OBJECTIVES To determine and compare the efficacy of Uterovaginal packing versus uterine balloon tamponade to control postpartum haemorrhage due to uterine atony unresponsive to medical treatment. METHODOLOGY This comparative prospective cross-sectional study was conducted in Hayatabad Medical Complex, OBG department. A total of 140 patients were categorised into two groups, group A underwent Uterovaginal packing and group B underwent uterine balloon tamponade. All women of 18 to 40 years with a history of delivery after 28 weeks of gestation, who developed primary postpartum haemorrhage due to uterine atony, unresponsive to medical treatment were included in the study. Women with a history of delivery before 28 weeks of gestation, secondary postpartum haemorrhage, genital tract trauma, retained placental tissue and membranes, placenta previa, morbidly adherent placenta, febrile illness and uterine structural lesion were excluded from the study. Efficacy was labelled if there was no ongoing blood loss after the procedure with concomitant hemodynamic stability. All information was recorded in a predesigned proforma, and data were analysed using SPSS version 22.RESULTS Our study included 140 women; 113 had a normal vaginal delivery, and 27 underwent cesarean section. Among cases with normal vaginal delivery, 45 women had Uterovaginal packing, and 68 had uterine balloon tamponade, while among cases of cesarean sections, 25 women had uterovaginal packing and 2 had uterine balloon tamponade. The efficacy of Uterovaginal packing was 90%, and that of uterine balloon tamponade was 87.1%, with no significant difference statistically (p- 0.51). Overall efficacy of both procedures was 88.6%.CONCLUSION All orthodontic and non-orthodontic treatment group participants required oral hygiene instructions and had periodontal treatment needs (TN1). The patients requiring scaling and prophylaxis and Oral hygiene instructions (TN 2) were more in the orthodontic treatment group than the non-orthodontic treatment group. A higher percentage of patients requiring complex treatment (deep scaling, root planning and complex surgical procedures), scaling and prophylaxis and Oral hygiene instructions (TN3) belonged to the non-orthodontic treatment group.

Introduction: Peripheral infarcts on maternal side are relatively common and are not thought to be clinically sig­nificant. However those that occupy more than 5% of the placental mass or are more than 3cm in di­ameter in size are associated with perinatal mortality and morbidity. Objectives: To determine the frequency of placental infracts and its different severity grades among women with severe placental abruption. Study Design: Cross sectional descriptive study. Setting: Department of Obstetrics & Gynaecology, Postgraduate Medical Institute, Lady Reading Hospital Peshawar. Period: January 2016 to July 2016. Material and Methods: Patients admitted in hypovolemic shock or intrauterine fetal death was considered as severe abruption. Placenta of the subject was collected from labour room of the wards and was fixed in 10% formalin. Gross examination of placenta performed and then the section of placenta was stained with hematoxylin & eosin stain. The consultant pathologist reviewed the slides. All the data was recorded on predesigned Performa and analyzed through SPSS version 11.0. Results: Among 124 cases, majority of women (41.93%) were in the age group 30-40 years and presented at gestation age more than 37 weeks. 21.77% of patients were having placental infarcts of less than 3 cm and 18.54% of cases were having placental infarcts of more than 3 cm. 79.03% of babies born alive, 41.12% were preterm and stillbirth was a finding in 20.96% of cases. Overall frequency of placenta infarcts in patients was 40.32%. Conclusion: Placental infarcts were seen in about 40.32% placentae of women with placental abruption. Association between placental infarcts and preterm babies and stillbirths was also significant.