Objective: To determine the frequency of factors responsible to small for gestational age infants in primigravid women. Study Design: Cross Sectional Study Setting: This study was carried out in the department of obstetrics and gynaecology of Agha Khan University Hospital, Karachi Duration of Study: This study was conducted from 15th September 2018 to 10th January 2019. Subjects and methods: A total of 127 women with singleton pregnancy and gestational age 28-35 weeks by LMP with 0 Parity were included. Women with history of miscarriage, diabetes and family history of SGA babies were excluded. Ultrasound was done to all women and Small for Gestational age babies (as per operational definition) was recorded. All the women was interviewed regarding smoking and detailed history and examination was done to make clinical assessment and for ordering the proper investigations to establish medical disorder by the researcher herself. Venous blood was collected from all women and was immediately sent to laboratory. Hemoglobin < 10 g/dL was recorded as anemia. Ultrasound examination was done for oligohydroamnios as per operational definition. Patients BMI were calculated. Hypertension was also calculated as per operational definition. Data was recorded for factors. Results: Age range in this study was from 18-40 years with mean age of 27.968± 2.05 years and mean gestational age 31.692±2.40 weeks, mean weight 71.645±12.94 Kg, mean height 1.549±0.10 meters and mean BMI was 29.924±5.12 Kg/m2. Majority of patients were from 18-30 years age group (89.8%). As far as risk factors are concerned smoking was seen in 5.5%, overweight 65.4%, hypertension 13.4%, oligohydramnios 29.1%, anemia 12.6%, preeclampsia 15.7%, hypothyroidism 16.5%, hyperthyroidism 6.3%, antiphospholipid antibody syndrome 13.4% and diabetes mellitus was 8.7%. Conclusion: A variety of risk factors have been discovered for newborns deemed SGA by customized centiles. SGA is associated with a number of lifestyle factors, many of which are controllable, such as food, smoking, and exercise. Future research is needed to verify our findings. Keywords: Small for Gestational Age, Primigravid women, Factors

Aim: To evaluate factors that are associated with re-laparotomy after cesarean section. Study design: Retrospective study Place and Duration: This study was conducted at Sheikh Zaid Hospital Quetta, Bolan Medical Complex Hospital Quetta, Jinnah Medical and Dental College karachi, Sandeman Provincial Hospital Quetta, Mekran Medical College Teaching Hospital Turbat Kech, Pakistan from the year 2019 to 2021 Methodology: For this research interview sessions with patients were conducted. Clinical examinations were done and Bed Head ticket (BHT) was used for examining the medical history of patients. All the information related to age, parity, indications of caesarian section, and gestational age were observed including time interval of re-laparotomy from caesarian section. Furthermore, information related to clinical features of re-laparotomy, duration of re-laparotomy, and outcomes were also kept for statistical analysis. Results: Over two years, we observed 22192 cases of caesarian deliveries. Out of these 37 emergency caesarian required re-laparotomy procedure. We observed non-progress of labor as a major indication of LUCS in the primary caesarian section comprised of 21.62% of cases. Another dominion indication of the caesarian section was reported as CPD (5.40%), meconium stained liquor (MSL) with Bradycardia (10.81%), and PROM in 10.81% of cases. Rectus sheath hematoma was a major indication of re-laparotomy in 29.7% of cases while 27.02% of cases in our study reported peritoneal hemorrhage. Conclusion: Findings of our study revealed that unnecessary usage of caesarian surgery on patient leads to severe complications resulting in re-laparotomy. Factors like rectus sheath hematoma, Intra-peritoneal hemorrhage and abscess are the dominant reasons for re-laparotomy. Keywords: Caesarian section, Gynecology, Re-laparotomy

Background: Short interpregnancy intervals have an adverse effect on maternal and neonatal outcome. The aim of this study is to determine the frequency of preterm labour in women presenting with short interpregnancy interval. Aim: To determine the frequency of preterm labour in women presenting with short interpregnancy interval. Study design: Cross-sectional study. Place and duration of study: Department of Obstetrics & Gynaecology Unit 2, Sandeman Hospital, Quetta from 8th December 2018 to 8th June 2019. Methodology: One hundred and ninety three patients were enrolled. After taking informed written consent history and clinical examination was done and all the follow-ups were monitored till the complete 37 weeks of gestation or the outcome i.e. preterm labour. Result: The mean age of mothers was 27.057±3.942 years. The mean interpregnancy interval was 14.880±2.084 months. The preterm labour was noted in 32 women (16.6%). Conclusion: Short interpregnancy interval was commonly observed in preterm labour. Awareness programs and family planning would prove advantageous in minimizing its associated risk both for mother and the newborn. Keywords: Preterm labour, Small for gestation age, Awareness programs, Pregnancy interval