Objective: To evaluate the indications of primary cesarean section in multipara and to assess the obstetric outcome including maternal, fetal morbidity and mortality, perinatal outcome. Study Design and Setting: It was a hospital based study of primary caesarean sections (CS) done on multiparous patients in duration of two years between January 1, 2016, and December 2017 at Jinnah medical college hospital Karachi. Methodology: Multiparous patients were those who had delivered through vaginal route one or more times (i.e. 28 weeks of gestation or above) or had 1–4children and grand-multiparous are those who had 5 or more children. All the cases included in the study were hospital based and cesarean section was decided by specialist. The procedure was performed by registrars and specialists. The selected patients were followed up till they were discharge from the ward with minimum hospital stay of three days. Data was compiled and results were carried out by SPSS version 23. Results: During the two years of study period, the number of total deliveries were 2064. The primary CS rate in multipara was 37.17%. These women have more likely to have an emergency cessarean sections compared to elective i.e. 85% and15%. The mean age of women was 29.5 years, booked cases were 72.5% and unbooked were 27.5%. Regarding indications for cesarean sections, non-progress of labour ranked first 25.5% followed by fetal distress 20%, pre eclampsia 12 % and ante partum hemorrhage 10.5% etc. Increase incidence of morbidity and mortality was seen in patients undergoing cesarean section due to different reasons. Conclusion: Primary caesarean sections in multipara comprise only a small percentage (37.17%) of total deliveries but were related to high maternal and fetal morbidity

Background: Improving maternal and child health is prioritized globally; however, adolescent pregnancies remain the prime one among the many obstacles. The study aimed to determine the maternal and perinatal outcomes in adolescent and adult primigravida. Methodology: This cross-sectional study was carried out between 1st December 2018 to 30th November 2019, over a sample of 487 pregnant women (primigravida), presenting at the Jinnah Medical College Hospital, Karachi, for childbirth/delivery. The patients were categorized as adolescents (aged ≤19 years) and labelled as group A and adults (aged 20-34 years) labelled as group B, comprising 83 and 404 patients. Data were recorded using a structured questionnaire containing details pertaining to socio-demographic characteristics, labour, delivery and immediate postpartum period complications of pregnancy. The data was analyzed using SPSS version 23.0. Results: A total of 1738 deliveries were completed in the study duration at Jinnah Medical College Hospital, Karachi. The mean age of the women was 18.35 ± 0.06 years, and the modal age was 27 years. The mean gestational age of the women was 36.86 ± 2.15 weeks among teens and 38.55 ± 0.55 weeks among adults. The incidence of adverse outcomes was higher among maternal [anemia; 46.9% (p-value 0.05)] and perinatal [preterm delivery (20%), low birth weight (22%), stillbirth (11.5%) and perinatal mortality (10%); p<0.05] was higher among teens. Conclusion: It is concluded that teenage pregnancies are comparatively riskier than adult pregnancies for the child and the mother, as is apparent from the significant

No abstract

Background: Infertility is defined as the inability to conceive after one to two years of unprotected intercourse. It is of two types primary infertility and secondary infertility Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies affecting 5%–10% of reproductive age women. To compare the efficacy of metformin plus clomiphene and clomiphene alone in the treatment of primary infertility due to polycystic ovary syndrome in obese women Materials And Methods: It was Randomized Controlled Trial, which was conducted in the department of Obstetrics and Gynaecology, Hospital, Peshawar, between 30th May 2019 to 8th January 2022) Sample size will be 380 in each group using P 1 = 15%, P 2 = 22% and power of 80% and 95% confidence interval under WHO Software for sample size determination. Results: A total of 380 patients in each group were observed. Average age of the patients was 26.60 years+ 3.99SD with range of 19-35 years. Group A showed 88(23.2%) efficacies. Similarly Group B showed 68 (17.9%) efficacies. Efficacy was significant in both the groups with p-value=0.044. Conclusion: Metformin plus clomiphene is more efficacious than clomiphene alone in the treatment of primary infertility due to polycystic ovary syndrome in obese women. Keywords: Efficacy, metformin, clomiphene, polycystic ovary syndrome, primary infertility

No abstract