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Aim: To determine the frequency of vitamin D deficiency in pre-eclamptic women admit in tertiary care hospital of Sindh Pakistan. Study design: Cross sectional study. Place and duration of study: Department of Obstetrics & Gynaecology, Liaquat University of Medical & Health Sciences Hospital Hyderabad from 1st December 2020 to 30th May 2021 Methodology: One hundred and fifty seven women with pre-eclampsia after 20 weeks of gestation were included. Detailed medical and obstetrical history and physical examination was carried out. Urine sample (MSU) was sent for test of proteinuria and after the confirm diagnosis of pre-eclampsia, blood sample was taken and sent to laboratory for measurement of serum Vitamin D (25(OH) D) levels and patients was categorized as Vitamin D deficient (below 75nmol/L (or 30ng/ml) of serum/plasma 25(OH)D concentration) or sufficient on the basis of serum vitamin D levels. Results: The average age was 29.06±3.96 years. Frequency of vitamin D deficiency was found in 130(82.8%) patients while sufficiency was found in 27(17.2%) of pre-eclamptic women. Conclusion: Pre-eclamptic women had a higher frequency of vitamin D deficiency. It is suggested that pregnant women at risk of vitamin D deficiency can be protected from hypertensive disease during pregnancy by a simple step of vitamin D supplementation during pregnancy. Keywords: Hypertensive disorders, Vitamin D deficiency, Pre-eclamptic

Aim: To determine the fetomaternal outcome in morbidly adherent placenta Study design: Cross-sectional study. Place and duration of study: Department of Obstetrics & Gynecology, Liaquat University Hospital Hyderabad from 1st January 2022 to 30th June 2022. Methodology: Forty five females of adherent placenta were enrolled. The consent was taken from every relevant patient having low lying placenta with previous scar/surgery the following details were collected. The operative events were recorded. Results: The mean age was 30.77 years and mean gestational age was 34.15 weeks. Majority of the cases 53.3% had history of three previous C-sections, 64.4% cases had placenta accreta, 20% had placenta percreta and 15.6% had p Placenta increta. Antepartum haemorrhage was seen in 68.9% of the cases. 55.6% females underwent C-sections, 22.2% were admitted in ICU, rate of the hysterectomy was high, 46.7% one patient was died. Considering the fetal outcome, 22.2% of the cases had fetal growth retardation, pre-term birth rate was 66.7%, neonatal ICU admission rate was 31.1% of the cases, respiratory distress was seen in 6.7% of the cases, perinatal sepsis was in 11.1% of the cases and intra uterine death rate was 8.9% of the cases. Conclusion: Morbidly adherent placenta was found to be a significant cause of adverse fetal and maternal outcome. It was frequently more prevalent among females who had previous history of scar. Key words: Invasive placenta, Fetomaternal complications

Objective: To determine the Prevalence of Pre-eclampsia in women with peripartum cardiomyopathy (PPCM) and to compare the maternal outcome in cases of PPCM who develop pre-eclampsia with those cases who are normotensive.      Study design: This is a prospective observational study. Setting: Study carried out at department of Gynecology and Obstetrics, Liaquat university hospital Hyderabad from 20th February 2019 to 19th February 2020. Materials and methods:  This prospective observational study was conducted in department of Gynecology and Obstetrics and department of Cardiology Liaquat University Hospital Hyderabad. Inclusion criteria were patients admitted with a diagnosis of peripartum cardiomyopathy diagnosed clinically and confirmed by echocardiography. Exclusion criteria were cases with multiple pregnancies, smokers, those with chronic hypertension and chronic renal disease or diabetes. We assessed patients for pre-eclampsia. Outcome measures studied were serious maternal complications like Pulmonary oedema, Cardiogenic shock, intensive care unit admission, and death. Results:  During one year study period, there were 71 cases of peripartum cardiomyopathy. The mean age of patients was 29.77±6.8 years. Pre-eclampsia was seen in 62% cases of Peripartum cardiomyopathy. Mean ejection fraction was 33.24±6.49. In patients of PPCM, serious maternal complications including cardiogenic shock 11(15.5%) cases, intensive care unit admission 10(14.1%) cases, pulmonary oedema 35(49.3%) cases and prolonged hospitalization 58(81.7%) cases.  Conclusion: We conclude that pre-eclampsia has high prevalence in patients with PPCM. Both when combined, significantly increase the chances of serious maternal complications including death.

Objective: To determine the impact of leiomyoma in pregnant women a tertiary care set up in Hyderabad. Methods: This prospective observational study conducted at OPD of Gynecology unit-III, Liaquat University of Medical and Health Science Hyderabad, from June 2018 to December 2018. A total of 18,402 pregnant women of age 20-45 years were attended, out of which 195 had leiomyoma and they were asked to take part in study. Data regarding demographic characteristics including complications during pregnancy, and indications of caesarean section was collected via study proforma. Results: Total 186 out of 195 females were studied, their mean age was 31.23+3.12 years, average gestational age was 33.12+3.15 weeks and average size of Leiomyoma was 3.12+2.15cm. The most common complications were PPH among 28.49% of cases, blood transfusion was required in 39.25% of the cases, miscarriage occurred in 6.45% of the cases, cord prolapse was seen in 24.3% cases, placental abruption in 5.91% cases, placenta previa in 11.32% cases and retained placenta was observed among 1.61% of the cases. Preterm labour occurred in 5.38% of the cases and IUGR was seen in 10.22% of the cases. Out of all cases, 10 females underwent preterm delivery, while 12 underwent fetus delivery before 24 weeks (miscarriage). Among all term pregnancies, 78.66% underwent C-Section due to failure in progress, cord prolapsed, fibroid in lower segment, breech presentation and low-lying placenta. Conclusion: Fibroid complicates pregnancy itself and also the outcome. Rural area dwelling women are at more risk, which include increase in caesarean section and a multifold increased risk of PPH and associated hysterectomy in these cases. Keywords: Leiomyoma, Uterine Fibroids, Pregnancy, complications.