Introduction: Vaginal birth after caesarean section is currently the preferred method of delivery for pregnant women who had previous one lower segment caesarean section. This common practice warrants some reconsideration in light of recent clinical data on the risks associated with VBAC. Objectives: To evaluate conditions which can achieve successful vaginal birth after one caesarean section. Study Design: Cross-sectional analytic study. Setting: Department of Obstetrics and Gynaecology, Unit-I, Services Hospital, Lahore. Duration of Study with Dates: Study was carried out over a period of six months from 08-06-2006 to 07-12-2006. Subjects and Methods: One hundred pregnant women meeting inclusion criteria were included. During trial of labour patients were closely monitored by vital signs, fetal cardiac activity, lower abdominal pain and tenderness, fetal distress, vaginal bleeding and loss of presenting part. Results: Mean age of the patients was 34.27 + 6.45. According to distribution of cases by parity, maximum number i.e 64 (64.0%) was P 3-6. 79 patients (79.0%) had prior vaginal delivery. Maximum 41.0% patients were due to fetal distress while in 28% indication for previous caesarean were breech presentation. In 71% patient membranes were intact while 29.0% patients presented with per vaginal leaking. 51.0% had dilatation between 3-4cm. VBAC was more successful in patients 58.0% with favourable Bishop score. Conclusions: BMI <20, prior vaginal delivery, non-recurrent indication for previous caesarean, spontaneous onset of labour, cervical dilatation or favourable Bishop score, weight of baby < 3.5kg predict an individual’s likelihood of successful VBAC.

Objective: To observe the relationship of parity with awareness &liberty of useof contraception among married women. Study design: Descriptive study. Period: 1.02.2014to 30.09.2014. Settings: Department of Obstetrics & Gynecology, Bhatti International Hospital,Affiliated Central Park Medical College, LHR. Methods: All Primipara & multipara women deliveringat Bhatti Hospital were included. The women opting for permanentmethod (Tubal Ligation) wereexcluded. A total of 100 women participated in the study. Results: P1=44,P2-7=56,& out oftotal 100 women only 50 (50%) had simple awareness about contraception. Only 27% (all ofgroup 2 i.e P2-7) had used some form of contraception. Among Group 2, 30% used Barrier(male condoms),7% withdrawal, IUCD 5%, Pills 3%,Injections1%. Multipara were more awarethan primiparas with p value 0.043(significant).Both groups were equally dependent on theirhusbands&/or in laws directly or indirectly about their decision &choice of contraception withp value 0.49 (not significant).The decision of contraceptives use depended on couples 36%,Only Husbands 34%,only women 27%& in laws 3%.The Group 2 had a low tendency to usecontraception despite a general expectation with p value 0.36 (not significant) indicating thatthe probability of use in Group 2 was not very high. Conclusions: Both men & women need tobe aware of the benefits of contraception & women’s role in contraception decision making isstill low in Pakistan

No abstract

Objectives: To follow post-op patients after autologous rectus sheath repair ofutero-vaginal prolapsed. Study Design: Observational study. Place & Duration of study: ServicesHospitals, SIMS, LHR & Bhatti International Hospital, Central Park Medical College LHR.2008-2012. Methods: Pts from 28to38 yrs of age with utero-vaginal prolapse were selected.Due to their younger age group uterus retaining procedure was planned whether they hadcompleted their family or not ,So autologous rectus sheath graft was used with abdominal approachto suspend the uterus along with plication of round ligament These patients were thenobserved for immediate post op complications & 6 months onwards follow up was also noted.Results: 10 pts were included in the study. Only one pt had dysurea & 1 pt had 1st Degreecystocele on discharge. Long term follow up showed that 2 pts had 1st degree cystocele & only1 pt had 1st degree uterovaginal prolapse. Conclusions: An easier procedure for utero-vaginalprolapse that can be easily performed in a regular hospital set-up without the need of Laparoscope,mesh or high surgical expertise.