Introduction: Corona virus is a new pathogen of high contagious abilities. Pregnant women are at an increased risk due to physiologic changes in their immune, cardiopulmonary and coagulation systems. This study was designed to evaluate the fetomaternal outcome of the pregnant patients with COVID-19. Methods: This retrospective observational study was conducted in CMH Dhaka from May 2020 to July 2020. Total 81 hospitalized pregnant patients with confirmed COVID-19 were enrolled. Relevant data were recorded in a preformed data collection sheet and analyzed by SPSS version 20. Results: Total patients were 81 with a mean age of 27 years; 49.1% were in third trimester, 83% were in 35-40 weeks of gestation and 48% were asymptomatic. Common symptom severe cough (26%) and fever(14%); 7.4% patients had multiorgan failure, 81% hadlymphopenia, 7.4% patients under went chest CT and had in filtrates in both lungs. Mild to moderate disease was common and 7.4 % had severe disease, 3.7% needed mechanical ventilation. There was a single maternal death. Most (92.6%) patients were treated in Corona ward and 7.4% in Corona HDU and ICU. There were 3 spontaneous abortions; 64.2% delivered during the study period, 80.8% underwent a Caesarean section, 2.4% had hysterotomy, 15.1% underwent normal vaginal delivery (NVD), 15.4% patients underwent premature termination of pregnancy. Ongoing pregnancy was 26 (32.1%).Four neonates were found COVID-positive. There was 47 livebirths, 3 intrauterine deaths (IUD) and 2 neonatal deaths. Their hospital stay was 13.1 days (SD±6.37).Mean interval of breastfeeding was 13.3 days (SD±6.44). Conclusion: From the study findings, it can be concluded that, COVID-19 had adverse fetomaternal outcomes. COVID-19 pandemic has exerted immense stress on health care system. With this study we can further modify our treatment strategy and reduce the load on our health system. J Bangladesh Coll Phys Surg 2021; 39(2): 100-105

Introduction: Treatment with misoprostol as per protocol is becoming widely recognized as a low cost and easy to use means of uterine evacuation. In contrast, post abortion care (PAC) with Dilatation evacuation and curettage (D, E & C), Manual Vacuum Aspiration (MVA) are costly and complicated procedures specially in inexperienced hands. Objective: To see the outcome of the patients treated with misoprostol as per the guideline. Materials and Methods: This prospective study was carried out at CMH Momenshahi from October 2016 to March 2017. 50 patients with 1st trimester abortion was selected, treated with directly observed doses of misoprostol. For incomplete abortion 600μgm orally, for missed abortion and blighted ovum 600 μgm sublingually, 3 hourly 3 doses. Then followed up after 7 days with an USG of pelvic organs report. Data was collected, processing was done using SPSS version 20. Results: Among 50 patients 10 were primigravida, 40 were multigravida. Their age ranged from 20-38 years. 11 had previous miscarriages. Gestational age ranged from 5-12 week. Symptoms were vaginal bleeding in 23, pain abdomen in 15 and both in 12 patients. 28 patients needed parenteral analgesia. Expulsion of product of conception occurred from 30 minutes to 96 hrs after administration of last dose. Surgical evacuation was done in 15 (30%) patients. Indications were excessive P/V bleeding and retained product of conception. Emergency curettage for bleeding was done in 4 patients. 5 patients needed readmission. All 50 patients attended after 7 days. Conclusion: Management of 1st trimester abortion with misoprostol as per guideline is highly satisfactory. But it requires patience, effective counselling and follow up. If we can follow these, we can reduce surgical interventions and its complications considerably. JAFMC Bangladesh. Vol 17, No 1 (June) 2021: 39-41