than one day have been seen. teenage pregnancy and obstetric fistula are preventable conditions. These findings suggest that efforts to reduce obstetrical fistula should target teenagers

Background: Ectopic pregnancy (EP) is defined as a pregnancy in which fertilized oocyte implants outside the endometrial cavity. Although there is no known etiology for ectopic pregnancy, some risk factors of EP have been determined. It has been evident that ectopic pregnancy can be of multifactorial origin. This multicenter research aims to study risk factors associated with increased risk of ectopic pregnancy in women living in Kabul. Methods: A multicenter case control study was conducted in five tertiary maternity hospitals located in Kabul, Afghanistan. A total of 457 pregnant women were included in this study. In the case group, women with diagnosed ectopic pregnancy, while in control group women with intrauterine pregnancy were included. For each case in this study, two controls were enrolled. Results: The mean (SD) age of women in case group was 27.9 (6) years while in control group it was 26.4 (5.5) years. This difference was not statistically significant. We found a significant association between history of abortion and EP (Adj. OR=1.57; 95%CI: 1.02, 2.42). Having history of abdominal/pelvic surgery was a risk factor for EP with adjusted OR 1.94 (95%CI: 1.15, 3.30). In this study we found an increasing risk of EP in women of 35 years or older compared to younger women (Crude OR=2.26; p= 0.024). In women reporting prior EP, the chance of its recurrence was increased (Crude OR= 9.64; 95%CI: 1.1, 83.2). No association of gravidity and parity was found with EP incidence. Conclusions: In this study we found a statistically significant association between history of abdominal/pelvic surgery and EP. In addition, history of abortion was suggested as a risk factor for ectopic pregnancy. In case of having a previous EP probability of its recurrence will be increased. Women with advanced age having other potential risk factors will be facing higher risk of EP.

Repeat cesarean deliveries are associated with complications of cesarean section (CS) and predisposition to morbidity resulting from placenta previa, morbidly adherent placenta, complicated surgeries, uterine rupture and bladder injury. Successful trial of labor and vaginal birth after cesarean section (VBAC) results in decrease in maternal morbidity. An unsuccessful trial of labor after Cesarean (TOLAC) is defined as failure to achieve a vaginal birth after cesarean section in women undergoing a TOLAC and the delivery ending with emergency cesarean section. In this study we aim to determine the frequency of inter delivery interval and emergency cesarean section attempt at vaginal delivery among women with one previous CS.The descriptive cross-sectional study was conducted at Malalai and Sharara maternity hospitals in Kabul, for three consecutive months. The collected data were presented as mean, standard deviation (±SD), frequency and percentage.A total of 204 women with one previous CS out of 180 were eligible for TOLAC according to the hospital protocol and 35 women (19.4%) of the studied women had emergency cesarean, 34.47% women with their inter delivery interval were between 16-19 months most cases of unsuccessful TOLAC 43% were seen among women between 25 to 29 y old with mean age of 26.43 ± 5.6. In our study frequency of repeat emergency cesarean in women with prior CS was found as 19.4%, most cases have been seen in women with short inter delivery interval, most cesarean performed between 37-39 week of gestational age, fetal distress was the most indication of repeat emergency cesareans.

Postpartum hemorrhage (PPH) is loss of 500 mL of blood from genital tract after normal vaginal delivery or 1000 mL after cesarean section. PPH is one of an important cause of maternal mortality and morbidity worldwide, the only strategy that has shown a significant reduction in maternal mortality in patients with PPH is active treatment and management of third stage of labor.In this study we aim to determine the frequency of atonic uterus due to postpartum hemorrhage.A descriptive cross-sectional study was carried out on women attending at Shar -Ara teaching hos-