IntroductionThe ABO blood group type has been considered an independent risk factor in the occurrence of pregnancyrelated complications leading to significant morbidity and mortality in pregnant mothers and neonates. This study aims to determine the maternal ABO blood group and its correlation with pregnancy-related complications. MethodsWe analysed data of 497 pregnant female patients aged between 25 and 40 years who presented with a gestational age of > 14 weeks from June 1, 2020, to November 30, 2020. Patients' age, parity, gestational age at the first visit, body mass index (BMI) at the first visit, ABO blood group, gestational age at delivery, mode of delivery, birth weight of neonate, and pregnancy-related complications including preeclampsia, gestational diabetes mellitus (GDM), preterm delivery, low birth weight (LBW), and small for gestational age (SGA) infants were evaluated. ResultsThe mean age of 497 patients was 27.6 (27.62 ± 3.35) years. Mean BMI was 22.7 (22.7 ± 3.1 kg/m 2 ), parity was 1.85 (1.85 ± 2.3), gestational age at first visit was 23.19 (23.19 ± 3.4) weeks and gestational age at delivery was 37.0 (37.0 ± 2.6) weeks. There were 205 (41.25%) spontaneous vaginal delivery and 292 (58.75%) cesarean sections. The average birth weight of the neonate was 2684.31 ± 622.4 g. Preeclampsia was observed in 107 (21.53%), GDM in 17 (3.42%), and preterm delivery in 154 (30.99%) women. Considering the neonatal outcome, 124 (24.95%) babies had LBW and 49 (9.86%) were SGA. The rate of preeclampsia and GDM was not statistically significant among different blood groups while the rate of preterm delivery, LBW, and SGA was significant among women with different blood groups. ConclusionWe conclude that the ABO blood group is associated with maternal and neonatal pregnancy-related complications when considering the risk of preterm delivery, LBW, and SGA but not with GDM and preeclampsia. This finding will help clinicians to identify the patients at risk of developing pregnancyrelated complications and hence, to take timely and appropriate measures.

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The traditional teaching was not to touch a fibroid during pregnancy, in fear of possibility of intractable intra operative bleeding and post-operative morbidity. In the recent years with advent in obstetric analgesia and availability of blood banks, many have been attempting myomectomy along with caesarean section [CS]. The advantages being avoiding laparotomy at the later date, for a myomectomy or hysterectomy and also preventing the complications like abortions, preterm deliveries that can occur in the future pregnancy of the patient. In the developing countries where the cost of surgery is being paid by the individuals, it is of much significance, if we can perform 2 surgeries in one sitting, sparing the cost and hospitalization time of a second surgery. A 2 years retrospective study from June 1 st 2011 to May 31 st 2013 was conducted on the effects of myomectomy during caesarean section and compared the morbidity with normal caesarean section deliveries. The routine protocol of Myomectomy, like a written informed consent, availability of blood products and antibiotic prophylaxis is recommended. All principles of Myomectomy were followed. In places where it is possible, myoma was removed through the caesarean incision itself. In subjects requiring additional incision, it was placed according to the site of fibroids. In cornual fibroids a vertical incision was preferred to avoid trauma to fallopian tube. In most of the other cases transverse incision was used. Obliteration of dead space in the bed of fibroid was done with sutures in multiple layers. It was found that myomectomy during caesarean section did not cause significant morbidity to the patient. There was no need for hysterectomy in this series of 26 cases. Thus has the advantage of avoiding a second laparotomy and anesthesia later for myomectomy / hysterectomy. Each surgery adds to the risk of adhesions adding to the importance of removing the fibroid along with caesarean.

Introduction: Thunderclap headache (TCH) is a severe headache that peaks within 60 seconds of onset. It's an uncommon type of headache, but recognition and diagnosis are important because of the possibility of a serious underlying brain disorder. Severe headache has long been recognized as a signature feature of subarachnoid hemorrhage (SAH). Lumbar puncture (LP) has the advantage of picking up cases missed on computed tomography (CT) scan, owing to its ability to detect small bleeds directly from the cerebrospinal fluid (CSF). This study can help us in understanding the role of this modality for early diagnosis and therefore timely management of patients. Subject and methods:A retrospective cross-sectional study for a period of six months was conducted at a tertiary care hospital in Karachi, Pakistan. A total of 189 patients presenting with TCH were included in this study. CT was performed on Toshiba Activion 16 slice CT scanner (Toshiba Medical Systems, Otawara, Japan). Presence of SAH was confirmed by CSF analysis after LP. Data were registered on proforma, then transferred to IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Armonk, NY) for statistical analysis. Diagnostic accuracy of CT scan in detecting SAH was calculated. Stratification was done on age and sex to see the effect of these modifiers on outcome using chi square test; p≤0.05 was considered as significant. Results:The average age of the patients was 47.97±9.96 years. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CT was 88%, 91.4%, 78.6%, and 95.5%, respectively while diagnostic accuracy of CT scan in the detection of SAH was 90.48%.Conclusion:This study concludes that CT is the preferred non-invasive approach for the majority of patients who present with suspected SAH.