Objective: To explore the knowledge, attitude and sexual practices among pregnant women reporting to a tertiary care hospital Study Design: Cross-sectional analytical study. Place and Duration of Study: Antenatal clinic of Obstetrics & Gynaecology Department, Combined Military Hospital Rawalpindi Pakistan, from Jan to Jun 2020. Methodology: Three hundred and seventy women who attended the antenatal clinic during the study period were interviewed. The responses to chosen preferences were recorded on a structured questionnaire. Results: The majority of participants believed that intercourse could be done throughout pregnancy, it does not result in complications, and improves marital relationships. However, it was difficult due to the changed physical appearance, but it was not unpleasant for the husband. Only 51.1% of participants agreed to decreased libido. 77.6%, 71.6% and 75.4% were of the opinion that it was not prohibited in religion, neither influence baby nor labour respectively. Conclusion: Most pregnant women maintain sexual activity during pregnancy. The majority had adequate knowledge and a positive attitude.

Objective: To compare the ovulation induction of letrozole and clomiphene citrate in sub-fertile women with polycystic ovarian syndrome. Study Design: Quasi experimental study. Place and Duration of Study: Combined Military Hospital Rawalpindi, from Jun 2018 to Aug 2019. Methodology: A total of 116 married sub-fertile women with polycystic ovarian syndrome, 16-40 years of age were included. Patients with previous surgery related to genital tract, hypothyroidism and chronic renal failure were excluded. Letrozole 5.0mg daily from Day 5-9 of menstruation was prescribed to group A women and clomiphene citrate 100 mg daily from Day 5-9 of menses was given to group B women. Results: In group A and in group B, mean age was 29.78 ± 4.71 years and 29.95 ± 4.22 years respectively. Most of the patients 59 (50.86%) were between 18-30 years of age. Mean duration since marriage was 4.23 ± 1.42 years. Mean body mass index was 29.71 ± 2.65 kg/m2. Frequency of ovulation of clomiphene citrate and letrozole in sub-fertile women with polycystic ovaries was 28 (42.28%) versus 42 (72.41%) respectively (p-value=0.008). Conclusion: This study concluded that ovulation induction of letrozole is better than clomiphene citrate in sub-fertile women with polycystic ovarian syndrome.

Objective: To determine the diagnostic accuracy of modified early obstetric warning system for predicting maternal morbidity keeping ICU admission as “gold standard”. Study Design: Cross sectional validation study. Place and Duration of Study: Department of Obstetrics and Gynecology, Pak Emirates Military Hospital, Rawalpindi, from Oct 2018 to Apr 2019. Methodology: A total of 205 patients of singleton pregnancy, post-natal period <6 weeks, history of hypertension and diabetes were considered in the study. Women were followed up to 6 weeks for maternal morbidity in term of intensive care admission. All the data regarding findings of Modified early obstetric warning system and intensive care admission was noted. Results: The age range of patients was 18-40 years with mean age of 31.585 ± 3.31 years, mean gestational age was 37.595 ± 1.84 weeks and mean parity was 1.839 ± 1.59. Modified early obstetrics warning system as shown sensitivity of 84.38%, specificity 97.11%, diagnostic accuracy by 95%, positive predictive value of 84.38%, negative predictive value of 97.11%, (p=0.001) for prediction of maternal morbidity. Conclusion: Modified early obstetrics warning system chart fulfills most of criteria of ideal screening tool making it a significant bedside screening tool which can predict obstetric morbidity and mortality in pregnant patients.