Background: To compare the effectiveness of postpartum intrauterine contraceptive device (PPIUCD) with interval IUCD in terms of effectiveness, expulsions, bleeding pain and other complications at Tertiary care Hospital.Methods: Current study was conducted among 224 women, at Gynaecology and Obstetrics of Reproductive Health Services-A (RHS-A) Centre of Jinnah Post Graduate Medical center, Karachi, for a period of Six months. Approval from Ethical committee and informed consent was taken from women and her husband before starting the study. The WHO medical eligibility criteria for contraceptive use (MEC) were followed and IUCD was inserted in 112 women in PPIUCD group and in 112 women in interval IUCD group. These cases were followed at 15 days, 6 weeks and 6 months. Results of PPIUCD group were compared with interval IUCDs group. Data was analyzed by using SPSS version 18.0. Continuous variables like age, parity, hemoglobin level were analyzed as mean±standard deviation. Frequencies and percentages were calculated for infection, expulsion, bleeding per vagina and effectiveness. Chi-square was applied to assess the difference between the categories. p value <0.05 was taken as significant.Results: The two groups were identical in mean ± SD age, parity, residence and baseline hemoglobin level. PPIUCD (Group-A) was more effective i.e., 87.5% as compared to interval IUCD (Group-B) i.e., 83.9%. Pain, PID, bleeding and expulsion of IUCD were more prevalent with interval IUCD (Group-B) than PPIUCD (Group-A) patients. Stratified analysis showed that age, parity & mean baseline hemoglobin were non-significant effect modifiers on the effectiveness among the two groups.Conclusions: Postpartum IUCD use was found to be a safe, simple, inexpensive and reversible procedure with higher chances of retention for a longer period. Additionally, there is decreased risk of complications and lower expulsion rates when compared with interval IUCD.

Objective: To determine the complications (infection, perforation and expulsion rate) of immediate postplacental insertion of intrauterine contraceptive device (Multiload Copper375) in postnatal patients. Methods: A case series study was conducted between October 28, 2014 to April 30, 2018 in obstetrics and gynaecology department, Civil Hospital Karachi,-+ Informed consent was taken. Intrauterine contraceptive device (Multiload) was inserted immediately within 10 min after delivery of placenta. These women were observed to determine outcome (infection, perforation and expulsion) at the time of discharge and 6 weeks postpartum. Absence of all these were taken as satisfactory outcome. Results: A total of 435 women were included in this study. 165 (38%) were delivered through cesarean section and 270 (62%) were delivered through vaginally. There were 36 (8.3%) cases of infection. The cumulative rate of expulsion and perforation at the end of sixth week of post insertion was 39 (9%) and 0% respectively and 360 (82.8%) had satisfactory outcome. Post-placental placements during cesarean delivery are associated with lower expulsion rates than post-placental vaginal insertions without increasing rates of postoperative complications like perforation, slightly increase infection rate following vaginal delivery. Conclusion: Immediate postpartum insertion of IUCD is an effective, safe and easily reversible method of contraception. Rates of the complications (Infection, expulsion and perforation) are remarkably low.

Background: Menopause is a natural process, occurring in women that marks the end of fertility among women. It is characterized by a cessation of menstruation, decline in ovarian activity and disturbances in periods along with vaginal dryness, mood swings and hot flashes. The age of menopause ranges in between 40 to 55 years. Although there are many factors affecting the age of menopause onset like metabolic syndrome, cytotoxic drugs, but there is no general agreement on them. Objectives: To explore the factors affecting age of onset of menopause among Pakistani women. Methodology: This cross-sectional-observation study was conducted on 139 women (aged at or above 40 years) presenting to the Outpatient Department of Obstetrics – Gynecology at Jinnah Medical College Hospital, Karachi – Pakistan from Nov 2020 to May 2021. Data was collected using a structured interview-based questionnaire containing inquiries pertaining to basic biodata, sociodemographic details, menstrual history, and probable factors affecting age of onset of menopause. Chi-square test was applied to check the association between the different factors and age of menopause. Results: The mean age of the participants was found to be 43.23 ± 4.11 SD years, while the mean age of onset of menopause was recorded to be 49.21 ± 3.83 SD years. The associations between the marital status, body mass index, use of OCP and socio-economic factors with age of onset of menopause, were found to be statistically significant. Conclusion: Menopausal age not only reflects the end of fertility era but also of aging as well. Age of menopause significantly effects physical and psychological health of women and is considered as a very important event in women’s lives. Controllable factors like obesity, tobacco use, use of OCP plays a significant role in age of onset of natural menopause.

Objective: To observe the association of chronic hypertension in pregnant women on their health and fetal outcome. Methodology: This cross-sectional study was carried out from September 2019 to September 2020 upon a sample of 183 consenting pregnant women (chosen via non-probability – consecutive sampling) aged 20 – 35 years admitted to the study setting via OPD and emergency at Gynae Unit IV, Liaquat University of Medical & Health Sciences, Jamshoro (LUMHS). The data obtained was recorded on structured questionnaire comprising of inquiries pertaining to basic biodata, sociodemographic details, inferences obtained from history, clinical examination, and blood pressure. Data obtained was analyzed using SPSS V. 21.0. Results: The mean age of the women was 24 years ±3 SD. The mean gestational age was 38 weeks (±1 SD). A majority of the participants hailed from an urban background and most presented as booked elective cases (normal delivery more often than cesarean delivery). Chronic hypertension (mean value 134/92) was present among 38.8% of the study participants. Poor maternal and fetal outcome were encountered among patients with chronic hypertension. Conclusion: A heavy burden of chronic hypertension was unearthed by this study which consisted of around 2/5th of whole sample. Adverse maternal outcomes including postpartum hemorrhage, eclampsia & spontaneous abortion and fetal (low birth weight & neonatal deaths complications were strongly associated with chronic hypertension.