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Vesico vaginal fistula disease is as old as antiquity, VVF has a profound effect on the patient`s emotional well being. The main object of our study was to find out the etiology, success of repair, in our set up. A total of 26 patients were included in our study, with the mean age of 30 years, all were almost illiterate (88.56%), Multiparous (57.69%), with the height more than 151cm (53.84%). The cause of injury noted for birth trauma was, Obstructed labor (42.30%). The time interval for the presentation of the patient for the treatment in 61.54% was 2-10 month. The success rate noted was 92.30%.

Aims & Objective: To find out the rate of vaginal delivery after one caesarean section Study Design: Non-interventional, descriptive study Study Setting: Department of Obstetrics & Gynaecology, Allama Iqbal Medical College and Jinnah Hospital, Lahore. Materials and Methods: A trial of vaginal delivery was carried out on 100 patients with previous one caesarean section. Selection criteria were subjects with normal pregnancy, adequate maternal pelvic dimensions vertex presentation and spontaneous onset of labour with previous one uncomplicated LSCS. Patients with classical caesarean section, medical complications, multiple pregnancy, IUGR, placenta previa and extensive myomectomy were excluded from the study. Informed consent was taken from all patients; trail of scar was given with vigilance. Maternal and fetal monitoring was carried out with facility of operation theatre, anaesthesia and paediatrician. Results: Majority of patients was between 20-24 years of age. 58% of the patients were primipara. Successful vaginal delivery was achieved in 72% and rate of repeat section was 28%. Leading indications for repeat section were failure to progress, (50%), fetal distress (28.5%) and scar tenderness (21.43%). No maternal & fetal mortality occurred. Conclusion: Trial of scar after one LSCS should be encouraged with vigilant monitoring provided no obstetric contraindication exists.

Aims and Objectives of Study: To compare the diagnostic accuracy of clinical and ultrasound evaluation in first trimester abortions and assess the impact of ultrasound on patient management. Study Design: Non-interventional comparative study conducted o n 100 patients, selected o n simple random basis from Gynae Outpatient Department. Study place: Department of Obstetrics & Gynaecology, Allama Iqbal Medical College and Jinnah Hospital, Lahore Materials and Methods: All the patients with symptoms of first trimester abortion were evaluated clinically and by ultrasound to formulate a diagnostic and management plan. Main Outcome Measures: Both Modalities were compared for diagnostic accuracy, positive and negative correlation in different types of abortions. Results: 34% of the patients were at l0 weeks of gestation, 28% were unsure of dates, 17% were at 11 weeks of gestation, 13% of the patients were at 9 weeks of gestation, 5% were at 6 weeks while 3% were at 7 weeks of gestation. Clinical diagnosis was made in 42% of cases; in 39% definite diagnosis was possible with combined clinical and ultrasound evaluation while in 19% no diagnosis was established with either modality In 89% of the cases the diagnosis was made on single ultrasound scan, while 11% required a repeat scan. Correlation between two modalities was present in 81% of the cases. Positive correlation was obtained in 59% and negative correlation was seen in 22% . The correlation was not possible in 19% of cases. Conclusion: Ultrasonography is an essential tool in diagnosis of early pregnancy failures especially where clinical evaluation is inconclusive.