Introduction: Infertility is a difficult conditions for the obstetricians to dealwith. Transvaginal ultrasound (TVS) is a investigation that is primarily done to evaluate the cases of infertility cases. The objective of the present study was to document the Transvaginal Scan (TVS) findings in women presenting with infertility in a teaching hospital of Bangladesh. Methods: Subjects were women of reproductive age presenting at the teaching hospital with infertility over a one year period. As part of their management, transvaginal scans was done. TVS was done by the researcher herself and was checked by a second observer. Data was complied and analyzed by SPSS 20. Results: Among the 100 cases regarding anthropometric variables where mean ± SD of age was found 28 ± 6.7 years, weight was 56 ± 12.5 kg, height 1.57 ± 0.76 m and BMI was 24.5 ± 3.6 Kg/m2. Type of infertility revealed 75% cases were primarily infertile and 25% having secondary infertility. Comorbid diseases revealed 6% cases had DM, 4% cases had HTN, 11% cases had PID, 14% patients had thyroid problems. All the 100 cases undergone TVS study where PCO was found among 69(69%) cases, chronic pelvic inflammatory disease 14(14%) fibroids 6(6%) anatomical problems 19(19%) endometrial/cervical polyp 18(18%) free fluid in pelvic/abdominal cavity 7(7%) endometritis 5(5%) endometriosis 4(4%) adenomyosis 5(5%) chocolate cyst 8(8%) tubo-ovarian mass 2(2%) intrauterine and intra pelvic adhesions 2(2%) septate uterus 292%) pelvic abscess 1(1%) and ectopic pregnancy 1(1%). Conclusions: Polycystic Ovaries (PCO) is the major finding in women with infertility in our study. This hitherto poorly recorded pathology should be actively investigated in women representing with these symptoms by the use of TVS.

Background : Risk factors of Pregnancy is a stress that may reveal a variety of medical conditions which includes hypertension, metabolic syndrome, pre-eclampsia, gestational diabetes and ischemic heart disease etc. Urinary tract infection in first trimester is not uncommon with different risk factors. So the objective of the present study was to describe the clinical profile and risk factors of urinary tract infections during 1st trimester of pregnancy. Materials and methods: A descriptive study was conducted in the Obstetric and Gynaecology Department of BGC Trust Medical College Hospital, Chittagong from 1st January to 30th August 2016. Total 100 women were selected to ascertain the frequency and pattern of urinary symptoms as well as the risk factors of Urinary Tract Infection (UTI) such as age, parity, past history of UTI and haemoglobin among women attending an antenatal clinic. All pregnant women at 1st trimester irrespective of age, parity and gestational age were included, while women with known underlying renal pathology, chronic renal disease, renal transplant, diabetes or taking immunosuppressant therapy were excluded. Informed consent was taken and data collected on a self designed proforma. All the women underwent complete examination of urine. Dipstick test was performed on midstream urine and urine was cultured incase of positive dipstick test and women with urinary symptoms. Data was analyzed on SPSS version 18. Results: Regarding age distribution of the patients and found more than a half (52.0%) of patients belonged to 20–25 years age group. The mean (±SD) age of the patients was 23.7±4.5 years with range from 16 to 32 years. Regarding the general examination it was observed that anxious was found 55(55.0%), mild anaemia 59(59.0%), fever 25(25.0%) and high respiratory rate 16(16.0%). Build, nutritional status, lungs and examination of breast shows normal of the studied patients. The mean (±SD) Hb% of the patients was 10.0±0.6 gm/dl with range from 9 to 11 gm/dl. The mean (±SD) total count of the patients was 8428.6±1746.9/cumm with range from 6000 to 10000 /cumm. The mean (±SD) differential count of the patients was 69.0±3.4% with range from 65 to 75. The mean (±SD) ESR of the patients was 43.6±5.4 mm in 1st hour with range from 30 to 50 mm and the mean (±SD) RBS was 95.7±8.7 mg/dl with range from 90 to120 mg/dl. Pseudomonas 23(23.0%) Klebsilla 15(15.0%) E. coli 45(45.0%) and Proteus 17(17.0%) isolated from urine of UTI after caesarean section cases. Abnormal voiding pattern 87 (40.3%). Illiteracy(15%) History of sexual activity(10%), Low socioeconomic (Monthly income < Tk. 10,000 / month) group(17%) Past history of UTI(5%) and Multiparity(14%) were found to be risk factors for UTI in 1st trimester in these women. Conclusion: The common urinary symptoms encountered in the studied women were abnormal voiding pattern followed by irritative symptoms. Majority of urinary symptoms were due to pregnancy related changes in the urinary system. Past history of UTI, sexual activity, lower socioeconomic group and multi parity were significant risk factors for UTI. JCMCTA 2017 ; 28 (1) : 21 - 26

Background: Pre-eclampsia and other hypertensive disorder in pregnancy are among the top causes of maternal and perinatal death globally. About 10% of all pregnancies have pre labor (premature) rupture of membranes (PROM), of which 7%–8% occur after 37–42 weeks. The objective of the study was to observe if pre-eclampsia is associated with spontaneous PROM. Method: Eighty (80) eligible pregnant women with gestational age ≥20 weeks were included in this study. They were divided into 2 equal case and control groups; 40 pregnant women with Pre-eclampsia and 40 pregnant women with normal blood pressure. The association of the risk of spontaneous PROM was assessed among these groups. Results: In this study 87.5% of the Pre-eclampsia case group and 75% of the normotensive control group were primigravida. There was a significant association between the gestational age of 82.5% of the Pre-eclampsia group and 70% of the normotensive group being full term (p=0.034). In the Pre-eclampsia group, there were 29(72.5%) PROM with a significant association (p=0.010), whereas in the normotensive group, there were 4 (10%) PROM with no significant association. The risk of PROM was found among Pre-eclampsia patients. Conclusion: In this study, we concluded that Pre-eclampsia is associated with the risk of spontaneous PROM.

Background: Management of critically ill obstetric patients in intensive care unit is a challenge. Pregnancy, delivery and puerperium can be complicated by severe maternal morbidity necessitating Intensive Care Unit (ICU) admission. So the objectives of the present study was to see the patterns of ICU referral from the obstetrics and gynaecology wards. Materials and methods: The study was conducted in Department of Obstetrics & Gynecology, of a tertiary Medical College Hospital and some Private Hospitals, Chittagong between January 2011 and December 2016. The antenatal patients (From 28 weeks onwards) and postnatal patients (Up to six weeks) who were referred to ICU were the study population. After collection data were analyzed by SPSS-20. Results: A total of 50 records kept in Gyne & Obstetrics ward. The mean age of the subjects was 27.8 ± 5.9 years and the lowest and highest ages were 18 and 40 years respectively. Majority were from rural resident (86%). Over 82% of the patients were poor and 18% middle class. The mean duration of married life of the patients was 6 ± 0.7 years and the minimum and the maximum duration were 1 year and 22 years respectively. The mean age of the last child was 2.8 ± 0.4 years and the lowest and the highest age of last child was 1 and 13 years respectively. Most (80%) of patients had a history of being pregnant 2–4 times and 18% 5–8 times and only 2% was primigravida. In terms of parity 38% of patients was primipara, 44% had 1–3 live-birth and rest 18% between 4–7 live-birth. The main causes of admission to ICU were Post Partum Haemorrhage (PPH) (42%) hypertensive disorder of pregnancy (40%) coincidental cardiac disease 4%, sepsis 6%, post cardiac arrest 4% and shock with postpartum dilated cardiomyopathy 4%. Respiratory failure and hemodynamic instability were the indication for ICU admission. Two-third (66%) of the patients was admitted in intensive care unit for respiratory failure and 46% for hemodynamic instability. For nine (98%) of 50 patients admitted to the ICU required mechanical ventilation. Conclusion: Maternal morbidity and mortality in such cases can be minimized by early assessment and aggressive intervention by a team work involving obstetricians, intensive care specialists and anesthetists. JCMCTA 2017 ; 28 (1) : 67 - 71