Scar pregnancy is a rare but serious form of ectopic pregnancy that is life-threatening and functional. Its actual incidence remains undetermined, but the increase in published cases over the past ten years testifies to the increased vigilance of obstetrician-gynecologists on ultrasound diagnosis, which remains the first-line examination. To date, there is no consensus on a reference treatment. We report our experience of a case of pregnancy on caesarean section scar in a 36-year-old patient treated in our department. The diagnosis was suspected in the presence of metrorrhagia associated with pelvic pain in the first trimester of pregnancy. Ultrasound confirmed the diagnosis and treatment consisted of surgical cure by laparotomy. The objective was to discuss the epidemiological, physiopathological, diagnostic aspects, the therapeutic and evolutionary modalities of this rare pathology.

Introduction: The present study was conducted to identify factors associated with late recourse to prenatal consultation in the city of Mbandaka. Method: This study was based on a case-control survey. A total of 650 pregnant women (325 cases and 325 controls) responded to a structured questionnaire. Cases were pregnant women seen late in the ANC service and each was paired with a control who came to the first antenatal visit in the first trimester. The data were analysed using SPSS 22 software where multivariate analyses based on the logistic regression model allowed the research objectives to be met. The risk of error considered was 0.05. Results: The factors associated with late recourse to ANC were: cost of ANC (p<0.01); lack of financial means (p<0.01); lack of motivation (p<0.01); shame (p<0.01); unavailability of the pregnant woman (p<0.01); traditional practice before performing ANC (p<0.01); parity (p<0.05) and marital status (p<0.05). Conclusion: The use of ANC remains late in Mbandaka. Any action aimed at encouraging pregnant women to start ANC in the first trimester of pregnancy should focus on improving the socio-familial environment, the service offer, socio-economic characteristics, socio-cultural characteristics and socio-demographic characteristics.

Background: Premature rupture of membrane (PROM) is linked to significant fetal and maternal morbidity and mortalities. The maternal and fetal outcomes in PROM are very important to decrease maternal and child mortality and for better management and prevention of complications. Objective: To find out maternal & fetal outcomes of preterm premature rupture of the membranes. Methods and Material: This is a cross-sectional observational study carried out in the Department of Obstetrics & Gynaecology, 250 Beded District Hospital, Chapainawabganj, Rajshahi, Bangladesh from January 2016 to July 2016. 50 pregnant women with preterm premature rupture of the membranes. Result: The majority of patients with preterm PROM (30%) belong to the age group 31-35 years. The mean age of the patients and SD were 26.4±6.58. 60% of respondents were multipara and 40% primipara. Most of the patients had irregular antenatal checkups (56%), 24% had regular antenatal checkups, and 20% had no antenatal checkups. Twenty percent of patients developed labor pain within 15 hours of rupture of membrane, 24% within 16-30 hours, 56% within 31-45 hours, 10% within 46-60 hours, and 12% without the onset of labour pain. 37 (74%) patients with preterm PROM had a normal vaginal delivery, and 13(26%) delivered by caesarian Section. Forty-three percent of patients delivered within 24 hours of the ruptured membrane, followed by 24% of patients within 24-48 hours, and 28% of patients within more than 48 hours. Among 50 patients, 12 (24.0%) had a previous history of abortion, 24 (48%) had H/O preterm delivery due to PROM, 2 (4.0%) had H/O MR, and 6 (12.0%) had H/O D & C. Among 50 respondents with PPORM 4 (8.0%) had diabetes mellitus, (12.0%) had HTN, 15 (2.0%) had urinary tract infection and 10 (20.0%) had lower genital tract infection. In this study, the total number of the alive baby was 42, and the stillborn baby was 2. Out of 42 alive babies, 18(42.86%) were affected by the consequence of preterm PROM and the birth process. Among 48 alive babies, 6(12.50%) developed birth asphyxia, 5(10.42%) developed jaundice, 3(6.25%) developed neonatal sepsis, and 4 (8.33%) developed respiratory distress syndrome. Maternal morbidity were chorioamnionitis 4(8%) puerperal sepsis 5(10%), postpartum endometritis 2(4%), abruptio placenta 1(2%) and wound infection 2(4%). Conclusion: The incidence of preterm PROM was more in multipara. The majority of the patients were from lower- and middle-class families. This study found some factors, e.g., Coitus, the recent history of abortion, M.R., D & C, and previous history of PROM. The study was done with a small population, but it introduces us to certain risk factors that can be prevented. Proper health education, patient motivation, improved health hygiene, and adequate maternity and childcare services are needed to reduce morbidity and mortality.

Introduction: Vitamin D (VitD) insufficiency is present in over half of population worldwide. Over a billion people worldwide are vitamin D deficient or insufficient. It has been long known that VitD insufficiency contributes to development of osteopenia and osteoporosis. Objective: To assess the serum vitamin D and TSH status in postmenopausal women who have undergone routine blood investigations. Methods: We performed a retrospective review of data of 61 patients in postmenopausal age group (45-75yrs) during their routine blood investigation for the first time at Dept. of Obstetrics and Gynaecology, Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh from January to March 2021. The data was collected from medical record section and appropriate statistical analysis was done using percentage and frequency. Results: Out of 61 patients Vitamin D was insufficient (10-30 ng/mL) in 34.4% and deficient (<10 ng/mL) in 18.0%, and remaining normal. In 4.9%, TSH was low (less than 0.3 mIU/L) and in 18.0% TSH was high (more than 4.5 mIU/L), while the remaining 77.0 had normal TSH levels (0.3-4.5 mIU/L). 54.5%(n-11) patients with high TSH, had vitamin D deficiency and 18% patients with high TSH had insufficient vitamin D. 100% (n-3) of patients with low TSH had normal vitamin D. 22 patients had normal TSH and normal vitamin D. Conclusion: Prospective longitudinal studies with larger subject numbers and more comprehensive measurement of thyroid function along with examining the indicators of innate immunity may shed light into the underlying pathophysiology and mechanisms involved in the interaction between thyroid function and VitD metabolism. High TSH levels was associated with low vitamin D levels, low TSH levels was associated with normal serum vitamin D level. Hence association was linear between TSH and vitamin D in post-menopausal women.

Background: The majority of perinatal research on COVID-19 currently focuses on the pregnancy consequences of SARS-CoV-2-infected women, including as cesarean sections, fetal distress, premature delivery, and even maternal mortality. However, it is currently uncertain how the COVID-19 pandemic would negatively affect premature membrane rupture. Aim of the Study: The aim of this study was to assess the impact of Covid 19 on preterm rupture of membrane. Methods: This cross-sectional study was conducted in department of obstetrics and gynaecology, Care Medical College Hospital, Dhaka, Bangladesh from 2021 to 2022. Total 100 pregnant women were included in this study. Where group A represented Covid 19 affected (n=50) and group B represented Not affected by Covid 19 (n=50). Result: In this study, mean age was 30.9 years (SD±8.5 years) in group A and 29.3 years (SD±7.5 years) in group B. Mean gestational age was 37.55 weeks (SD±2.42 weeks) in group A and 36.10 weeks (SD±3.08 weeks) in group B. Both groups had history of preterm delivery (2%), 8% of group A and 4% of group B had history of postpartum hemorrhage, and 22% of group A and 2% of group B had other family members affected. The commonest mode of delivery in both groups; 74% and 62% in group A and group B respectively. 16% in group A and 8% in group B had premature rupture of membranes and 4% in group A and 2% in group B had preterm premature rupture of membranes. Table V shows the neonatal outcome. Neonatal Covid 19 positive was 4% in group A. 18% of group A and 10% of group B were admitted in NICU. Neonatal mortality was 4% in group A and 2% in group B. Conclusion: Preterm births are more likely to occur in pregnant COVID-19 patients and the disease has an impact on NICU admissions. Premature rupture of membranes at term and preterm are more frequent in patients with COVID-19.