Objective: Determine the frequency of hypothyroidism in recurrent pregnancy loss. Study Design: This is cross sectional. Place and Duration of Study: This study was conducted at Obstetrics and Gynaecology department of Dow Medical University & Hospital, Ojha Campus, Karachi, from 7th July 2018 to 6th July 2019. Methodology: This study was conducted on 83 patients. Detailed history was taken from all the patients with special regard to demographics like age, parity and recurrent pregnancy loss. A 3 ml venous blood was drawn by the staff on duty and sent to institutional laboratory for TSH and free T4 level. TSH values more than 4.5 μIU/L and normal free T4 level (0.7 to 1, 8 ng/ml) were considered as hypothyroidism. All pregnant female was between age 20-35 years with > 6 months gestational age and history of parity 3 and gravida 4 were included in the study. Exclusion criteria were known case of hypothyroidism or history of taking medication for hypothyroidism, history of Hypertension and DM. Results: This study was conducted on 83 patients. There was wide variation of age ranging from a minimum of 20 years to 35 years. The mean age was 28.4+ 4.49 years. Mostly patients were parity 3 and gravid 4 in 55(66.26%) cases followed by parity 4 and gravid 4 in 28(33.73%) cases. Gestational age was measured on ultrasound ranging from 8 weeks to 22 weeks. The mean gestational age was 14.20+4.71 years. Patient's thyroid profile mean Thyroid-stimulating hormone (TSH) level was 2.39+1.66 mU/L, mean free T4 was 17.23+6.41 nmol/L and mean free T3 was 4.87+1.18 μmol/L. Observed hypothyroidism was in 11(13.3%) cases while rest of 72(86.7%) cases within normal range. Conclusion: We concluded that hypothyroidism is problem in recurrent pregnancy loss. 11(13.3%) cases Frequency of hypothyroidism in women with pregnancy, the possible role of thyroid functional disorders in etiology of at least some part of recurrent pregnancy loss, had emphasized the importance of thyroid functions tests screening as routine in all pregnancies. Keywords: Thyroid disease, Pregnancy outcome, Hypothyroidism.

Aim: Frequency of cervical cancer in women of reproductive age presenting with abnormal vaginal bleeding. Methodology: Descriptive cross sectional study, done at Department of Obs &Gynae, JPMC, Karachi Duration of study: Six months from 01-11-2014 to 30-04-2015 Total 73 patients of age 18-45 years, having history of abnormal vaginal bleeding > 3 menstrual cycles were selected. Pregnant woman, abortion within last 6 months, age >45 years, fibroid/ tumors/ polyps, PID, gonorrhea, or Chlamydia patients were excluded. Chi-square was used as test of significance with a P value <0.05 taken as significant. Results: Mean ± SD age was 38.12 ± 4.33 years. Mean ± SD parity was 2.21 ± 1.67 children (Range: 0-5). Mean ± SD duration of presenting symptoms was 7.45 ± 2.81 months (Range 3-11). About one fifth of patients (i.e. 19.2%) were of age between 18-25 years. a vast majority (i-e; 43.8%) were in 26-35 years age category while remaining (36.99%) patients were of age between 36-45 years. 12.3% women had no children, 35.6% had 1-2 children, 28.8% had 3-4 children while remaining 23.3% women had 5 children. 12 out of 73 (16.4%) women had cervical cancer confirmed through biopsy and histopathology of cervical tissue. Age was significant (P value = 0.003) while parity & duration of presenting symptoms were non-significant (P values = 0.110 & 0.405 respectively). Conclusion: The study found that almost every 6th women with abnormal vaginal bleeding is suffering from cervical cancer. Younger age women and those having lesser parity are less prone to this condition. Keywords: Abnormal vaginal bleeding, Cervical cancer, Postcoital bleeding

Objective: The current study aim to understand the anxiety, depression, psychological reaction and impact of COVID-19 on human fertility in Karachi, Pakistan. Materials and Methods: This cross-sectional study was conducted on all married 243 patients at Out Patients Department (OPD) of Gynecology and Obstetrics at Civil Hospital, Karachi, Pakistan. The data were collected through a standardized questionnaire and this was done between from July 2020 to December 2021. Regarding the inclusion criteria, only patients who consulted a gynecologist were invited to participate in the study voluntarily. The principles of research ethics regarding the confidentiality of the data collected and ensure the anonymity of the participants. The data were analyzed by way of descriptive statistics and cross tabulation, with a P value of 5 per cent used to determine level of significance. Results: Mostly patients were observed above 30 years 42.38% with mean age was 36.12± 3.2 years (range 18-50 years) and majority of patient’s relatively good health status 153(62.96%). Mostly couple 161 (66.25%) avoid the pregnancy in covid-19 period. Patients preferring to avoid the pregnancy due to higher COVID-19 contagion anxiety 121(75.15%) were observed. The main reason for avoid the pregnancy was fear of delivering a baby in the current situation 110(68.32%) cases. Followed by infected 55(34.16%), financial concerns 63(39.13%) and risks for the pregnancy 88 (54.65%) cases. There are significant number of patients, who report moderate anxiety 73(30.04%), severe anxiety 55(22.63%), findings of PHQ9 shows moderate depression 67(27.57%), moderately severe depression 71 (29.21%), and severe depression 25(10.28%).  Conclusion: In Covid-19 period were observed high rate of anxiety, depression, and psychological reaction in female patients who wants to conceive. Anxiety, depression, and psychological reaction might be leading to changes in sexual behavior can all predict the quality of a couple’s relationship.

Objective: To determine the frequency and outcome in pregnant women with COVID-19 infection. Study Design: This is a observational cohort study. Setting: Study carried out at Department of Obstetrics & Gynecology, Civil Hospital, Dow University of health sciences Karachi, from July 2020 to November 2021. Materials & Methods:  The study was conducted in a tertiary care hospital in Karachi. Women having COVID-19 positive status during any stage of their pregnancy having antenatal visits in our hospital were included in our study. Maternal demographics, race, maternal outcome, and neonatal complications were noted on a self-made Performa. Statistical analysis was done by SPSS version 21 and descriptive statistics with frequencies were mainly calculated. Results: During the defined time of 14 months, we had 143 women visiting antenatal outpatient department and were tested positive for COVID-19. Majority of the women were tested for COVID-19 due to symptoms like fever, flu, cough and diarrhea. The mean age of women in our study was found to be 30 ± 6.7 years. The most frequent maternal outcome with SARSCOV-2 was preterm delivery. Out of 143, 27 cases had emergency lower segment C-section.PCR testing of neonates was carried out and 8.39% (n=12) neonates tested positive for SARSCOV-2.  Conclusion: Infection with Covid-19 during pregnancy is associated with adverse pregnancy outcomes. Covid-19  infection can be transmitted to the fetus during pregnancy or childbirth. Neonatal has a high chance of being admitted to the ICU, and women also faces other complications of Covid 19, such as the risk of miscarriage and premature delivery.