Objective: To determine the Incidence of Placental Abruption and the morbidity / mortality associated with it. Design:Prospective and Observational case Study. Setting & Duration: Department of Obstetrics & Gynecology, Liaquat University of Medicaland Health Sciences Hyderabad, for a period of 15 months from January 2007 to March 2008. Patients & Methods: Among all theantenatal patients delivered during the period under review, those suffering from Placental abruption were entered into this study bycompleting a proforma for each patient. After history, examination and initial management, investigations were carried out. These patientswere managed on case to case basis depending on the progression of abruption and delivery. After delivery whether spontaneous or bycesarean section the condition of mother and subsequent complications were recorded and results analyzed on SPSS version 10.Results: During the period 15 months, 2760 patients were admitted to labour room /labour ward and delivered. Among these, 100patients had abruption making an incidence of 2.89% per year. According to the degree of abruption 33 had mild, 50 had moderate and 17had severe abruption. 42% had spontaneous vaginal delivery, and 52% underwent cesarean section. 36% of Abruptio patients, developedcomplications like shock, PPH and DIC. One (1%) patient died in severe abruption. Conclusions: The incidence of Abruptio Placentae inthis study is comparable to local studies and studies from developing countries, but is high in comparison to studies from developedcountries. The maternal morbidity and mortality rate is not as high as in other studies.

Background: Trial of labour is a clinical test to assess the adequacy of pelvis andability of fetus and mother to withstand labour. If progressive changes in dilation and station donot occur, a cesarean delivery is performed. Objective: Feto-maternal outcome after trial oflabour in women with gestational age b/w 37 to 42 weeks. Study Design: Cross sectional study.Setting: Department of Obs/ Gyn unit-I Liaquat University Hospital Hyderabad. Duration ofStudy: One year from 01-02-2009 to 31-01-2010. Subjects and Methods: 100 pregnant women,with gestational age between 37-42 weeks, who underwent trial of labour at labour ward,Obs/Gyn Unit-1 Liaquat University Hospital, after fulfilling the inclusion criteria were included inthe study. Detailed history and examination including abdominal and pelvic examination as wellas Ultrasound for fetal well being was performed. Fetal monitoring was done by auscultation andCTG. Partogram was maintained to observe the progress of labour. Those who progressed withtrial either delivered normally or with the help of instruments and those who did not progress weredelivered by C-section. After delivery, mothers were watched for any postpartum complicationand condition of neonates was assessed by APGAR score. Results: Out of 100 women includedin this study 58% delivered vaginally, 31 % delivered by cesarean section and 11 % hadinstrumental deliveries. Labour was induced in 34%, augmented in 34% and 32% hadspontaneous labour. 77.0% babies had apgar score > 5(7.1±0.72), 16% < 5(3.68±2.18) and 6%were still birth. 81% mothers had no complication during or after delivery, whereas 19 developedcomplications and these were 12 Genital tract traumas, 5 postpartum haemorrhage, one uterinerupture and one retained placenta. There was no statistically significant difference (P=0.42)when mode of delivery was compared with the trial of labour. However augmentation of labourwas associated with increased rate of maternal complications when maternal outcome wascompared with the type of labour (P=0.03). Conclusions: Trial of labour in carefully selectedwomen with high probability to deliver their babies vaginally decreases the rate of LSCS, therebyreducing the maternal morbidity and mortality associated with it. However augmentation oflabour is associated with increased rate of maternal complications as compared to spontaneousor induced labour.