… Primary postpartum hemorrhagic, rightly called as obstetrician's nightmare, refers to excessive blood loss of more than 500ml during the third stage of labour or in the first 24 hours after delivery. It continues to be one of the leading causes of maternal mortality and morbidity all over the world including Pakistan where it is responsible for 21-31% of maternal mortality and morbidity. Objectives: Objective of study was to determine the efficacy of balloon tamponade in the management of primary PPH, so that a low cast, easy to use technology is available for conserving future fertility by treating postpartum hemorrhage. Settings: Department of Gynae & Obs, Allied Hospital, Faisalabad. Study Design: Descriptive cross sectional study. Study Period: 6 months from 1 st Oct, 2015 to 31 st March, 2016. Material & Methods: All patients delivered vaginally at term (after 37 completed weeks of gestation) who developed PPH due to uterine atony after failure of conventional medical therapy were included in this study. Patient selection was based on inclusion and exclusion criteria. Their demographic profile and efficacy of balloon tamponade was checked in terms of time required to control hemorrahage and need of laparotomy. Results: During study period total no. Of vaginal deliveries were 3000. Out of these 298 developed PPH, 220 had PPH due to uterine atony and did not respond to conventional medical therapy. The age of patients ranged between 22 and 40 years with mean age of 30 year (±4.88SD). The parity of the patients ranged between 1 and 14 with the mean parity of 4 (±2.26SD). The condom catheter was introduced in all the selected 80 patients and was successful in 73 patients. Conclusions: In developing countries such as Pakistan where the maternal death rate from PPH is very high, this safe, in expensive and easy procedure (it does not require any expertise) can be applied in any situation to save a life and to save the uterus in young patients to conserve reproductive capacity and prevent them from surgery and its morbidity. This will protect the patients from irreversible shock and even death with a success rate of 85-95%.

Hysterectomy is one of the most frequently performed gynaecological procedurein female. Objectives: The purpose of this study was to compare the outcome between totallaparoscopic hysterectomy and abdominal hysterectomy regarding blood loss during surgery,surgical time and postoperative hospital stay. Settings: Department of Gynecology & ObstetricsAllied Hospital, Faisalabad Medical University, Faisalabad. Period: 1st January 2016 - 31stDecember 2016 (1 Year). Study Design: Randomized control Study. Material & Methods: Theethical committee of Faisalabad Medical University, Faisalabad approved the study protocol. Thepatient demographical characteristics were similar in both groups. 112 patients were enrolled.Including 56 case of total laparoscopic hysterectomy and 56 cases of abdominal hysterectomywhich meets inclusion criteria. Result: Average blood loss in TLH was 83.09+10.74ml while itwas 387.88+59.54ml in TAH. When both groups were compared regarding operative time, itwas 76.73+20.2min in TLH while it was 84.7+19.9 in TAH. Postoperative stay in the hospitalwas 1.25+0.44 days in TLH while it was 5.72+0.83 in TAH. Conclusion: The laparoscopichysterectomy is a modern surgical method in current gynecological practice. With increasingexperience and good collaboration of surgical team, time duration can be shortened and bloodloss can be reduced to negligible.

Primary postpartum hemorrhagic, rightly called as obstetrician’s nightmare,refers to excessive blood loss of more than 500ml during the third stage of labour or in the first24 hours after delivery. It continues to be one of the leading causes of maternal mortality andmorbidity all over the world including Pakistan where it is responsible for 21-31% of maternalmortality and morbidity. Objectives: Objective of study was to determine the efficacy of balloontamponade in the management of primary PPH, so that a low cast, easy to use technology isavailable for conserving future fertility by treating postpartum hemorrhage. Settings: Departmentof Gynae & Obs, Allied Hospital, Faisalabad. Study Design: Descriptive cross sectional study.Study Period: 6 months from 1st Oct, 2015 to 31st March, 2016. Material & Methods: All patientsdelivered vaginally at term (after 37 completed weeks of gestation) who developed PPH due touterine atony after failure of conventional medical therapy were included in this study. Patientselection was based on inclusion and exclusion criteria. Their demographic profile and efficacyof balloon tamponade was checked in terms of time required to control hemorrahage andneed of laparotomy. Results: During study period total no. Of vaginal deliveries were 3000.Out of these 298 developed PPH, 220 had PPH due to uterine atony and did not respond toconventional medical therapy. The age of patients ranged between 22 and 40 years with meanage of 30 year (±4.88SD). The parity of the patients ranged between 1 and 14 with the meanparity of 4 (±2.26SD). The condom catheter was introduced in all the selected 80 patients andwas successful in 73 patients. Conclusions: In developing countries such as Pakistan wherethe maternal death rate from PPH is very high, this safe, in expensive and easy procedure (itdoes not require any expertise) can be applied in any situation to save a life and to save theuterus in young patients to conserve reproductive capacity and prevent them from surgery andits morbidity. This will protect the patients from irreversible shock and even death with a successrate of 85-95%.

ABSTRACT... Objectives: To determine the diagnostic accuracy of biophysical profile in preterm fetuses with intrauterine growth restriction for diagnosis of birth asphyxia. 19% (n=38) were between 31-35 years of age, mean+sd was calculated as 27.52+4.69 years diagnostic accuracy of biophysical profile in preterm fetuses with intrauterine growth restriction for diagnosis of birth asphyxia while keeping Apgar score as gold standard was recorded, it shows 34.29% (n=36) true positive, 7.61%(n=8) had false negative, 6.67%(n=7) false positive and 51.43%(n=54) had true negative. Sensitivity, specificity, and diagnostic accuracy rate were calculated as 81.82% 88.52% and 85.71% respectively. Conclusion: Higher diagnostic accuracy of biophysical profile in preterm fetuses with intrauterine growth restriction for diagnosis of birth asphyxia. It is recommended that these high risk patients must be screened in their antenatal period for diagnosis of birth asphyxia so that proper treatment protocols may be followed. Key words:Preterm Fetus, Intrauterine Growth Restriction, Biophysical Profile, Diagnostic Accuracy. Article Citation: Zafar SA, Mehdi A, Noor S, Javed N. Biophysical Profile; Biophysical profile in preterm fetuses with intrauterine growth restriction for diagnosis of birth asphyxia.

Objectives: To determine the diagnostic accuracy of biophysical profile in pretermfetuses with intrauterine growth restriction for diagnosis of birth asphyxia. Study Design: Crosssectionalstudy. Settings: Department of Radiology / Obstetrics & Gynaecology FaisalabadMedical University, Faisalabad and affiliated Hospitals. Duration of Study: The study wascarried out for a period of one calendar year, 1st January, 2016 to 31st December, 2016. Material& Methods: Total 105 patients admitted through OPD and emergency fulfilling the criteria wereincluded in this study. Results: In our study, 63.81% (n=67) were between 18-30 years and36.19% (n=38) were between 31-35 years of age, mean+sd was calculated as 27.52+4.69years diagnostic accuracy of biophysical profile in preterm fetuses with intrauterine growthrestriction for diagnosis of birth asphyxia while keeping Apgar score as gold standard wasrecorded, it shows 34.29% (n=36) true positive, 7.61%(n=8) had false negative, 6.67%(n=7)false positive and 51.43%(n=54) had true negative. Sensitivity, specificity, and diagnosticaccuracy rate were calculated as 81.82% 88.52% and 85.71% respectively. Conclusion:Higher diagnostic accuracy of biophysical profile in preterm fetuses with intrauterine growthrestriction for diagnosis of birth asphyxia. It is recommended that these high risk patients mustbe screened in their antenatal period for diagnosis of birth asphyxia so that proper treatmentprotocols may be followed.