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A Case Series On Uterine Arteriovenous Malformations: A Life-Threatening Emergency In Young Women, Rabia Hammad, Sidrah Nausheen, Mumtaz Malik Jul 2020

A Case Series On Uterine Arteriovenous Malformations: A Life-Threatening Emergency In Young Women, Rabia Hammad, Sidrah Nausheen, Mumtaz Malik

Department of Obstetrics & Gynaecology

Uterine arteriovenous malformation (AVM) is a rare condition, with few cases reported in the literature. Despite being rare, it is a potentially life-threatening condition in women of child-bearing age. It should be considered in the differential diagnosis of prolonged or irregular vaginal bleeding, which, otherwise, can lead to critical complications ending up in severe morbidity and mortality. This case series describes four cases of young Asian women aged between 33 and 38 years who presented with irregular vaginal bleeding. Trans-abdominal ultrasound of the pelvis showed increased vascularity with multi-directional blood flow in the uterus. Magnetic resonance imaging (MRI) confirmed an …


Achieving Accurate Estimates Of Fetal Gestational Age And Personalised Predictions Of Fetal Growth Based On Data From An International Prospective Cohort Study: A Population-Based Machine Learning Study, Russell Fung, Jose Villar, Ali Dashti, Leila Cheikh Ismail, Eleonora Staines-Uria, Eric O. Ohuma, Maria Carvalho, Shama Munim, Zulfiqar Ahmed Bhutta, International Fetal And Newborn Growth Consortium For The 21st Century (Intergrowth-21st) Jun 2020

Achieving Accurate Estimates Of Fetal Gestational Age And Personalised Predictions Of Fetal Growth Based On Data From An International Prospective Cohort Study: A Population-Based Machine Learning Study, Russell Fung, Jose Villar, Ali Dashti, Leila Cheikh Ismail, Eleonora Staines-Uria, Eric O. Ohuma, Maria Carvalho, Shama Munim, Zulfiqar Ahmed Bhutta, International Fetal And Newborn Growth Consortium For The 21st Century (Intergrowth-21st)

Department of Obstetrics & Gynaecology

Background: Preterm birth is a major global health challenge, the leading cause of death in children under 5 years of age, and a key measure of a population's general health and nutritional status. Current clinical methods of estimating fetal gestational age are often inaccurate. For example, between 20 and 30 weeks of gestation, the width of the 95% prediction interval around the actual gestational age is estimated to be 18-36 days, even when the best ultrasound estimates are used. The aims of this study are to improve estimates of fetal gestational age and provide personalised predictions of future growth.
Methods: …


International Gestational Age-Specific Centiles For Umbilical Artery Doppler Indices: A Longitudinal Prospective Cohort Study Of The Intergrowth-21st Project, Lior Drukker, Eleonora Staines-Urias, José Villar, Fernando C. Barros, Maria Carvalho, Shama Munim, Rose Mcgready, Francois Nosten, James A. Berkley, Shane A. Norris, Ricardo Uauy, Stephen H. Kennedy, Aris T. Papageorghiou Jun 2020

International Gestational Age-Specific Centiles For Umbilical Artery Doppler Indices: A Longitudinal Prospective Cohort Study Of The Intergrowth-21st Project, Lior Drukker, Eleonora Staines-Urias, José Villar, Fernando C. Barros, Maria Carvalho, Shama Munim, Rose Mcgready, Francois Nosten, James A. Berkley, Shane A. Norris, Ricardo Uauy, Stephen H. Kennedy, Aris T. Papageorghiou

Department of Obstetrics & Gynaecology

Background: Reference values for umbilical artery Doppler indices are used clinically to assess fetal well-being. However, many studies that have produced reference charts have important methodologic limitations, and these result in significant heterogeneity of reported reference ranges.
Objectives: To produce international gestational age-specific centiles for umbilical artery Doppler indices based on longitudinal data and the same rigorous methodology used in the original Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project.
Study design: In Phase II of the INTERGROWTH-21st Project (the INTERBIO-21st Study), we prospectively continued enrolling pregnant women according to the same protocol from 3 of the original …


Prevalence Of Pelvic Organ Prolapse In Women, Associated Factors And Impact On Quality Of Life In Rural Pakistan: Population-Based Study, Abdul Hakeem Jokhio, Raheela Mohsin Rizvi, Christine Macarthur Apr 2020

Prevalence Of Pelvic Organ Prolapse In Women, Associated Factors And Impact On Quality Of Life In Rural Pakistan: Population-Based Study, Abdul Hakeem Jokhio, Raheela Mohsin Rizvi, Christine Macarthur

Department of Obstetrics & Gynaecology

Background: Pelvic organ prolapse (POP) is a gynecological condition resulting from pelvic floor dysfunction in women. The objective of this study is to estimate "the prevalence of pelvic organ prolapse" associated factors, duration and impact on women's quality of life in rural Pakistan.
Methods: A cross-sectional study was conducted with a three stage random sampling strategy. Three health centers were selected and selected Lady Health Workers from each health center interviewed a random sample of women in their households. The interview used a structured questionnaire to collect symptom data. Female gynaecologists then conducted a clinical examination at the local health …


Prenatal Diagnosis Of Rare Genetic Conditions At A Tertiary Care Hospital In Karachi, Kouser Karim, Dhanwanti Dileep, Shama Munim Apr 2020

Prenatal Diagnosis Of Rare Genetic Conditions At A Tertiary Care Hospital In Karachi, Kouser Karim, Dhanwanti Dileep, Shama Munim

Department of Obstetrics & Gynaecology

This study aims to observe the spectrum of Prenatal Diagnosis of Rare Genetic conditions at a Tertiary care hospital in Karachi. This is a retrospective review conducted at the Aga Khan University Hospital, Karachi from January 2016 to July 2018. All cases undergoing invasive testing by Chorionic villus sampling for indications other than Thalassemia were included. Forty percent of patients in our cohort underwent invasive testing for muscular dystrophies particularly survival motor neuron (SMN) gene deletion and 32% for Cystic Fibrosis. Other rare disorders like JAM 3 mutation, PEX 1 gene, Barters Syndrome, Wardenberg, Bardet-Beidl Syndrome and Lissencephaly accounted for …


Assessing The Adherence Of Obstetricians Towards Postpartum Diabetes Screening Guidelines: A Pre- And Post-Intervention Study At Secondary Care Hospital In Karachi, Pakistan, Sadiqa Munir Razzaqui, Neelofur Babar, Zaib Un Nisa Memon, Sarah Rafiq Nov 2019

Assessing The Adherence Of Obstetricians Towards Postpartum Diabetes Screening Guidelines: A Pre- And Post-Intervention Study At Secondary Care Hospital In Karachi, Pakistan, Sadiqa Munir Razzaqui, Neelofur Babar, Zaib Un Nisa Memon, Sarah Rafiq

Department of Obstetrics & Gynaecology

Objective: To assess the adherence level of obstetricians towards postpartum diabetes screening guidelines.
Methods: The quasi-experimental pre- and post-intervention study was conducted from May 2014 to April 2015 at Aga Khan Hospital for Women-Karimabad, Karachi, and comprised all obstetricians practicing at the time. All the booked women with gestational diabetes delivered in the 6 months before refresher lecture (group 1) and those delivering in the 6 months following the intervention (group 2) were included. Data was analysed using SPSS 19.
Results: Of the 550 cases, 275(50%) each were in groups 1 and 2. All pregnant women had live-birth. The intervention …


Antibiotic Prophylaxis In The Surgical Management Of Miscarriage In Low-Income Countries: A Cost-Effectiveness Analysis Of The Aims Trial, Ilias Goranitis, David M. Lissauer, Arri Coomarasamy, Amie Wilson, Jane Daniels, Lee Middleton, Jonathan Bishop, Catherine A. Hewitt, Andrew D. Week, Chisale Mhango, Ronald Mataya, Iffat Ahmed Sep 2019

Antibiotic Prophylaxis In The Surgical Management Of Miscarriage In Low-Income Countries: A Cost-Effectiveness Analysis Of The Aims Trial, Ilias Goranitis, David M. Lissauer, Arri Coomarasamy, Amie Wilson, Jane Daniels, Lee Middleton, Jonathan Bishop, Catherine A. Hewitt, Andrew D. Week, Chisale Mhango, Ronald Mataya, Iffat Ahmed

Department of Obstetrics & Gynaecology

Background: There is ongoing debate on the clinical benefits of antibiotic prophylaxis for reducing pelvic infection after miscarriage surgery. We aimed to study the cost-effectiveness of antibiotic prophylaxis in the surgical management of miscarriage in low-income countries.
Method: We did an incremental cost-effectiveness analysis using data from 3412 women recruited to the AIMS trial, a randomised, double-blind, placebo-controlled trial designed to evaluate the effectiveness of antibiotic prophylaxis in the surgical management of miscarriage in Malawi, Pakistan, Tanzania, and Uganda. Economic evaluation was done from a health-care-provider perspective on the basis of the outcome of cost per pelvic infection avoided within …


Integration Of Postpartum Care Into Child Health And Immunization Services In Burkina Faso: Findings From A Cross-Sectional Study, Danielle Yugbaré Belemsaga, Anne Goujon, Aristide Bado, Seni Kouanda, Els Duysburgh, Marleen Temmerman, Olivier Degomme Oct 2018

Integration Of Postpartum Care Into Child Health And Immunization Services In Burkina Faso: Findings From A Cross-Sectional Study, Danielle Yugbaré Belemsaga, Anne Goujon, Aristide Bado, Seni Kouanda, Els Duysburgh, Marleen Temmerman, Olivier Degomme

Department of Obstetrics & Gynaecology

Background: The Missed Opportunities for Maternal and Infant Health (MOMI) project, which aimed at upgrading maternal and infant postpartum care (PPC), implemented a package of interventions including the integration of maternal PPC in infant immunization services in 12 health facilities in Kaya Health district in Burkina Faso from 2013 to 2015. This paper assesses the coverage and the quality of combined mother-infant PPC in reproductive, maternal, newborn and child health services (RMNCH).
Methods: We conducted a mixed methods study with cross-sectional surveys before and after the intervention in the Kaya health and demographic surveillance system. On the quantitative side, two …


Comparison Of Neonatal Outcomes Between Category-1 And Non-Category-1 Primary Emergency Cesarean Section: A Retrospective Record Review In A Tertiary Care Hospital, Dureshahwar Kanwar, Iffat Ahmed, Azra Amerjee, Zahra Hoodbhoy Aug 2018

Comparison Of Neonatal Outcomes Between Category-1 And Non-Category-1 Primary Emergency Cesarean Section: A Retrospective Record Review In A Tertiary Care Hospital, Dureshahwar Kanwar, Iffat Ahmed, Azra Amerjee, Zahra Hoodbhoy

Department of Obstetrics & Gynaecology

Objective: To compare neonatal outcomes between Category-1 and Non-Category-1 Primary Emergency Cesarean Section.
Methods: This was a retrospective analysis, conducted at Aga Khan University Hospital Karachi from January 1st 2016 till December 31st 2016. Non-probability purposive sampling technique was used. A sample size of 375 patients who had primary Emergency Caesarean Section (Em-CS) was identified by keeping CS rate of 41.5% and 5% bond on error. Data was collected from labor ward, operating theatre and neonatal ward records by using structured questionnaire.
Results: In the current study, out of 375 participants who underwent primary Em-CS; majority (89.3%) were booked cases. …


Availability And Use Of Magnesium Sulphate At Health Care Facilities In Two Selected Districts Of North Karnataka, India, Geetanjali Katageri, Umesh Charantimath, Anjali Joshi, Marianne Vidler, Umesh Ramadurg, Sumedha Sharma, Sheshidhar Bannale, Beth A. Payne, Sangamesh Rakaraddi, Rahat Qureshi Jun 2018

Availability And Use Of Magnesium Sulphate At Health Care Facilities In Two Selected Districts Of North Karnataka, India, Geetanjali Katageri, Umesh Charantimath, Anjali Joshi, Marianne Vidler, Umesh Ramadurg, Sumedha Sharma, Sheshidhar Bannale, Beth A. Payne, Sangamesh Rakaraddi, Rahat Qureshi

Department of Obstetrics & Gynaecology

Background: Pre-eclampsia and eclampsia are major causes of maternal morbidity and mortality. Magnesium sulphate is accepted as the anticonvulsant of choice in these conditions and is present on the WHO essential medicines list and the Indian National List of Essential Medicines, 2015. Despite this, magnesium sulphate is not widely used in India for pre-eclampsia and eclampsia. In addition to other factors, lack of availability may be a reason for sub-optimal usage. This study was undertaken to assess the availability and use of magnesium sulphate at public and private health care facilities in two districts of North Karnataka, India. Methods: A …


The Feasibility Of Task-Sharing The Identification, Emergency Treatment, And Referral For Women With Pre-Eclampsia By Community Health Workers In India, Umesh Charanthimath, Marianne Vidler, Geetanjali Katageri, Umesh Ramadurg, Chandrashekhar Karadiguddi, Avinash Kavi, Anjali Joshi, Geetanjali Mungarwadi, Rahat Qureshi, Zulfiqar Ahmed Bhutta Jun 2018

The Feasibility Of Task-Sharing The Identification, Emergency Treatment, And Referral For Women With Pre-Eclampsia By Community Health Workers In India, Umesh Charanthimath, Marianne Vidler, Geetanjali Katageri, Umesh Ramadurg, Chandrashekhar Karadiguddi, Avinash Kavi, Anjali Joshi, Geetanjali Mungarwadi, Rahat Qureshi, Zulfiqar Ahmed Bhutta

Department of Obstetrics & Gynaecology

Background: Hypertensive disorders are the second highest direct obstetric cause of maternal death after haemorrhage, accounting for 14% of maternal deaths globally. Pregnancy hypertension contributes to maternal deaths, particularly in low- and middle-income countries, due to a scarcity of doctors providing evidence-based emergency obstetric care. Task-sharing some obstetric responsibilities may help to reduce the mortality rates. This study was conducted to assess acceptability by the community and other healthcare providers, for task-sharing by community health workers (CHW) in the identification and initial care in hypertensive disorders in pregnancy.
Methods: This study was conducted in two districts of Karnataka state in …


Amniotic Fluid Embolism, Nadia Nawaz, Ahmed Raheem Buksh Jun 2018

Amniotic Fluid Embolism, Nadia Nawaz, Ahmed Raheem Buksh

Department of Obstetrics & Gynaecology

Amniotic fluid embolism is a rare and severe problem in obstetric patients. We experienced a 21-year primigravida who underwent emergency cesarean section due to sudden collapse and fetal distress after rupture of membranes in labour. Subsequently, she developed intraoperative coagulopathy, hemorrhage, hypotension, and respiratory collapse requiring ventilation. Both maternal and neonatal lives were saved with full recovery and discharged in stable condition. The clinical diagnosis of amniotic fluid embolism (AFE) was made, which is a very rare complication of pregnancy/puerperium with varying presentation, ranging from cardiac arrest, circulatory collapse and death through mild degrees of organ system dysfunction with or …


Successful Use Of Balloon Tamponade In The Management Of Postpartum Hemorrhage In A Case Of Bicornuate Uterus, Erum Saleem, Ayesha Basharat May 2018

Successful Use Of Balloon Tamponade In The Management Of Postpartum Hemorrhage In A Case Of Bicornuate Uterus, Erum Saleem, Ayesha Basharat

Department of Obstetrics & Gynaecology

Worldwide 50%–70% of all cases of maternal morbidity have been attributed to postpartum hemorrhage. This report discusses a case of bicornuate uterus in a term pregnancy. The delivery was by cesarean section, which was followed by massive postpartum hemorrhage, managed successfully with balloon tamponade. This is the second reported case of successful management of post partum hemorrhage in a bicornuate uterus with balloon tamponade. A 22-year-old primigravida at 39 weeks of gestational age presented with vaginal leaking of clear fluid. Cesarean section was done due to meconium stained liquor in early labor; with an incidental finding of bicornuate uterus followed …


Caesarean Section Rate Amongst Obstetricians At A Tertiary-Care Hospital Of Karachi, Iffat Ahmed, Dureshahwar Kanwar, Munazza Akhtar, Azra Amerjee May 2018

Caesarean Section Rate Amongst Obstetricians At A Tertiary-Care Hospital Of Karachi, Iffat Ahmed, Dureshahwar Kanwar, Munazza Akhtar, Azra Amerjee

Department of Obstetrics & Gynaecology

Objective: To analyze the Caesarean Section (CS) rate among different groups of consultants dealing with Nulliparous Term Singleton pregnancy with Vertex (NTSV) presentation delivering at a tertiary care hospital of Karachi over four months.
Methods: This is a secondary analysis of a retrospective data that analyzed factors affecting the CS-rate of NTSV patients. Patients with CS (n=106) were taken as cases and vaginal deliveries (n=106) as controls. This was an unmatched retrospective case-control study.
Results: Mean age of patients was 26.6(SD: 4.2) years. Mean gestational-age was 38.6(SD: 1.0) weeks. Likelihood of CS was slightly less in patients who were attended …


Uterine Arteriovenous Malformations After Suction Evacuation Of Missed Miscarriage, Arshia Javed, Reeta Chander, Zahra Hoodbhoy Mar 2018

Uterine Arteriovenous Malformations After Suction Evacuation Of Missed Miscarriage, Arshia Javed, Reeta Chander, Zahra Hoodbhoy

Department of Obstetrics & Gynaecology

Uterine arteriovenous malformation (AVM) is an uncommon but life-threating source of bleeding. AVM is an abnormal connection between uterine arteries and veins. Patients typically present with vaginal bleeding following miscarriage (medical/surgical) or cesarean section. The treatment of choice depends on the symptoms, age, desire of fertility, localization and size of the lesion. Uterine artery embolization is the first choice in symptomatic patients of reproductive age group. We report a case of AVM presenting after dilation and evacuation with extensive lesion, which was successfully treated with bilateral uterine artery embolization


A Rare Case: Rupture Of Internal Pudendal And Uterine Artery In A Vaginal Delivery, Novera G. Chughtai, Raheela Mohsin Rizvi Mar 2018

A Rare Case: Rupture Of Internal Pudendal And Uterine Artery In A Vaginal Delivery, Novera G. Chughtai, Raheela Mohsin Rizvi

Department of Obstetrics & Gynaecology

The management of puerperal hematomas after normal delivery has always been challenging for obstetricians. Vulvar, vulvovaginal, or paravaginal hematomas are common. On the other hand, retroperitoneal hematomas are uncommon and can be life-threatening. The diagnosis of vascular injury is rarely made preoperatively as atonic or traumatic postpartum hemorrhage (PPH), uterine rupture and amniotic fluid embolism are more common differential diagnoses. Injury to internal pudendal and uterine vessels is extremely rare in cases of vaginal delivery and, therefore, the literature on this topic is very scarce. We present a rare case of both internal pudendal and uterine artery rupture in a …


A Rare Case: Rupture Of Internal Pudendal And Uterine Artery In A Vaginal Delivery, Novera G. Chughtai, Raheela Mohsin Rizvi Mar 2018

A Rare Case: Rupture Of Internal Pudendal And Uterine Artery In A Vaginal Delivery, Novera G. Chughtai, Raheela Mohsin Rizvi

Department of Obstetrics & Gynaecology

The management of puerperal hematomas after normal delivery has always been challenging for obstetricians. Vulvar, vulvovaginal, or paravaginal hematomas are common. On the other hand, retroperitoneal hematomas are uncommon and can be life-threatening. The diagnosis of vascular injury is rarely made preoperatively as atonic or traumatic postpartum hemorrhage (PPH), uterine rupture and amniotic fluid embolism are more common differential diagnoses. Injury to internal pudendal and uterine vessels is extremely rare in cases of vaginal delivery and, therefore, the literature on this topic is very scarce. We present a rare case of both internal pudendal and uterine artery rupture in a …


Uterine Arteriovenous Malformations After Suction Evacuation Of Missed Miscarriage, Arshia Javed, Reeta Chander, Zahra Hoodbhoy Mar 2018

Uterine Arteriovenous Malformations After Suction Evacuation Of Missed Miscarriage, Arshia Javed, Reeta Chander, Zahra Hoodbhoy

Department of Obstetrics & Gynaecology

Uterine arteriovenous malformation (AVM) is an uncommon but life-threating source of bleeding. AVM is an abnormal connection between uterine arteries and veins. Patients typically present with vaginal bleeding following miscarriage (medical/surgical) or cesarean section. The treatment of choice depends on the symptoms, age, desire of fertility, localization and size of the lesion. Uterine artery embolization is the first choice in symptomatic patients of reproductive age group. We report a case of AVM presenting after dilation and evacuation with extensive lesion, which was successfully treated with bilateral uterine artery embolization.


Factors Associated With Low Birthweight In Term Pregnancies: A Matched Case–Control Study From Rural Pakistan, Atif Habib, Camille R. Greenow, Shabina Arif, Sajid Bashir Soofi, Abid Hussain, Qamar Junejo, A Hussain, Fariha Shaheen, Kirsten I. Black Jan 2018

Factors Associated With Low Birthweight In Term Pregnancies: A Matched Case–Control Study From Rural Pakistan, Atif Habib, Camille R. Greenow, Shabina Arif, Sajid Bashir Soofi, Abid Hussain, Qamar Junejo, A Hussain, Fariha Shaheen, Kirsten I. Black

Department of Obstetrics & Gynaecology

Low birthweight (LBW) remains a significant public health problem in Pakistan and further understanding of factors associated with LBW is required. We conducted a hospital-based matched case control study to identify risk factors associated with LBW in a rural district of Pakistan. We found that illiteracy (AOR: 2.68; 95% CI: 1.59 - 4.38), nulliparity (AOR: 1.82; 95% CI: 1.26-2.44), having a previous miscarriage/abortion (AOR: 1.22; 95% CI: 1.06-2.35), having < 2 antenatal care (ANC) visits during last pregnancy (AOR: 2.43; 95% CI: 1.34-2.88), seeking ANC in third trimester (AOR: 3.62; 95% CI : 2.14-5.03), non-use of iron folic acid during last pregnancy (AOR: 2.72; 95% CI: 1.75-3.17), having hypertension during last pregnancy (AOR: 1.42; 95% CI: 1.13-2.20), being anemic (AOR: 2.67; 95% CI: 1.65-5.24) and having postpartum weight of <45 kg (AOR: 3.30; 95% CI : 1.97-4.52) were significantly associated with an increased odds of having a LBW baby. Our study identifies modifiable risk factors requiring immediate commitment from the health authorities.


The Role Of Mucin-Educated Platelet Activation In Tumor Invasiveness: An Unfolding Concern In The Realm Of Cancer Biology, Akbar Shoukat Ali, Arzoo Ajaz Dec 2017

The Role Of Mucin-Educated Platelet Activation In Tumor Invasiveness: An Unfolding Concern In The Realm Of Cancer Biology, Akbar Shoukat Ali, Arzoo Ajaz

Department of Obstetrics & Gynaecology

Metastasis is a complex and well-coordinated phenotypic transformation of cancer cells governed by aberrant genetic and molecular pathways. It has been approved as the most consistent cause of cancer death. With emerging insight into the genomics, transcriptomics and proteomics, progress has been made and reasonably large number of molecular pathways of metastasis has been forwarded, but our understanding of precise underlying molecular mechanisms remains largely scarce. It has been well-known for around a decade and more that platelets are intriguingly contributing to the cancer metastasis. However, it is only recently that cancer cells can activate platelets have started to become …


Foeto-Maternal Outcome In Instrumental Vaginal Delivery Attending A Secondary Hospital In Hyderabad (Aga Khan Maternal And Child Care Centre), Nigar Jabeen, Raheela Baloch, Pushpa Malhi, Sana Zahiruddin, Kiran Mawani Dec 2017

Foeto-Maternal Outcome In Instrumental Vaginal Delivery Attending A Secondary Hospital In Hyderabad (Aga Khan Maternal And Child Care Centre), Nigar Jabeen, Raheela Baloch, Pushpa Malhi, Sana Zahiruddin, Kiran Mawani

Department of Obstetrics & Gynaecology

Objective: To evaluate the foeto-maternal outcome in instrumental delivery.
Methods: This retrospective record review was conducted at Aga Khan Maternal and Child Care Centre, Hyderabad, Pakistan, and comprised medical records from January 2014 to January 2016. Data related to all women with singleton pregnancy at term gestation and having undergone vacuum or forceps delivery was included. Data of women who had multiple pregnancies, caesarean section, and presentation other than cephalic, placenta previa were excluded. SPSS 19 was used for data analysis.
Results: Of the 400 participants, 255(63.75%) were aged between 22-28 years and 145(36.25%) between 29-35 years. Moreover, 268(67%) women …


Graft And Mesh Use In Vaginal Surgery, Raheela Mohsin Rizvi, Novera G. Chughtai Dec 2017

Graft And Mesh Use In Vaginal Surgery, Raheela Mohsin Rizvi, Novera G. Chughtai

Department of Obstetrics & Gynaecology

Pelvic organ prolapse and urinary incontinence are among the most common chronic disorders in women. These are common problems whose pathogenesis remains unclear. As life expectancy increases, significantly greater number of women now present with pelvic organ prolapse and urinary incontinence requiring surgical intervention. Currently, the lifetime risk of undergoing prolapse or continence surgery is one in 11, and up to 30% of patients will require repeat reconstructive surgery and repeat surgery for incontinence in 10%. In an attempt to improve surgical outcomes and to preserve vaginal capacity and coital function, a number of synthetic and biological prostheses have been …


Educating Before Birth Via Talking To The Baby In The Womb: Prenatal Innovations, Shelina Bhamani Nov 2017

Educating Before Birth Via Talking To The Baby In The Womb: Prenatal Innovations, Shelina Bhamani

Department of Obstetrics & Gynaecology

Education is the only major weapon that enables nations to progress socio-economically and gives a huge rise to their human development index. More so, it is considered to be the most fundamental requirement for poverty eradication, for addressing socio-political issues and for stabilizing peace and harmony among nations. Education is a lifelong process and does not have a preset parameter for its accessibility and provision (Sharkey, 1998). Learning is innate and natural and the human mind is set to learn since its conception. Additionally, in the recent era, investigations are focused on education and learning even before birth and extensive …


Constructing A Reference Framework For Ecep Evaluation: A Constructive Grounded Theory, Shelina Bhamani, Nasreen Husain Jul 2017

Constructing A Reference Framework For Ecep Evaluation: A Constructive Grounded Theory, Shelina Bhamani, Nasreen Husain

Department of Obstetrics & Gynaecology

The purpose of this research study, which is a thesis investigation, was to develop a reference framework that can help program staff to evaluate quality in Early Childhood Education (ECE) settings. The study was approached with three questions. This paper presents the first question of the study that enables practitioners to understand what are the variables that best define quality in early childhood education. The grounded theory, design was approached to explore the experiences of 20 ECE experts in the field. The data analysis revealed eight main indicators, that are, holistic development, interactive teaching, trained practitioners, conducive learning environment, safe …


Comparison Of Foeto-Maternal Outcome In Pregnant Women With Hepatitis E - A Review Of 12 Years., Tahira Naru, Farheen Yousuf, Ayesha Malik, Sumaira Naz, Humera Ismail Apr 2017

Comparison Of Foeto-Maternal Outcome In Pregnant Women With Hepatitis E - A Review Of 12 Years., Tahira Naru, Farheen Yousuf, Ayesha Malik, Sumaira Naz, Humera Ismail

Department of Obstetrics & Gynaecology

Objective: To compare adverse maternal and foetal outcome in pregnant women with hepatitis E immunoglobulin M reactive versus non-reactive.
Methods: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised records of pregnant patients at any gestational age with clinical and biochemical evidence of hepatitis E from January 2002 and December 2014. . Maternal and perinatal outcome of the subjects were analysed. SPSS 20 was used for data analysis.
Results: Out of the 200 subjects, 168(84 %) were hepatitis E immunoglobulin M reactive and 32(16%) were non-reactive. The overall mean age was 26.7±4.5 years. Also, 12(7%) …


Twin Chorionicity And Prospective Stillbirth Risk: Experience At A Tertiary Care Hospital, Shazia Masheer, Zaheena Islam, Dhanwanti Dileep, Shama Munim Mar 2017

Twin Chorionicity And Prospective Stillbirth Risk: Experience At A Tertiary Care Hospital, Shazia Masheer, Zaheena Islam, Dhanwanti Dileep, Shama Munim

Department of Obstetrics & Gynaecology

Objective: To determine the prospective risk of stillbirth, perinatal death and neonatal morbidities in twins.

Methods: This retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised cases of twin pregnancies from January 2001 to December 2012. . Cases of both monochorionic diamniotic and dichorionic diamniotic twin pregnancies were included. SPSS 19 was used for data analysis.

Results: Of the 394 cases, 84(21.3%) were monochorionic diamniotic twins and 310(78.7%) were dichorionic diamniotic twins. There were no cases of stillbirth beyond 30 and 34 weeks in monochorionic and dichorionic twins, respectively. Neonatal mortality stood reduced beyond 36 …


Globalization And Early Childhood Education: Urban Families Perceptions, Shelina Bhamani Jan 2017

Globalization And Early Childhood Education: Urban Families Perceptions, Shelina Bhamani

Department of Obstetrics & Gynaecology

This study attempted to explore the belief patterns and opinions of families of young children in the context of globalization and its role in the provision of education. The paper’s particular focus was to argue how urban families perceive and practice globalization for their children’s education. Additionally, it briefly reviewed the school of thought (i.e. Modern or Traditional) sample families belong to. The research focuses on the narrative paradigm with a mixed methodical design through which quantitative and qualitative perspectives can be sought. A total sample of 104 family members was taken to carry out a quantitative survey and a …


Case Of Xanthogranulomatous Oophoritis, Bushra Khan, Aliya Aziz, Rashida Ahmed Jan 2017

Case Of Xanthogranulomatous Oophoritis, Bushra Khan, Aliya Aziz, Rashida Ahmed

Department of Obstetrics & Gynaecology

Xanthogranulomatous inflammation is characterized by destruction of the tissues of the organ involved and replacement by chronic inflammatory cells such as lymphocytes, plasma cells, occasional neutrophils with or without multinucleated or Touton giant cells. Exact aetiology is not known but the theory of infection with organisms like Proteus, E coli, and Bacteroides fragilis is most popular. Xanthogranulomatous inflammation of the female genital tract is not common and usually involves the endometrium; however, xanthogranulomatous inflammation of the ovaries is a rare entity.


Implementation Of Warning Tool To Improve Maternal Newborn Health Outcomes In A Developing Country, Sana Sheikh, Rahat Qureshi, Sidrah Nausheen, Rozina Sikandar Sultanali Jan 2017

Implementation Of Warning Tool To Improve Maternal Newborn Health Outcomes In A Developing Country, Sana Sheikh, Rahat Qureshi, Sidrah Nausheen, Rozina Sikandar Sultanali

Department of Obstetrics & Gynaecology

Objective: To improve health outcomes through the implementation of national early warning sign tool for babies delivered through emergency caesarean section in off-work hours.

Methods: This comparative clinical study was conducted at the Aga Khan Hospital for Women and Children, Karachi, from April to August 2014, and comprised women who had an emergency caesarean section. Maternal and perinatal outcomes were compared of patients in Group A and Group B which represented individuals before and after the implementation of the national early warning score respectively.

Results: Of the 200 participants, there were 100(50%) in each group. The overall mean age was …


Maternal And Fetal Outcome In Renal Transplant Recipients, Wajeeha Syed, Lumaan Sheikh Jan 2017

Maternal And Fetal Outcome In Renal Transplant Recipients, Wajeeha Syed, Lumaan Sheikh

Department of Obstetrics & Gynaecology

Objective: To determine maternal and fetal outcome in renal transplant recipients.
Methodology: Retrospective analysis of the antenatal patients with renal transplant
was done between January 1st 2005 till December 31st 2015 and maternal
and fetal outcomes were determined. Data was entered and analyzed in SPSS
version 20.
Results: 08 pregnancies in 07 women who had undergone renal transplant
were included in this study. The mean age at the time of transplantation was
25.29 ±5.5 years (16-32 years). 25% cases had gestational diabetes mellitus,
75% had anemia and 50% had urinary tract infection. The mean birth weight
of babies was 2210 …