Background: Vesico-vaginal fistula (VVF) is still a persisting scourge in the developing countries with devastating medical and social consequences. These consequences were studied among patients presenting with vesico- vaginal fistula in Sylhet MAG Osmani Medical College Hospital, Sylhet. Objectives: To analyzethe vesico-vaginal fistula patients during the 2 years period. Materials and Methods: This was a descriptive and cross-sectional study conducted in the Department of Obstetrics and Gynaecology, Sylhet M.A.G. Osmani Medical College Hospital, Sylhet from May 2008 to April 2010 (2 years).Fifty-three hospitalized patients with vesico-vaginal fistula were selected by Inclusion and exclusion criteria, undergoing repair operation irrespective of age. After selection of the patients informed written consent was taken. Each patient was interviewed using the semi-structured questionnaire containing socio- demographic and other relevant information like age, occupation, education of the patient and her husband, age at marriage, age at 1* child birth, monthly income and detailed history of the delivery. Type of fistula and related examination of the fistula was also done and noted. Type of repair of vesico-vaginal fistula, postoperative complications and outcome was recorded in the same manner. Results: The mean age of the patients with vesico-vaginal fistula was 30.5 years (SD± 8.5; range, 18 to 52). Majority (73.6%) were between 21 to 40 years; and 52.8% patients were primipara, 81.1% patients were illiterate and 69.8%patientswere from lower social class. The aetiology of fistula were obstructed labour 49.1%, emergency lower segment caesarean section 37.7%, destructive delivery 11.3% and caesarean hysterectomy 1.9%.The repair operation was done of all patients in this series through vaginal approach. Repair was done first time in 83% and rest had history of failed repair. Postoperative complications were catheter block and urine leakage in 37.7% and urinary tract infection in 11.3% patients. Successful outcome was found in 79.2% cases. Causes of failure were severe scaring 36.5% difficult operation, catheter block and others each constituted 18.2% and large fistula 1.9%. Conclusion: Young primi are the victims of vesico-vaginal fistula, obstetric causes add up to form a major share of the etiology of vesico-vaginal fistula. Proper perinatal management is most important to reduce obs fistula formation.

Objective: Unsafe abortions among the various age groups of women due to unintended pregnancy and socio- economic constraints have a deleterious effect on their reproductive and mental health. Hence, review and modification of safe abortion practices are crucial, owing to the rampant availability of over-the-counter MTP kits and D&C by unskilled professionals resulting in Maternal Mortality and Morbidity. This study provides an estimate of the outcomes of unsafe abortions. Methods: WHO [1] defines unsafe abortion as the termination of a pregnancy by people lacking the necessary skills, or in an environment lacking minimal medical standards, or both. The present study is a cross-sectional descriptive analysis of outcomes of unsafe abortions at a tertiary care center, GGH Kadapa. The study data includes all the women admitted to the emergency obstetric unit and treated for unsafe abortions between January 2019 to June 2020. Age group of the selected population is between 15-45. The sample included 342 cases of recent induced abortions. The primary outcome of the study is to emphasise the burden, causes, setting and the morbidity of unsafe abortions. Results: Total number of deliveries that occurred between Jan 2019 to June 2020 is 13787 and the total number of induced abortions during this period was 342. Out of which, 211(61.7%) were unsafe abortions. Among them, 53 women (25.11%) presented with shock. 89 women (42.1%) needed blood transfusions. 8 (3.79%) women went into DIC. One woman had a uterine rupture, and underwent uterine rent repair. Four women had uterine perforation with associated bowel injury. Bowel repair was done in 1 case, and a colostomy was required in 3 cases. Emergency laparotomy was performed in these 5 cases. Conclusion: Unsafe abortions are one of the leading causes of maternal mortality and morbidity in a developing country like India. This is mainly attributed to socio-economic constraints, poor awareness of contraception, and cultural beliefs against sterilization forcing the pregnant women to indulge in unsafe abortion practices. Creating contraception awareness in reproductive age group, strict laws against unsafe abortion practices are to be implemented to reduce the maternal morbidity and mortality due to unsafe abortions.

Background: Multiple pregnancies are prone to be associated with adverse maternal and perinatal outcome. The incidence of multiple pregnancies has shown a significant increase over the last decades. Aim of the Study: This study aimed to describe the maternal and perinatal outcomes in multiple pregnancies delivered in a tertiary care hospital, Bangladesh. Methods: This was a prospective observational study; 23 patients were enrolled and analyzed. The study conducted with 23 women with twin pregnancies, over 2 year’s months from January 2020 December 2021 in the department of Gynecology and Obstetrics, Chittagong Medical College and Hospital, Chittagong, Bangladesh. Result: Out of 23 cases, 8 patients had intrapartum complications like PPH, mal-presentation, cord prolapse, low-lying placenta, and placental abruption. In this, 4(23.53%) had mal-presentation, and only one had PPH. These intrapartum complications were also categorized according to their chronicity. Mal presentations were seen in 23.53% of DCDA and 33.3% of MCDA with p=0.47. Both were not statistically significant, as shown in Table 4. These twin-specific complications were noted according to their chronicity. Discordant twin was seen in 11.76% of DCDA and 16.67% MCDA. Single IUD in 7.9% of DCDA. The complications and outcomes of the study population; more than 65% of patients needed NICU. In our study, we noted 4 perinatal death caused by intrauterine death, twin-to-twin transfusion syndrome, birth asphyxia, and respiratory distress. Conclusion: Majority of the multiple pregnancy is high risk one. So, all multiple pregnancies need early diagnosis, adequate antenatal, intra-natal and post-partum care to improve the outcome and should have mandatory hospital delivery.

Introduction: Cervical Intraepithelial Neoplasia is a precancerous condition in which abnormal cells grow on the surface of the cervix. CIN is a symptomless illness that often goes undetected by the naked eye. In most cases, the afflicted cervix appears to be in excellent health. As a result, the illness is detected by chance during cervicological histology or as a result of programs for routine cervical cytology or colposcopy screening. Colposcopy is an extra and valuable technique for identifying cervix anomalies. This study aimed to analyze the correlations between colposcopy findings and histopathological results from colposcopy-directed biopsy in cervical pre-cancerous lesions. Methods: A prospective observational study was conducted at the Department of Gynecology and Obstetrics, Chittagong Medical College Hospital, Chittagong, from September 2014 to February 2015. VIA-positive 72 women fulfilling all inclusion criteria who attended at colposcopy clinic of CMCH were included in the study. Statistical analyses were done by using the Statistical Package for Social Sciences (SPSS) version 16.0 for Windows. The quantitative observations were indicated by frequencies and percentages. Result: In the present study, the majority of the participants were over the age of 30 years, with 43.1% being in the age group of 30-39 years. Another 30.6% were from the age group of 40-49 years, while only 15.2% were from the age group of 20-29 years. Colposcopy findings were normal in 9.7% of the participants. CIN I was observed in the majority of the participants (54.2%), while CIN II and CIN III were observed in 29.2% and 6.94% respectively. According to the colposcopy-directed biopsy results, 5.6% of patients had normal outcomes, 7.7% had inflammations, 45.8% had CIN I, 30.6% had CIN II and 8.3% had CIN III. The correlation was calculated by reporting the number of cases histologically confirmed to the number of cases of colposcopic diagnosis for each lesion group separately. The correlation was 71.8% (28 out of 39) in the CIN I category, 76.2% (16 out of 21) in the CIN II category, and 75% (3 out of 4) in the CIN III category. The sensitivity and specificity of colposcopy were calculated considering a colposcopy-directed biopsy. Colposcopy findings revealed 65 CIN positive cases and 07 CIN negative cases, while biopsy findings revealed 60 positive and 12 negative cases. The sensitivity of colposcopy was 96.7%, specificity was 41.6%, the false positive rate was 58.4% and the false negative rate was 03.3% according to this study. Conclusion: This study demonstrated high accuracy and correlation between colposcopy and histology. The sensitivity of colposcopy was 96.7%, specificity was 41.6%, the false positive rate was 58.4% and the false negative rate was 03.3%. Specificity was lower in this study probably because biopsies were performed in all cases during diagnostic workups.

Background: Amniotic fluid is the fluid present in amniotic sac which surrounds the foetus, provides nutrition and maintains temperature of the foetus. Physically it allows the foetus to move and prevents it from injury. Functionally it enables foetal breathing mobility that prevents pulmonary hypoplasia and exercises digestive tract by swallowing amniotic fluid. Objective: The objective of the study was to explore the role of amnioinfusion in intrapartum management of meconium stained amniotic fluid in the pregnant women at labor and foetomaternal outcome of the patients attending labor ward of Rajshahi Medical College Hospital. Methods: This experimental randomized control trial study carried out in the Department of Obstetrics and Gynecology of Rajshahi Medical College Hospital, Rajshahi from July, 2012 to June, 2014. Sample size was 100 and randomly allocated into equally two halves as study group and control group. Purposive sampling technique was followed. Results: In this study the age of the study group up to 30 years was 38(47.5%), control group 42(52.5%) and total 80(80.0%). On the other hand, in >30 year’s study group was 12(60.0%), control group 8(40.0%) and total 20(20.0%) respectively. and that of control group was 26.24 (±4.75) years. The mean age of the study group was 27.44 ± 5.59, control group was 26.24 ± 4.75 and total was 26.84 ±5.18 years. The mean weight of the study group was 66.84 (±3.25) kg and in the control group 62.64(±2.84) kg. In this study, 96.0% of the respondents had normal vaginal delivery and among them, 52.1% were in the study group and 47.9% in the control group. On the other hand, only 4% of the respondents had lower segment caesarean section and all of them were in the control group. The mean gestational age at delivery of the respondents in the study group was 39.88 ± 0.78 weeks and in the control group 39.84 ± 0.75 weeks. Conclusion: In this study Tran’s cervical amnioinfusion gave positive result by providing reducing picture of operative delivery in study group. There was significant difference in respiratory distress in the baby having lower percentage in the study group. A large scale study should be carried out to make the result of this study a reliable one.