Introduction: Hysterectomy is the most common gynecological procedure. Abdominal approach is preferred for an enlarged uterus especially in cases of fibroids. However, in a small sized uterus, use of vaginal route is supported in well selected cases Objective: Aim of this audit was to analyze indications, complications, and correlation of preoperative diagnosis with the histopathology report for all hysterectomies, performed in a Shalamar Hospital Lahore. Methods: This study was crass sectional and population the obs. And Gyn. Patients of Shalamar Hospital Lahore. This study is a three year retrospective review of 755 cases of hysterectomy either for gynecological or obstetric reasons managed at Shalamar Hospital Lahore from January 2019 to December 2021. Results: Abdominal hysterectomy accounted for 94%, while vaginal hysterectomy accounted for the remaining 6%. In the former category, an 86% had total abdominal hysterectomy while 9% had subtotal hysterectomy. The average duration of hospital stay following surgery was 3-5 days. The average indoor stay was 2-3 days after vaginal hysterectomy and 4-5days after abdominal hysterectomy. There were 4 cases of mortality accounting for a mortality rate of 1.8 %. Post operative morbidity was encountered in 29.4% of the patients. Anaemia was observed in 45.9%,post operative wound infection in 30.1%, pyrexia in 9% patients, chest infection in 6.7%, bladder injury in 3.6%, bowel injury in 1.8% of the patients. Practical Implication: The practical implication of this study is to correctly treat the patients with pre-operative investigation, Complications, and Correlation of Preoperative Diagnosis with the Histopathology Report of Hysterectomies in private hospitals. Conclusions: Hysterectomy is a major gynaecological procedure. Selection of a appropriate route is very important for the safety of the patient and for hospital stay. Like any other surgery, hysterectomy has an inherent set of complications. So clinical selection should be well justified. Like in any major gynecological procedure, a skilled operator can reduce the morbidity and mortality rates. The conservative approaches should be offered before opting for hysterectomy. Keywords: Pre-operative investigation, Hysterectomies, complications, private hospital, Obs and Gyn patients

Background: For the growth and development of the unborn child, amniotic fluid is absolutely necessary. Strong interactions between the fetus, placenta, and parts of the mother are given their volume1. Oligohydramnios is defined as having an amniotic fluid index (AFI) <5th percentile or AFI 5 cm during pregnancy and no water at a depth of 23 cm before the cornea. This is a common problem that occurs in 35% of pregnancies during childbirth2. Aim: To determining the correlation between oligohydramnios in pregnant women who are late in pregnancy (3rd trimester) and adverse birth outcomes such as partial surgery, decreased Apgar score, and lower birth weight. Study design: Cohort study Study set up: Obstetrics and Gynecology Department, Fatima Memorial Hospital Lahore. Study period: six months starting15-01-2022 to 14-07-2022 Methods: 242 females were enrolled. Two groups of participants were created: group II had normal AFI and group I had oligohydramnios. Females given intra venous fluids to group I after ruling out any contra indication. The perinatal result was then documented. SPSS version 20 was used to enter and evaluate all of the gathered data. Results: In exposed group the mean age was 27.79±6.72 years, whereas in unexposed group the mean age was 28.25±6.77 years. The C-section was done in 124(51.2%) females. RR = 0.693 [1.25-3.49] While the Low Birth Weight and poor APGAR score has shown protective effect. Practical implication: Oligohydramniosmeans decreased amniotic fluid around the fetus. There is deficiency of amniotic fluid < 200 ml at a time. Approximately 8-10% of pregnant ladies may have decreased level of amniotic fluid but 5% have been confirmed diagnosis of oligohydramnios. Conclusion: So complications of surgery are directly related to the severity of oligohydramnios in pregnant women while low birth weight and poor APGAR scores has shown protective effect in women presented in last trimester of pregnancy. Keywords: Oligohydramnios, Low Birth Weight, Perinatal Outcome, APGAR SCORES, Pregnancy

OBJECTIVE To report the frequency of causes of female infertility by laparoscopy in females presenting in a tertiary care hospital MATERIALS & METHODS Study design: Cross sectional study Setting: Department of Obstetrics & Gynecology, Shalimar Hospital, Lahore Duration of study: July 01, 2020, till July 31, 2021 DATA COLLECTION PROCEDURE: A total of 370 females fulfilling selection criteria were selected from operation theatre of Department of Obstetrics and Gynecology, Shalimar Hospital Lahore. Informed consent was obtained from each case. Demographic information (name, age, BMI, duration of marriage, type of infertility, and parity) will also be noted. Then females underwent laparoscopy under general anesthesia by researchers. On laparoscopy, the pelvis was inspected, including uterus, fallopian tubes, round ligaments, uterovesical pouch, uterosacral ligaments, and Pouch of Douglas. The tubes were inspected for any abnormality in their length and shape and patency was checked by retrograde dye test. Both ovaries were examined regarding their size, shape, thickness of peripheral follicles, evidence of ovulation and their relationship with fimbrial end of the tubes. Peritubal, periovarian and omental adhesions, tubo-ovarian masses, endometriotic deposits, fibroid, presence of fluid in the Pouch of Douglas or any other pathology, if present was noted. Data was entered and analyzed in SPSS version 21.0. RESULTS: The mean age of our cases was 33.93 ± 5.81 years with minimum and maximum ages of 18 and 45 years. According to the etiology of infertility, 5(1.4%) cases had unexplained infertility, 140(37.8%) cases had tubal infertility, 60(16.2%) cases had polycystic ovaries, 41(11.1%) cases had Peritubal and peri-ovarian adhesion, 71(19.2%) cases had endometriosis, 38(10.3%) females had fibroids and 20(5.4%) cases had an ovarian cyst. CONCLUSION: We conclude that on diagnostic laparoscopy the frequency of causes of female infertility was found to be tubal infertility (37.8%), followed by endometriosis (19.2%), polycystic ovaries (16.2%), Peri-tubal and peri-ovarian adhesion (11.1%), fibroids (10.3%), ovarian cyst (5.4%), unexplained infertility (1.4%).

Objective: To assess the frequency of IUDs and their possible causes since the Covid-19 pandemic.Material and Methods:Study design: Cross-sectional studySetting: Department of Obstetrics and Gynaecology, Shalamar Hospital, Medical and Dental College, Lahore, Pakistan.Duration of study: 15/03/2020 to 15/06/2020This is a cross-sectional single-center study. The relevant details about IUDs like age, parity, social status, booked status, comorbidities, and social status were entered into a Performa and the data analyzed.Results: The Intrauterine death rate from the study was 41.99 fetal deaths per 1000 live births (Total births: 643, IUDs: 27) while the mean age of the mothers was 29.67 with a minimum age of 22 years and a maximum of 37 years. According to the risk factors associated with the IUD, 11.1% had Pregnancy Induced hypertension, 11.1% had Pre-Eclampsia, 22.2% had Gestational Diabetes Mellitus and 22.2% Pregnancy Induced Hypertension and Gestational Diabetes Mellitus and 33.3% had no comorbidities. Amongst all the patients 33.3% of cases were unbooked.Conclusion: We conclude that in the last one year the fetal deaths per 1000 at Shalamar Hospital were around 28.57 per 1000 live births, during the last 3 months they gone up to 41.99 fetal deaths per 1000 live births. The leading cause(s) for IUDs in Pregnancy during the Covid-19 were pandemic Induced Hypertension and Gestational Diabetes Mellitus, which cumulatively account for 44.4% cases but 33.3% cases had no co-morbidities and still ended up in an Intra-Uterine death, which may or may not have been influenced by a Covid-19 infection. From the looks of it, Non-clinical reasons seem to have a higher probability of increasing the IUD rate but clinical effects of the Covid-19 infection can also not be ruled out completely, further studies are required into the pathogenesis and the effect of Covid-19 on pregnancy.