Background: Worldwide, caesarean section (CS) is one of the most commonly performed obstetric procedures. Maternal mortality and morbidities associated with repeat caesarean section is an important health problem in global perspective that needs to be addressed. Objectives: To evaluate the complications of repeat caesarean section. Materials and Method: This cross-sectional descriptive study was conducted in the department of Obstetrics & Gynaecology, Rangpur medical college hospital, Rangpur from July ’18 to June ‘20 after acceptance and ethical clearance of the protocol. During data collection total admitted patient were 2123 out of which 446 caesarean section was done among them 100 patients of my study population were selected by fulfilling inclusion and exclusion criteria. After full explanation, informing the details of the purpose of the study informed written consent was obtained from the study subjects/ or her legal gardian. After Meticulous history taking thorough physical examination was done on every patient and available investigations according to the need of management was done in the hospital. Per operative and postoperative complications were noted. Information’s were collected in predesigned questionnaire and presented in tabulated form and that was finally was analyzed with the help of computer program SPSS (Statistical Package for Social Science) version 23. Result: Total patient admitted during my data collection were 2123 and of them 446 caesarean sections were done and repeat caesarean sections were 100. The incidence of repeat caesarean section was 22.42%. 35% respondents were between >25-30 years of age. Average gestational age was >36 – 40 weeks. Emergency caesarean section was done in 79% cases and elective in 21% cases. 68% patients had adhesion, 38% had uterine atonicity, 26% had injury to the surrounding structure, placenta previa was found in 7% cases and morbid adhesion of placenta was found in 3% cases. Additional procedures like blood transfusion needed in 34% cases, adhesiolysis performed in 21% cases, ICU admission needed in 16% cases, caesarean hysterectomy performed in 11% cases and B-Lynch suture in 8% cases. Among the postoperative complications wound infection occurred in 20% cases, PPH in 13% cases, UTI in 9% cases, paralytic ileus in 4% cases and postpartum psychosis in 3% cases. Maternal mortality was found in only 3% cases. Conclusion: Repeat caesarean section is associated with increased number of intraoperative and postoperative complications like adhesion, placenta previa, morbid adherent placenta, PPH, wound infection thus increasing maternal morbidity. So, the best way to reduce these morbidity and mortality by reducing primary caesarean section rates by taking judicious decision and indications should be appropriate and C/S should be done by well-trained doctors and specialists in well-equipped centre.

Background: Preterm labor is one of the biggest health issues in the globe and is associated with high perinatal mortality and morbidity. A healthy pregnancy can turn into one that is at high risk for both the mother and the fetus in one of these clinical scenarios. Objective: The aim of the present study is to determine the risk factor and maternal and perinatal outcome of patients presenting with preterm labor and to evaluate the preventable causes of preterm labour. Methods: A Case control study conducted in the Department of Gynaecology and Obstetrics Dhaka Medical College Hospital, during February 2010 to July 2010. Results: A total of 50 cases having preterm labour in between 28 - 36 weeks of gestation and 50 controls having 37-40 weeks pregnancy with lobour pain were screened and enrolled in the study. Several significant risk factors were associated with preterm labour and the following risk factors were identified. Low socio-economic class, rupture of membrane (OR = -2.45), previous history of abortion (OR = 2.25), Preterm delivery (OR -9.33), and Anaemia (OR = 8.31). Conclusions: As preterm labour is grave consequences for both the mother and the newborn of preterm labor should be aim and developing awareness of pregnant mother who are high risk for preterm labor.

Intercellular communication is an integral part of the physiological process in a living organism. Evidence has shown that a significant amount of human protein-coding genes is endowed with the production of membrane and secreted protein types. Some of these proteins possessed post-translational influence that interferes with cellular functions. Recently the concept of cell communication gravitated to the use of membrane-bound particles called Extracellular Vesicles (EVs). EVs are released from the host cell and impact on the recipient cell through its contents (Cargo). The cargo contains various particles such as lipids, proteins, RNA, and glycolipids derived from the host cells. The current widespread research in EVs has brought its mediating role in physiological and pathological processes to limelight. Though the regulatory part of EVs has been widely embraced by researchers, the discrepancy associated with its collection and isolation as well as its analysis has remained a subject of debate in the literature. The facts emanating from the literature suggest that EVs, with its prospective application in Reproductive biology, has prompted extensive research in the last decade. Its knowledge has broadened the scope of understanding the physiology and pathology scenarios involved in reproductive processes. As a potential biomarker, it has become a valuable tool for diagnosis, prognostic, and therapeutic purposes, especially in the context of reproductive processes. However, the challenges of standardizing the isolation, purification, and analyzing EVs have remained a nightmare that need to be surmounted. Emerging evidence has demonstrated its impact in gamete development, fertilization, and embryo implantation. Thus, it could serve as a platform to understand the mechanism of conception and implantation. By extension, define a therapeutic approach for women with recurrent pregnancy loss.

Introduction: Gestational diabetes mellitus (GDM) is a common complication during pregnancy that affects both maternal and neonatal health outcomes. Identifying risk factors associated with GDM is crucial for early detection and intervention to improve pregnancy outcomes. Methods: This retrospective observational study was conducted at the Department of Gynecology, Gonoshasthaya Nagar Hospital, Dhaka, Bangladesh during the period of January 2019 to December 2019 with a total of 348 hospital patient records. Result: Of the 348 participants, 24.71% had GDM. Significant differences were observed between the groups in age, gravida, BMI distribution, family history of GDM, and previous history of GDM. Higher rates of non-spontaneous vaginal deliveries were found in the GDM group (36.05%) compared to the non-GDM group (22.52%). Age ≥35 years, obesity, family history of GDM, and history of GDM were significantly associated with GDM (p<0.05). Conclusion: Our findings support the existing evidence that advanced maternal age, obesity, family history of GDM, and previous history of GDM are significant risk factors for GDM. These results highlight the importance of early screening and intervention for high-risk groups to prevent adverse pregnancy outcomes.

The objective is to report a clinical case of vaginal caesarean performed to save a fetus in distress by retroplacental hematoma. For this indication, the vaginal caesarean can be an alternative to the classic caesarean because of its short duration and the preservation of the possibility of future childbirth by natural means. However, this surgical technique described since the 19th century is still unknown to many practitioners and few publications exist on the subject throughout the world. Considered obsolete by some practitioners, it retains all its advantages in the practice of modern obstetrics. We report this case of fetal rescue performed by vaginal caesarean section at the Reference Health Center of the Sanitary District (District Hospital) of Bla in Mali in a 34-year-old patient, admitted for retroplacental hematoma with live fetal on a non-term pregnancy in latency phase of labor.

Introduction: Many women and girls face financial challenges in meeting their menstrual hygiene management needs. The main objective of this study is to estimate the financial cost of menstrual hygiene management among school-going girls. Methodology: This is a prospective study carried out in a semi-urban school environment at the Public High School in the health district of Bla in 2020. Results: This study was conducted among 125 high school girls with no income. The average age was 18 years old. Parents lived in rural areas with no fixed monthly income in 52% of cases. Multipurpose pieces of cloth were the protective material used in 67% of cases. The girls explained this choice in 100% of cases by the high cost of single pads and tampons. The average monthly cost of menstrual hygiene management was 0, 56 $ or 6, 67 $ per year with extremes of 0, 16 and 2, 45 $ per month. This amount was used to buy either single-use pads or soap for body care and multiple-use pads. This financial cost was covered at 92% by female support (mother, aunt, sister); male support (father, spouse) accounted for only 8%. Conclusion: This study made it possible to estimate the average annual financial cost of menstrual hygiene management among young school girls in Bla. These findings call for further studies to better understand the financial implications of menstrual hygiene management in low-resource settings.