Background: Short inter-pregnancy interval (SIPI) has been linked with low maternal haematological indices and adverse fetal outcome. The World Health Organization (WHO) recommended a minimum of 24 months inter-pregnancy interval to reduce the risk of adverse maternal and fetal outcomes. However, sub-optimal pregnancy spacing is common in many developing countries including Nigeria. Objectives: To determine the impact of inter-pregnancy interval on maternal serum ferritin, haematocrit level and fetal outcome among parturient in University of Ilorin Teaching Hospital, Ilorin, Nigeria. Study Design: A prospective cohort study of parturient less than 20weeks gestation. Those who did not satisfy the WHO recommended inter-pregnancy interval of at least 24months were categorized as group II while gestational age and social status matched parturient who satisfied the WHO recommendation were in group I. Methodology: A total of 316 parturient who satisfied the inclusion criteria were recruited for the study by systematic sampling. These were equal number of 158 participants each as subject and control. Subject and control were matched for gestational age and social status. The serum ferritin and haematocrit levels as well as fetal outcome were evaluated for each participant. The results were analysed using SPSS version 20.0 with appropriate tables and figures generated. Results: There was statistically significance difference in the mean levels of serum ferritin (P<0.001) and haematocrit (P<0.001) at booking for the two groups of participants. There was statistically significant difference in the gestational age at delivery (P<0.001) with higher rate of preterm delivery (22.1% vs. 1.9%; P<0.001) in group II compared to group I. In addition, there were higher percentages of group II babies with 1st (32.5% vs. 9.6%; P<0.001) and 5th minute (18.2% vs. 1.9%; P<0.001) APGAR scores < 7 compared to group I babies (P<0.001). The mean birth weight was lower in group II (2.70±0.35 vs. 3.10±0.31; P<0.001) with higher need for neonatal resuscitation (16.9% vs. 2.6%; P<0.001) and intensive care admission (18.2% vs. 1.3%; P<0.001) among neonates of women in group II. Neonatal anaemia (15.4% vs. 0.0%; P<0.001) occurred only in group II participants’ babies. Neonatal mortality was zero for group I and 18(11.7%) for group II babies. Conclusion: Inter-pregnancy interval below the WHO recommendation is associated with low maternal serum ferritin and haematocrit levels as well as adverse fetal outcome. Recommendations: Adequate child spacing should be emphasized during antenatal visits, postpartum counselling, postnatal clinic visits as well as other contacts with non-pregnant women of reproductive age.

Management of cervical fibroid which is one of the rare sites of uterine fibroid comes with challenges to gynaecologists especially in young nulliparous women where uterine conserving surgery is to be instituted. Cervical fibroid locations can be in the supravaginal or vaginal aspect of the cervix. It can also present as pedunculated fibroid or sessile fibroid from the cervical lip. The commonest presentations of cervical fibroid are pelvic pressure symptoms and menstrual irregularities. This is a case of a 24 year old nulliparous woman with recurrent pelvic pressure symptoms, heavy menstrual flow and vaginal discharge with diagnosis of cervical fibroid and vaginal fibroid polyp and was managed by uterine conserving surgery.

Adnexal torsion is a spontaneous rotation of the ovary and sometimes the fallopian tube around its axis which can interfere with arterial supply and lead to ischemia It is a rare complication of an ovarian cyst, which can occur at any age, from the fetal period to adulthood. The mature cystic teratoma accounts for 20% of all ovarian tumors and is seen especially in young girls and therefore is most often benign. It's a surgical emergency. We report here two cases of adnexal torsion operated at the level of the pediatric surgery unit of the Hospital of Mali The two girls are 14 and 13 years old, nulligest and normoregulated with recurrent abdominal pain admitted for acute pelvic pain. On palpation, an abdomino-pelvic mass of a firm and painful consistency is noted. An abdominopelvic ultrasound was performed in both cases and revealed torsion of the left adnexa on the left ovarian cyst in the first and on the right in the second. The surgical procedure performed was manual detorsion and cystectomy in both cases. The anatomopathological examination concluded with a dermoid cyst In the two girls and their postoperative course was simple.

Background: Preeclampsia, gestational diabetes, and premature delivery are three obstetric problems related with high iron reserves during pregnancy. Few studies have found an association between preeclampsia and higher serum ferritin levels, however, this finding was not convincing. Objectives: The aim of this study was to assess the variation in the levels of serum ferritin and serum iron level in preeclamptic Bangladeshi women compared to healthy pregnant women. Methods: This case control study was carried out in the Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University (BSMMU) during October 2018 to September 2020. A total of 94 pregnant women between 18-40 years of age were included in this study in her 32 weeks to 38 gestational weeks. Among them 47 diagnosed case of preeclampsia and rest 47 healthy pregnant women were consider as control. Purposive sampling technique was followed. After taking consent and matching eligibility criteria, data were collected from patients on variables of interest using the predesigned structured questionnaire by interview, observation, clinical examination and hematological investigation of the patients. The serum ferritin and serum iron level were measured in Department of Biochemistry in BSMMU. Statistical analyses of the results were be obtained by using window based Microsoft Excel and Statistical Packages for Social Sciences (SPSS-22), where required. Results: Serum ferritin in preeclamptic women was (124.54±32.14 ng/ml), versus (50.83±2.53 ng/ml) in the control group with P-value (0.001). Serum iron in preeclamptic women was (110.19±23.62µg/dl), versus (105.15±26.6 µg/dl) in the control group with P- value (0.334). Almost three fourth (74.5%) patients had serum ferritin >120 (ng/ml) in case and 17(36.2%) in control. The difference was statistically significant (p<0.05) between two groups with OR= 5.15 (95% CI 2.12-12.47). There was a positive significant Pearson’s correlation coefficient between serum ferritin and each systolic and diastolic blood pressure (r=0.561, p<0.001 and r=0.556, p<0.001 respectively). Serum ferritin level increases significantly in preeclamptic women. There was no significant difference in serum iron levels between the preeclamptic women and control groups. Increased level of serum ferritin may play a role in pathogenesis of preeclampsia. Conclusion: Preeclampsia as one of pregnancy related complications is a notable burden of adverse health. This case-control study demonstrated that preeclampsia is associated with high serum ferritin levels, and that in preeclamptic women, serum ferritin was positively correlated with blood pressure.

Introduction: Urinary tract infections (UTIs) are a common health issue among pregnant women, leading to adverse maternal and neonatal outcomes. Despite this, the etiology of UTIs among pregnant women, particularly in resource-limited settings like Bangladesh, is poorly understood. Methods: This prospective observational study was conducted at the Department of Obstetrics and Gynecology, Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh. A total of 120 pregnant women with UTIs, admitted between January 2021 and June 2022, were included in the study following specific inclusion and exclusion criteria. Result: The majority of the women was aged 18-24 years (35.83%) and had secondary education (32.50%). Anemia and proteinuria were present in 31.67% and 20.00% of the women, respectively. The primary obstetric characteristic was being primigravida (60.00%). Key risk factors of UTIs included a history of UTI (25.00%), diabetes mellitus (12.50%), frequent sexual activity (33.33%), history of urinary tract abnormalities (8.33%), use of urinary catheters (4.17%), and recent antibiotic use (20.83%). The primary etiological agent was Escherichia coli (60.00%). Conclusion: The findings underscore the need for comprehensive antenatal care, including routine screening for UTIs, anemia, and proteinuria among pregnant women in Bangladesh. Targeted interventions, such as health education and improved sanitation, are recommended to mitigate the identified risk factors. Further research on antimicrobial resistance patterns among the identified etiological agents is warranted to guide appropriate antimicrobial therapy.

Background: In gestational diabetes mellitus (GDM), risk prediction is mostly based on maternal history and clinical risk factors and may not optimally identify high risk pregnancies. Therefore, universal screening is widely recommended. Homocysteine levels during pregnancy in women with GDM have been studied; however, it remains unclear whether hyperhomocysteinemia is a useful predictor of GDM. Objective: To determine the association of serum homocysteine level in women with gestational diabetes mellitus. Methods: Case control study was conducted in the Department of Obstetrics and Gynaecology, Institute of Child and Mother Health (ICMH), Dhaka. Pregnant women in their 24 weeks to 40 weeks of gestation attended for antenatal care diagnosed as GDM was selected as cases. Non- diabetic pregnant women matching with cases by age and gestational age were selected as control in this study. GDM was diagnosed by oral glucose tolerance test (OGTT). The serum homocysteine level of these patients was measured. Descriptive and inferential analysis was carried out using SPSS version 22.0. P-value less than 0.05 will be considered as statistically significant. Results: Among the cases fasting blood sugar (6.13 ± 0.66) and controls (4.60 ± 0.57). Similarly, 2 hours after 75 gm. glucose blood sugar among cases (8.46 ± 0.88) and controls (6.32 ± 0.96). Both results were statistically significant p=0.001. Majority of patients were at third trimester of pregnancy (67.0%). 37.5% were primigravida and 2.5% were multigravida. Mean gestational age of cases (30.25 ± 2.74) and controls (30.02 ± 3.03). Among the cases 62.1% had history of GDM where 37.9% don’t have history of GDM. Among control group only 7.7% had history of GDM. This result statistically significant p=0.001. 6.9% cases had history of macrocosmic child which was not statistically significant p=0.49. There was no history of still birth or other congenital defect. Mean serum homocysteine level among cases (6.50 ± 1.72) and controls (5.20 ± 1.87) which was statistically significant p=0.001. Positive correlation observed between maternal serum homocysteine level and maternal blood sugar (r=0.209, p=0.005) in this study. Respondents with high homocysteine level have 3.94 times more chance to develop GDM (OR=3.94; 95% CI = 1.59-9.77). Conclusion: Finding from the present study suggests that maternal elevated serum homocysteine level in pregnancy is significantly associated with Gestational Diabetes Mellitus.

Objective: The study was carried out to evaluate the outcome of post placental COPPER T380 A insertion in women during caesarean section. Methods: A descriptive quasi-experimental study was carried out to evaluate the outcome of post-placental COPPER T380 A insertion in women during caesarean section. They were interviewed with a specific pre-designed questionnaire Results: The patients were asked to visit 1, 6 and 12 months after the insertion of COPPER T380 A to record the complaints during the follow-up period. It was found that only 2(1.33%) complaints of expulsion after 1 month of insertion and 1 (0.66%) after 6 months, and there was no complaint of expulsion at 12 months of follow-up. In case of PID, there were 3(2%) at 1 month, 1(0.66%) at 6 months and 1(0.66%) at 12 months follow up. The most frequent complaint was pain lower abdomen which accounted for 13 (8.67%), 12 (8.00%) and 8 (12.67%) at 1. 6 and 12 months of follow-up, respectively. The next common complaint was the vaginal discharge of 9 (6.00%) at 1 month, 8 (4.67%) at 6 months and 10 (6.67%) at 12 months of follow-up. No failure of COPPER T380 A insertion during cesarean section within 12 months of follow-up (No pregnancy within 12 months). Conclusion: Clients and providers can benefit from COPPER T380 A's high motivation, low risk of infection, and fast insertion speed when used after childbirth. The use of an intrauterine device as a form of birth control immediately after delivery has been shown to be effective and safe. Furthermore, considering the large number of puerperal who do not return for contraception, the use of a safe contraceptive method, provided quickly after delivery and before discharge from the hospital, is a far-reaching reproductive health strategy.