OBJECTIVES This study aimed to assess the burden of obstetrics and gynaecological cases, causes and pattern of referral to tertiary care hospital. METHODOLOGY This descriptive cross-sectional study was carried out from May 2022-July 2022 using the data of patients who were referred to the Department of Obstetrics and Gynecology Unit 2 at Isra University Hospital from various primary, secondary, tertiary, and private hospitals for any obstetric or gynaecological emergency were the primary source of data. The confidentiality of each patient was carefully respected. This study evaluated the prevalence, reasons and pattern of referral of various obstetric and gynaecological conditions for which patients were referred to Isra University Hospital within the study duration and the management options provided to these patients. RESULTS The gynaecological cases accounted for the majority (71%) of referrals.  Patients between 21-30 yrs of age comprised 51% of the total. Most patients (20%) were multipara in their third trimester (18%). High-risk patients (60%) were this study’s most common reason for referral, whereas financial restrictions (4%) were the least common. Only 5% of patients were referred from other tertiary care facilities, whereas 49% of patients came from the primary sector (49%), secondary (33%), and private (13%). CONCLUSION There is an imperative need to upgrade health system infrastructure, mainly primary and secondary health care systems and especially in the field of maternal and childcare, to enable prompt and appropriate diagnosis and management of various conditions in all nearby hospitals.

Objective: To assess, the type of obstetrics and gynaecological cases referred to tertiary care hospitals.Study Design: Descriptive cross-sectional study.Place and Duration of Study: The study was carried out at the Department of Obstetrics and Gynecology Unit 2 of Isra University Hospital Hyderabad, Pakistan from May 2022 to July 2022.Materials and Methods: The patients who were referred to the Department of Obstetrics and GynaecologyUnit 2 at Isra University Hospital during the study duration from various primary, secondary, tertiary, andprivate hospitals for any obstetric or gynaecological emergency were the primary source of data. Theconfidentiality of each patient was carefully respected. This study evaluated the prevalence of various obstetricand gynaecological conditions for which patients were usually referred to Isra University Hospital within thestudy duration as well as the management options provided to these patients.Results: The bulk of referrals (71%) were for gynaecological cases, according to the results of our study. Patients under 20 years of age comprised 31% of the total. The majority of patients (20%) were multipara and in their third trimester (18%). Vesicovaginal fistula (VVF) was the most common gynaecological reason for referral(27%) and the least were ectopic pregnancy and UV prolapse 9% each. Placenta previa (13%), was the mostcommon obstetric referral in our study and at least 2% were placental abruption, preterm labour, and preeclampsia. Furthermore, 24% of VVF patients were successfully managed transvaginal while only 4% weremanaged transabdominal. All gynaecological malignancies were treated with total abdominal hysterectomywith bilateral salpingo-oophorectomy and omentectomy. Laparotomies were done for ectopic pregnanciesand 5 patients of UV Prolapse underwent vaginal hysterectomy whereas only 1 had pessary insertion. Amongstobstetric cases 7% cases of placenta previa/accreta had Cesarean section, 4% had Cesarean section along withbladder repair and 2% of cases necessitated myometrial excision. Compression sutures were the mostfrequently used form of treatment (5%) for postpartum hemorrhage patients, followed by hysterectomy (4%)and medical management (2%). Preterm labour was monitored, whereas placental abruption and preeclampsiarequired caesarean procedures.Conclusion: The majority of patients both gynaecological and obstetric referred to Isra Tertiary Care Hospitalthroughout a 3 months period had either an urgent need for treatment or a serious condition that necessitateda specialist's expertise and the availability of the appropriate resources. Therefore, it can be concluded thatthere is a critical need to upgrade our health system infrastructure, particularly in the area of maternal and child health care, in order to make it simple to provide timely and appropriate management to a variety of health conditions and lower the likelihood of any mishaps involving the mother or the fetus. Additionally, this will also benefit patients by avoiding unnecessary travel from distant regions and helps reduce the burden on tertiary care health system.    

Obesity is the major threat to social and medical wellbeing in Pakistan and worldwide. Increased BMI poses certain risks to mother as well as fetus. The objective of this study is to assess the maternal and fetal morbidities in women presenting with increased BMI during pregnancy. Study Design: Descriptive cross sectional study. Setting: Isra University Hospital. Period: 1st June 2017 till Nov 2017. Materials and Methods: 100 Patients with singleton pregnancy were included in this study. Results:                                                                     . Conclusion: It was concluded that there are complex and noteworthy socio- statistic imbalances related to different age groups, parity status and BMI. It was also concluded that increased no of patients are at high risks of maternal and fetal complication rates and require proper access to antenatal care. Facilities and interventions should be provided to improve both maternal and fetal health care and reduce the risks of adverse effects of increased BMI.

ABSTRACT… Objectives: To determine frequency of different mode of deliveries and associated maternal complications in primigravidas in tertiary care setup. Study Design: Case series study. Setting: Department of Obstetrics and Gynaecology (Liaquat University Hospital) Hyderabad, Sindh, Pakistan. Period: 6 months from Jan 2009 till June 2009. Methodology: All the primigravidas underwent delivery by any means i-e emergency\elective caesarean section or spontaneous vaginal delivery\instrumental vaginal delivery and developed postpartum complications up till 7 days after delivery were included. Data was analyzed on pre-designed profoma and was analyzed through software program SPSS version 10. Results: In this study most frequent mode of delivery were found to be spontaneous vaginal delivery 46(36.8%) and emergency caesarean section 29(23.2%) while forceps 8.8%, vacuum 20% and elective caesarean section 1.2%. Complications associated with mode of deliveries included postpartum hemorrhage were reported to be 51.2%, abdominal wound infection 11.2%, perineal wound infection 17.6%, retained products of conception 28% and puerperal sepsis 16.8%. Conclusion: Deliveries in our setup are mostly conducted by dais (birth attendants) without any aseptic measures and without assessing the abnormalities that will leads to emergency caesarean section or instrumental vaginal deliveries and in the consequence of these entire patients develop postpartum complications. Key words:Spontaneous vaginal delivery, Primigravidas, Perineal wound infection

Introduction: Pregnancy is a high risk factor not only for the mother but for the fetus as well. Certain oral changes especially bleeding gums, loosening of teeth, bad breath altered taste etc  occurs secondary to factors like hormonal changes, lack of oral hygiene maintenance, diet, failure to visit dentist despite of having problems. Now a day along with that some other serious issues like low birth weight, pre-term labour, pre- eclampsia and certain oral infections have also been noticed. A study was conducted to evaluate the knowledge of pregnant patients regarding their oral health status, issues and the complications reported to the fetus so that necessary measures could be taken in addition to antenatal care for the health and benefit of mother and the fetus. Objectives: Assess the general and oral health status of expectant mothers along with their knowledge regarding the associated complications to fetus. Study Design: Random cross - sectional study design. Setting: Isra University Hospital. Period: August 2017 to January 2018. Methodology: A self-administered questionnaire was used to assess the general and oral health status of expectant mothers along with their knowledge regarding the associated complications to fetus. Collected data was statistically analysed by using spss version 17. Conclusion: This study provided an invaluable awareness regarding knowledge of pregnant females. Majority of them were poorly educated, did not know even about simple methods of oral hygiene maintenance, refused to visit dentists rather of having problems and above all were completely unaware about the possible risks and hazards to their baby secondary to oral health issues. Thus it was felt deemed necessary to aware and educate expectant mothers regarding routine oral checkup during antenatal period.