Background: Dysfunctional uterine bleeding is the idiopathic complication in premenopausal females or females that have chance to get pregnancy. It can have significant impact on quality-of-life of female and also lead to several complications including subfertility. Objective: To determine the frequency of dysfunctional uterine bleeding in patients presenting with problem of sub-fertility. Study design: Cross sectional study. Setting: Department of Obstetrics & Gynaecology, Lahore General Hospital, Lahore. Duration: 3 months (July to October 2020). Method: Sample size of 150 patients were enrolled in the study through Non Probability, Consecutive Sampling. Patients of age 20-40 years, presented with diagnosis of subfertility were included. Then females were evaluated for presence of dysfunctional uterine bleeding. Data was recorded on proforma and analyzed by using SPSS version 22. Results: The mean age of females was 32.56 ± 8.93 years. The mean BMI of females was 29.61 ± 12.43 kg/m2. The mean duration of marriage was 8.94 ± 3.47 years. There were 97 (65%) females with primary subfertility while 53 (35%) females had secondary subfertility. Out of 150 females, dysfunctional uterine bleeding was noted in 69 (46%) females while 81 (54%) females did not had dysfunctional uterine bleeding. In females with primary subfertility, dysfunctional uterine bleeding was observed in 38 (39.2%) females. In females with secondary subfertility, dysfunctional uterine bleeding was observed in 31 (58.5%) females. The difference was significant (p<0.05). Conclusion: Though this study, we found significantly high frequency of dysfunctional uterine bleeding in females with subfertility. Also the frequency of dysfunctional uterine bleeding was significantly higher in females with secondary subfertility as compared to primary subfertility.

Background: Premature Rupture of Membranes (PROM) is common in obstetrics and management of such patients depends on whether the rupture has occurred or not. With membranes ruptured the fetus is deprived of protection provided within the amniotic cavity. Beta-Human chorionic gonadotrophin (β-HCG) is a hormone and is present in high concentration in amniotic fluid as well as in the blood and urine of the mother and is studied as possible predictor of preterm labour and as marker of PROM. Objective: To compare the diagnostic accuracy of B-hCG & nitrazine paper test in vaginal washings taking amniotic fluid pooling as gold standard for diagnosing premature rupture of membranes. Material & Methods: It was a comparative cross-sectional study conducted at Unit Department, of Obstetrics & Gynecology, Lahore General Hospital, Lahore. After that vaginal washings were taken for β-hCG testing. A pregnancy test kit (Accu Check) was used for detection of β-hCG in vaginal fluid washings. According to amount of µ-hCG in the washings the result has been positive as early as 40 Seconds but for labeling the result negative 5 minutes complete reaction time has been observed. On netrizine kit, the positive test is indicated by distinct colour band on both; control and test side. Results: Mean age of women was 27.17+4.55 years. Mean age of gestation was 36.16 + 3.30 weeks. Sensitivity & specificity of Nitrazine Paper Test were 92.17% & 66.67%. However the PPV & NPV for Nitrazine Paper Test was 98.15% & 30.77% respectively. Sensitivity & specificity of β-hCG Test was 94.35% & 75%. However the PPV & NPV for β-hCG test was 98.64% & 40.91% respectively. Conclusion: Results of this stud y showed that B-subunit of hCG measured by over-the-counter available pregnancy test kit is a dependable quick and easy test for detection of premature rupture of membranes. This test can be performed on the bed side of the patient without Lab involvement. This test can be promoted as an additional help for the diagnosis of doubtful and ambiguous cases of premature rupture of membranes.

Background: Placenta Previa is one of the major obstetric complication. It is a serious condition that may lead to severe morbidity and mortality. The risk of cesarean and blood loss, particularly, in emergency cesarean section. Objective: To compare the mean blood loss and need for blood or blood products with emergency versus elective cesarean section in females with placenta previa. Study design: Cohort study. Settings: Department of Obstetrics & Gynaecology. Duration: 3 months (April to June 2020). Method: Sample size of 70 patients were enrolled in the study through Non Probability, Consecutive Sampling. Patients of age 20-40 years, presented >24 weeks of pregnancy, with diagnosis of placenta previa were included. Then females were booked and were followed-up in OPD till delivery. Emergency cesarean section was done if active labor and bleeding started while elective cesarean was done on given date for delivery. Intraoperative blood loss and need for blood or blood components transfusion was noted. Data was recorded on proforma and analyzed by using SPSS version 22. Results: The mean age of females in emergency group was 30.80 ± 4.36 years and mean age of females in elective group was 31.06 ± 3.76 years. The mean gestational age of females at delivery in emergency group was 35.74 ± 2.89 weeks and in elective group was37.54 ± 0.70 weeks. The average blood loss during emergency caesarean section was 1471.43 ± 891.65 ml while during elective cesarean section, average blood loss was 1042.86 ± 402.41 ml (p<0.05). In emergency caesarean group, 7 (20%) did not require blood transfusion while 28 (80%) required blood transfusion. In elective caesarean group, 21 (60%) did not require blood transfusion while 14 (40%) required blood transfusion (p<0.05). Conclusion: Though this study, we found significantly higher blood loss and need for blood transfusion in emergency caesarean section as compared to elective caesarean sections for placenta previa.