Objective: To evaluate the frequency of adverse maternal and perinatal outcomes in teenage pregnancies at secondary hospital Hyderabad. Methods: Retrospective record review was conducted between January 2012 to January 2016. Total No. of deliveries was 15,395 out of which No. of teenage was 452. Results: Rate of teenage pregnancy in our hospital during study period was 2.93%. Majority of women were uneducated. Teenage mother more likely to develop pregnancy induced hypertension 19.5%, frequency of mild, moderate, and severe anemia were reported to be 69.9%, 28.8% and 1.3% respectively. Conclusion: Fetal and neonatal outcome was not adversely affected. Teenage pregnancy outcome can be achieved favorable with good antenatal care.

Objective: To evaluate increasing rate of caesarean section due to non-reassuring cardiotocography. Methods: This study is carried out in obs/gyn department of Liaquat university hospital from 2012 to 2013. After permission from ERC, patients enrolled for study meeting inclusion criteria with nonreactive cardiotocography undergo caesarean section, and results are analysis through SSPS version 17. Results: There was wide variation of maternal age ranging from a minimum of 20 years to 30 years. The mean age was 26 ± 2.1 years. In our study mostly patients were primigravida 58 (58%) between 2 -4 were 22 (22%) more than para 5 were 20 (20%) patients. In our study mostly patients undergone caesarean section 81 (81%) 19 delivered vaginally (19%). In our study the gestational age was >37 weeks, ranging from a minimum of 37 weeks to 42 weeks. The mean age was 37 + 2.4 week. Mostly patients observed 37 -38 wks in (52.67%), 39 -40 wks in (32.14%) and 41 -42 wks in (15.17%). In our study mostly Apgar score were more than 7 was 63 (63%) cases and less than 7 Apgar score in 37 (37%). Conclusion: Cardiotocography is a useful and indispensable adjunct to monitor the condition of endangered fetus. However, there is a need to develop a standardized and unambiguous definition of FHR tracing to reduce the incidence of false positive findings that may result in increased incidence of unnecessary intervention particularly caesarean section.

Efficacy and safety of intra-vaginal prostaglandin E2 pessary for induction ofLabor. Objectives: To evaluate the efficacy and safety of intra-vaginal prostaglandin E2 pessaryfor induction of Labor. Study Design: Case control study. Setting: Gynecological and obstetricward of Liaquat University of Medical and Health Sciences Hospital, Hyderabad. Period: 14 Feb2012 to 13 Feb 2013. Study Population: All the Pregnant women at term or post term admittedin gynae ward from 14th February 2012 to 13th February 2013. Results: 100 women recruitedin the study, study carried out at Gynecological ward of Liaquat University of Medical and HealthSciences Hospital Hyderabad. Analysis of booking status listed in Table-I revealed that 68% (n= 68) were un-booked having no antenatal care and 32.0% (n = 32) were booked. There wereno protocol violation, relation to the parity listed in Table-II showed maximum number of patients(n = 62) 62.0% Primigravida and (n = 38) 38.0% multigravidas were include. Age distributionis listed in Table-III maximum patients (n = 49) 49.0% at age between 26 - 35 years, 35 (35.0%)were between 20 - 25 years, 10 (10.0%) were >35 years and 06 (6.0%) patients were belong toless than 20 years. Regarding the gestational age 57 (57.0%) patients in our study presentedbetween 37 - 39 weeks of gestation. However, 47 (47.0%) patients were at 40 - >40 weeksof gestation showed in the (Table-IV). Indication for cervical ripening and induction of laboris listed on Table-V commonest indication was pregnancy induced hypertension followed byprolonged pregnancy, and IUGR etc. Table-VI shows the Bishop score 30 (30.0%) had BishopScore 2 – 3, while 70(70.00%) had a bishop score 4-5. Table-VII shows induction-deliveryinterval, Greater number of women (66/100) delivered within 24 hours of start of induction.Table-VIII showed mode of delivery, majority of the women had normal vaginal deliveries 64.00while 16 deliveries by assisted vaginal deliveries while in remaining 20 cases caesarean sectiondone. Table-IX shows four babies had an Apgar score 4/10 at end of 1 min and 7/10 at end of5 min, whereas 96 babies had an Apgar score of 9/10 in 1 min. The indications for caesareansection are shown in Table-X. There were 09(9%) cases of failed induction, 11 cases of a fetaldistress (Meconium stained liquor). There was no increased incidence of neonatal sepsis orChorioamniotis or puerperal sepsis in any of our patients. No perinatal morbidity or mortalityor any severe maternal complications were noted while mild side effects were noted which ismentioned in (Table-XI). Conclusion: In developed countries prostaglandin E2 are widely usedfor ripening of unfavorable cervix in induction of labor but patient response vomiting, diarrhea,tachycardia, and fever are commonly observed minor side effects. Induction with Prostaglandinreduced the rate of pregnancies progressing beyond 41 weeks and related feto-maternalmorbidity and mortality. After excluding contra indication all women should be offered inductionat 41 completed weeks. Induction with prostaglandin with medical disorder like preeclampsia issafe and better feto maternal outcome.

Efficacy and safety of intra-vaginal prostaglandin E2 pessary for induction of Labor. Objectives: To evaluate the efficacy and safety of intra-vaginal prostaglandin E2 pessary for induction of Labor. Study Design: Case control study. Setting: Gynecological and obstetric ward of Liaquat University of Medical and Health Sciences Hospital, Hyderabad. Period: 14 Feb 2012 to 13 Feb 2013. Study Population: All the Pregnant women at term or post term admitted in gynae ward from 14th February 2012 to 13th February 2013. Results: 100 women recruited in the study, study carried out at Gynecological ward of Liaquat University of Medical and Health Sciences Hospital Hyderabad. Analysis of booking status listed in Table-I revealed that 68% (n = 68) were un-booked having no antenatal care and 32.0% (n = 32) were booked. There were no protocol violation, relation to the parity listed in Table-II showed maximum number of patients (n = 62) 62.0% Primigravida and (n = 38) 38.0% multigravidas were include. Age distribution is listed in Table-III maximum patients (n = 49) 49.0% at age between 26 -35 years, 35 (35.0%) were between 20 -25 years, 10 (10.0%) were >35 years and 06 (6.0%) patients were belong to less than 20 years. Regarding the gestational age 57 (57.0%) patients in our study presented between 37 -39 weeks of gestation. However, 47 (47.0%) patients were at 40 ->40 weeks of gestation showed in the ( Table-IV). Indication for cervical ripening and induction of labor is listed on Table-V commonest indication was pregnancy induced hypertension followed by prolonged pregnancy, and IUGR etc. Table-VI shows the Bishop score 30 (30.0%) had Bishop Score 2 -3, while 70(70.00%) had a bishop score 4-5. Table-VII shows induction-delivery interval, Greater number of women (66/100) delivered within 24 hours of start of induction. Table-VIII showed mode of delivery, majority of the women had normal vaginal deliveries 64.00 while 16 deliveries by assisted vaginal deliveries while in remaining 20 cases caesarean section done. Table-IX shows four babies had an Apgar score 4/10 at end of 1 min and 7/10 at end of 5 min, whereas 96 babies had an Apgar score of 9/10 in 1 min. The indications for caesarean section are shown in Table-X. There were 09(9%) cases of failed induction, 11 cases of a fetal distress (Meconium stained liquor). There was no increased incidence of neonatal sepsis or Chorioamniotis or puerperal sepsis in any of our patients. No perinatal morbidity or mortality or any severe maternal complications were noted while mild side effects were noted which is mentioned in (Table-XI). Conclusion: In developed countries prostaglandin E2 are widely used for ripening of unfavorable cervix in induction of labor but patient response vomiting, diarrhea, tachycardia, and fever are commonly observed minor side effects. Induction with Prostaglandin reduced the rate of pregnancies progressing beyond 41 weeks and related feto-maternal morbidity and mortality. After excluding contra indication all women should be offered induction at...

Impact of maternal weight on success of VBAC. Introduction: Worldwide Cesarean section is the commonest obstetrical procedure to be performed and same situation is in Pakistan. One strategy is to offer vaginal birth after cesarean section to reduce the alarming cesarean rate. Many factors have been Identified which can affect success of trial of labor. Maternal weight has an important relation with the reproductive health of women, as obesity during pregnancy is associated with increased maternal and fetal risk. Maternal obesity has been shown to be associated with increased rates of primary cesarean delivery and failed trial of vaginal birth after cesarean delivery. Objectives: To determine the effect of maternal weight on success of VBAC. Study Design: Cross sectional study. Period: May 2012 to October 2013. Setting: Liaquat university hospital, Hyderabad. Material and Methods: a total of 96 women which fulfilled the selection criteria were included in the study. Results: The women included in the study had a mean age of SD (range), 29.94+ 4.41 (20-40 years) successful vaginal births was observed in 57(59.4%) women and 39(40.6%) had an emergency repeat cesarean delivery. Body mass index was noted among all the women, 23(24.0%) were obese and 73 (76.0%) were non-obese. Out of 23(24.0), 7(30.4%) had successful VBAC and 16(69.6%) women had successful trial of labor and 23(31.5%) delivered by repeat Caesarean delivery. (P.0.002) P value = 0.001 is statistically significant and calculated by Fisher's exact X 2 test. Conclusions: Obesity is associated with decreased chances of successful VBAC, making it a risky option for obese women.