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Objective:To determine the frequency of placenta Previa in patients coming to a tertiary care unit with previously scarred and non-scarred uterus.Methods:A descriptive cross sectional study was carried on 114 cases who underwent caesarean sections (37 cases out of 645 cases with non scarred uterus and 77 cases from 721 cases with scarred uterus) in the department of obstetrics and gynecology Lady Willingdon Hospital from January 2008– December 2011.Results:Most patients (47.36%) were between 26-30 years age group, presented with gestational age between 36-40 weeks (70.17%), were mostly G2-4, while frequency of placenta Previa in non-scarred uterus was 32.45% (37 cases), and frequency in previously scarred uterus was 67.54% (77 cases). Major degree Previa was found in 88 cases (77.19%). There were 5.70% cases of placenta Previa from non-scarred uteruses and 10.67% cases of placenta Previa (10.67%) from already scarred uteruses. Stratification revealed a higher trend of the morbidity with the increase in number of previous caesarean sections.Conclusion:A significantly higher frequency of placenta Previa was found among patients coming to a tertiary care hospital with previously scarred uterus.

Background: Anovulation is the commonest cause of female infertility and polycystic ovarian syndrome (PCOS) is the most frequently seen cause of anovulation among infertile females. Letrozole and Clomiphene Citrate are two common drugs for PCOS. But controversial data was noticed regarding their effectiveness. Aim: To compare effectiveness of Letrozole versus Clomiphene Citrate to evaluate the ovulation induction in patients with polycystic ovarian syndrome Methods: After fulfilling the selection criteria, total 360 females were enrolled according to calculated sample size and were randomly divided into two equal groups. One is treated with letrozole and other is clomiphene citrate. Successful ovulation was noted on follow up. Data was collected in proforma and later on analyzed in SPSS version 23. Results: The mean age of patients in letrozole group was 26.61± 4.81 years and in clomiphene citrate was it 27.89±4.24 years. Successful ovulation induction was noted in 172 with letrozole and 150 with clomiphene citrate i. e p-value=0.001. Conclusion: Letrozole has significantly better efficacy for successful ovulation than Clomiphene Citrate for PCOS. Keywords: Ovulation, Clomiphene citrate, Letrozole, polycystic ovarian syndrome

The little data that exist on reasons for postpartum readmission after initial hospitalization for delivery have focused primarily on route of delivery rather than specific indications that necessitate readmission. The aim of this study was to investigate indications for postpartum readmission. The study participants were women who delivered during 2007 and were readmitted within 6 weeks of the original delivery discharge date at 114 Hospital Corporation of America hospitals in 21 states. Preliminary data suggested an especially higher rate of readmission than could be expected for pneumonia, cholecystitis, and acute appendicitis. To address this issue, a stratified analysis was conducted for hospital readmission rates among women with these indications who were readmitted within 180 days after their delivery. Curve comparisons were made using linear regression analysis, survival curve fitting, and Gehan-Breslow statistic with Holm-Sidak all pairwise analysis for multiple comparisons.Of the 222,751 women who delivered in 2007, 2655 women (1.2%) were readmitted within 6 weeks. There was a more than 2-fold increase in frequency of readmission for women who had cesarean section delivery compared to those who had vaginal birth (1.8% vs. 0.83%, P Ͻ 0.001). More than 80% of readmittances for pneumonia occurred within the first 6 weeks of delivery, as did more than 40% of readmittances for appendicitis or cholecystitis. Women readmitted during first 6 weeks after delivery had higher cumulative readmission rates for pneumonia, appendicitis, and cholecystitis compared to those who had been readmitted in the next 20 weeks (6 vs. 20 week comparison: pneumonia curve gradient, 3.7 vs. 0.11; appendicitis curve gradient, 1.1 vs. 0.36; cholecystitis curve gradient, 6.6 vs. 1.7).These findings show that the primary cause of postpartum readmission is infection and suggest that recent pregnancy may increase the risk of pneumonia, appendicitis, and cholecystitis. The investigators do not believe that any of these conditions has been causally linked previously to pregnancy or delivery. EDITORIAL COMMENT(Lydon-Rochelle, et al analyzed the risks for hospital readmission in a cohort of 256,795 women who delivered over a 10-year period in Washington state and found that, overall, 1.2% of women were rehospitalized in the 60 days following birth. The risk varied by mode of delivery: 1% after spontaneous vaginal birth, 1.2% after assisted vaginal birth, and 1.7% after cesarean delivery. Many of the diagnoses associated with the increased rate after cesarean were intuitive, and included higher rates of uterine and wound infection, postpartum hemorrhage, and thromboembolic disease. However, some were not, including an increased risk of admis-OBSTETRICS Volume 65, Number 5 OBSTETRICAL AND GYNECOLOGICAL SURVEY ABSTRACTMaternal ovarian torsion is a very rare complication in pregnant women that may be misdiagnosed because signs and symptoms such as abdominal pain and nausea/vomiting are nonspecific and are present in a number of obstetric and sur...

Pregnant women are particularly considered to be the most vulnerable groupbecause of the additional demands that are made on maternal stores during pregnancy. Theiron deficiency anemia is the most common nutritional deficiency problems in females and isresponsible of high maternal death rate in our society. Objectives: To determine the relationshipof frequency and severity of iron deficiency anemia to preterm labor and eventual perinatalout come in anemic patients. Study Design: It was a case control study. Study Setting: InObstetrics and Gynecology Unit-III, Sir Ganga Ram hospital, Lahore from July 2012 to June2013. Methodology: The study was conducted on 200 patients (100 cases and 100 controls)were studied. Cases were patients admitted in labor room with preterm labor and Controlswere females in labor at term at. Convenience sampling was done. On admission relevanthistory taking examination and investigation were done. The data was collected on a Performa.Results: There were 50 patients with anemia amongst the patients with preterm labor. In thecontrol group, 40 patients were suffering from anemia. In the patients with preterm labor themean hemoglobin was 9.83 grams/deciliter. In the control group the mean hemoglobin was10.3gm/dl. (Pregnant women having hemoglobin <10gm/dl are considered to be anemic). Theodds ratio was calculated to be 3.4 and P value was <0.05. Conclusions: Iron deficiencyanemia was associated with increased risk for low birth weight, preterm delivery, and perinatalmortality. The frequency of iron-deficiency anemia was seen in both groups of pregnant women.