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Objectives: The objective of the study was to assess the factors indicating success in vaginal delivery after previous one C-Section. Material and Methods: The study was carried out to assess the factors indicating successful VBAC ( vaginal birth after caesarean section). Over a period of two years from Jan 2011 to Dec 2012 at the department of Obstetrics and Gynecology Al-khidmat Teaching Mansoorah Hospital, Lahore affiliated with University College of Medicine and Dentistry Results: The frequency of normal vaginal delivery after previous 1 C-Section was 47.29% while 52.7% had repeat CSection. The only statistically significant factor which could favor successful vaginal delivery was history of previous vaginal delivery prior to previous C-Section. Patients who had previous C-section for bad obstetrical history were delivered by repeat caesarean section. Majority of the patients included in the study group were booked belonged to educated middle class families having awareness of the complications that may occur during trial of labor. Provision of adequate antenatal health care services, timely identification of high risk cases, use of electronic fetal monitoring, involvement of senior , skilled and experienced personnel in the management of obstetrical emergencies are responsible for successful trial of Labor i.e. almost 50% patients delivered vaginally after previous I C-Section. Thus in order to increase the rate of NVD frequency of trial of labor must be increased with the goal of vaginal delivery but without compromising maternal and fetal health. Conclusion: Almost 50% of the patients with previous one C-Section can be delivered normally especially if they had delivered vaginally previously. The decision of VBAC is complex and ultimately resides with the women and her Obstetrician after counseling the patient regarding all the risk - benefit profile.

Purpose: This study aims to investigate the incidence and the relative risk factors of retinopathy of prematurity (ROP) and posterior-ROP (P-ROP): ROP in Zone I and posterior Zone II, as well as to analyze the occurrence of surgical treatment of ROP and to evaluate the short term outcome of the disease . Methods: It is a prospective observational study; all infants with a birth weight (BW)  ≤ 750 g and/or a gestational age (GA) ≤27 weeks born between January 1st 2010 and 18 January 2014 in neonatal intensive care unit were included in the study. Results: 71 infants were examined: 49 (62.01%) developed ROP and 22 (30.99%) P-ROP. Following the multivariate analysis erythropoietin-therapy (p  < 0.0001) and intraventricular hemorrhage (IVH) (p  = 0.003) were significantly associated with ROP while gestational age ≤24 weeks (p  = 0.011) and sepsis (p  = 0.002) were associated with the onset of P-ROP. A favorable outcome was reported in 59 (83.09%) newborns affected by ROP. Adverse outcome occurred in 12 patients. Conclusions: P-ROP is the most aggressive type of ROP. It associates with lower GA and sepsis. Obstetricians and Neonatologists must focus on the reduction of severe preterm births

Objective: Pregnancy results in a lot of hormonal changes in the body and the eyes are no exception. These ocular changes could be physiologic, pathologic or a modification of a pre-existing condition. The aim of this study was to determine physiologic ocular changes that are associated with pregnancy in healthy women. Materials and Methods: A total of 100 women were followed longitudinally through out the course of their pregnancy and 6 weeks postpartum. The women were recruited at 8 weeks of pregnancy at the anti-natal clinic in the Department of Obstetrics and Gynecology, Mansoorah Teaching Hospital,Lahore. The women were aged between 20 and 35 years. Tests carried out included visual acuity, ophthalmoscopy, retinoscopy, and tonometry. The tests were carried out in each of the three trimesters of pregnancy and 6 weeks postpartum. Results: There was a fall in intraocular pressure across the trimesters and this was very significant (P<0.0001). Postpartum, the intraocular pressure began to rise. The difference between the third trimester and post-partum values was also statistically significant (P< 0.0001). The difference in visual acuity through out the pregnancy was not significant (P= 0.8477). Although, there was a fall in refractive error across the different trimesters, it was not statistically significant (P=0.3). There was also no difference in the third trimester and the 6 weeks postpartum values of both visual acuity and refractive error. Conclusion: Ocular changes associated with pregnancy are transient and most tend to resolve postpartum, with values returning to near pre-pregnant state.

Objective: The purpose of this study is to assess the frequency of epigastric pain following intravenous infusion versus intravenous bolus administration of oxytocin in caesarean section. Study Design: Case control/Prospective Place and Duration: M. Islam Medical College, Gujranwala from 1st January 2018 to 30th June 2018. Methods: A total of 100 patients were enrolled in this research. After obtaining written agreement, detailed demographic information such as the patient's age, BMI, and parity were collected. Those who took part in the study ranged in age from 18 to 45. Patients were separated into two equal groups, designated as I and II, respectively. Group I received an intravenous infusion, while group II received an intravenous bolus of medication. There was a significant difference in the frequency of epigastric pain between the groups. The SPSS 25.0 version was used to examine the entire set of data. Results: In group I mean age was 26.11± 7.64 years and mean BMI was 25.12±3.19 kg/m2 while in group II mean age was 27.07 ±4.37 years with mean BMI 25.01±4.55 kg/m2. Mean diastolic blood pressure was 80.88± 3.55 and 81.34 ±7.78 among both groups. We found that most of the patients were multigravida in both groups 33 (66%) and 34 (68%) while frequency of primigravida in group I was 17 (34%) and in group II was 16 (32%).We found that prevalence of epigastric pain was observed higher 25 (50%) in bolus group II as compared to infusion 14 (28%) group I with p value < 0.05. Conclusion: We found from this study that the frequency of epigastric discomfort was higher in the intravenous bolus group as compared to the infusion of an equivalent dose of oxytocin in the control group. Keywords: Intravenous bolus, Intravenous infusion, Epigastric pain, Pregnancy, C-section