Introduction: Menstrual regulation, or the evacuation of the uterus of a woman at risk of being pregnant is done to ensure a state of no pregnancy, was introduced in Bangladesh in the 1970s in the context of a restrictive abortion law, in part to reduce maternal morbidity and mortality associated with unsafe abortion. Objectives: The study is designed to see the efficacy, safety and acceptability of uterine evacuation by medication using oral mifepristone and buccal misoprostol. Methods: All the patients attending the outpatient department. Of obstetrics & gynaecology in DNMCH during the study period seeking for MRM unwanted pregnancy. Of them 100 cases were selected purposively according to inclusion and exclusion criteria. Success was defined as medical abortion. Results: The oral misoprostol-mifepristone regimen, used by 100 women with a gestational age below 63 days, had a success rate of 92.0%. Ninety two percent patients were completely evacuated and Eight percent patients were incompletely evacuated. Conclusion: An evidence based regimen of 200 mg of mefipristone orally followed by home use of 800 mcg of buccal misoprostol 24hr later is safe and effective up to 9 weeks (63 days) of pregnancy. Further the need of aspiration for any reason was low and hospitalization was rare.

Background: The definition of stillbirth recommended by WHO for international comparison is a baby born with no sign of Life at or after 28 weeks gestation. Aim of the study: The study aims to identify common risk factors associated with IUFD in Gaibandha 250 Bedded District Hospital, Gaibandha, Bangladesh. Methods: This Cross-sectional study was conducted at the Department of Gynecology & obstetrics, Gaibandha 250 Bedded District Hospital, Gaibandha, Bangladesh. participant was recruited retrospectively from medical records spanning one year from March, 2023 to Feb 2024. Result: The study involves 75 participants, predominantly aged 21-30 (57.90%) with primary education (55.00%). Most are housewives (65.50%) with average income. Pregnancy experience varies, with 2-3 pregnancies being the most common (36.40%). Most have normal systolic blood pressure (81.80%) and mild anemia (78.40%). Obstetric history includes abortion (18.20%) and IUFD (13 patients). Regular antenatal care (63.60%) is prevalent. Gestational age is >36 weeks for 37% of cases. Birth weights range primarily from 1-2kg (39%). Maternal factors contribute significantly to intrauterine fetal demise (IUFD), including chronic hypertension, pre-eclampsia, and premature rupture of membranes (PROM). Conclusion: The findings underscored the significant impact of maternal, fetal, and socio-demographic variables on IUFD incidence. Maternal factors such as hypertension and pre-eclampsia emerged as significant contributors, alongside fetal and cord-related issues. Socioeconomic disparities and inadequate antenatal care underscored the importance of holistic healthcare interventions to mitigate IUFD risks.

Introduction: Postdated and prolonged pregnancy are accepted terms by WHO and the International Federation of Gynecology and Obstetrics to describe pregnancy beyond dates (expected date of delivery). It complicates up to 10% of all pregnancies and carries an increased risk to the mother and fetus. This study aimed to analyze the outcome of combined induction of labor in post-dated pregnancy. Methods: This prospective interventional study was conducted at the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Bangladesh, from March 2013 to August 2013. A total of 50 patients with post-dated pregnancies were selected as study subjects by purposive sampling technique. In this study, 34.0% of patients' labor induction was given by oxytocin drip followed by ARM, and 20.0% of patients' labor induction was given by ARM followed by oxytocin drip. In 46.0% of patients with an unfavorable cervix, prostaglandin was used followed by ARM. Collected data were analyzed using different methods of statistics. Statistical analyses were carried out by using the Statistical Package for Social Sciences version 20.0 for Windows. Result: It was observed that intrapartum fetal distress occurred in a total of 12 babies. 10 babies needed resuscitation and 40 babies needed no resuscitation. In this series, among the healthy babies majority (20) were born at 40 completed weeks of gestation, 18 babies at 41 completed weeks, and 2 babies were born at 42 completed weeks of gestation. Among the asphyxiated baby 6 babies were borne at 42 completed weeks of gestation, no one at 41 completed weeks, and 2 asphyxiated babies were borne at 40 completed weeks of gestation. All babies with other complications like LBW, birth trauma, and post-maturity syndrome. Conclusion: This study concludes most frequent indication was fetal distress and unfavorable cervix in postdated pregnancy. Abnormal uterine action and asphyxiated baby were the more frequent maternal and fetal complications respectively. A small number of LBW, birth trauma, and post-maturity syndrome were observed but no maternal and fetal death was found in this study.

Introduction: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting women's reproductive health and fertility. This study aimed to investigate the demographic, clinical, and biochemical characteristics of primary sub-fertile women with and without PCOS. Methods: This cross-sectional comparative study was conducted at the Fertility Care Centre, Department of Obstetrics & Gynaecology, Dhaka Medical College Hospital, Dhaka, from June 2017 to November 2017. The study included 146 primary sub-fertile women, divided into two groups: Group A (n=73) with PCOS and Group B (n=73) without PCOS. Data on age distribution, educational background, occupation, BMI, hirsutism prevalence, and biochemical findings (TSH, FT3, FT4 levels) were collected and analyzed. Result: The study found significant differences in BMI and hirsutism prevalence between the two groups. Group A (with PCOS) had a higher mean BMI (26.8±7.2) and a greater prevalence of hirsutism (26%) compared to Group B (without PCOS), which had a mean BMI of 24.4±4.3 and a hirsutism prevalence of 11%. Additionally, Group A exhibited significantly higher mean TSH levels (5.0±2.4 µU/ml) than Group B (2.9±1.3 µU/ml). However, no significant differences were observed in FT3 and FT4 levels between the groups. Conclusion: The study highlights the association of PCOS with higher BMI, increased prevalence of hirsutism, and altered thyroid function, particularly elevated TSH levels, in primary sub-fertile women. These findings underscore the importance of considering both metabolic and endocrine factors in the management of sub-fertility in women with PCOS. The study contributes to a better understanding of the complex interplay between PCOS, thyroid function, and sub-fertility, suggesting the need for comprehensive evaluation and targeted treatment strategies in this population.

Introduction: The optimal timing for postpartum discharge remains a subject of debate, with varying recommendations and practices globally. This study aims to compare the outcomes of early versus late discharge in postpartum care following normal delivery. Methods: This randomized controlled trial was conducted at the Department of Gynaecology and Obstetrics, Institute of Child and Maternal Health, Matuail, Dhaka, Bangladesh, from March 2011 to August 2011. 200 patients who underwent normal vaginal delivery were randomized into early (<24 hours) and late (>24 hours) discharge groups. Baseline characteristics, regularity of antenatal care visits, clinical examination findings at discharge and 7-day follow-up, and postpartum complaints were recorded and analyzed. Result: In our study of 200 participants, the early discharge group (n=100) and late discharge group (n=100) showed comparable baseline characteristics. Age, residence, socioeconomic status, educational status, and gestational age were similar across groups. Antenatal care regularity showed no significant difference with a p-value of 0.75. Clinical examination findings at discharge and the 7-day follow-up revealed no statistically significant differences in maternal and newborn health indicators: anemia (early: 26, late: 28), edema (early: 15, late: 12), minor breast problems (early: 8, late: 6), jaundice (early: 15, late: 12), dehydration (early: 12, late: 9), excessive crying (early: 26, late: 21), and complications of the umbilical stump (early: 7, late: 11). Postpartum complaints such as excessive vaginal bleeding (early: 5, late: 4), fever (early: 8, late: 6), foul-smelling lochia (early: 6, late: 8), feelings of depression (early: 16, late: 14), breast engorgement (early: 26, late: 22), and feeding difficulty (early: 32, late: 28) also showed no significant differences. A substantial number of mothers in both groups preferred the same or a shorter duration of hospital stay for their next delivery (shorter duration preference: early: 46, late: 39). Conclusion: The study concludes that both early and late discharge protocols can be viable options in postpartum care after normal delivery, without significant differences in maternal and newborn health outcomes. The findings support the implementation of flexible discharge policies, tailored to individual needs and preferences, in postpartum care.

Background: One of the most dangerous complications of pregnancy and a major contributor to maternal and perinatal morbidity and death is preeclampsia. The goal of the current study was to measure the level of inflammation in severe preeclampsia by measuring serum high-sensitive C-reactive protein (hs-CRP) and establishing a relationship between hs-CRP and blood pressure. Objective: The aim of this study is to evaluate the impact high sensitivity C-reactive protein as an independent risk factor for preeclampsia with severe features. Methods: The cross-sectional study was carried out in the Department of Obstetrics & Gynecology of Dhaka Medical College Hospital, Dhaka, from July 2022 to June 2023. A total of 200 patients were enrolled and analyzed in this study. The questionnaire was pretested, corrected and finalized. Data were collected by face-to-face interview and analyzed by appropriate computer based programmed software Statistical Package for the Social Sciences (SPSS), version 24. Results: In this study, majority 95 (47.5%) of the patients were in 21 – 30 years age group and 60 (30.00%) patients were in >30 years age group, Mean±SD of age was 27.12 ± 4.12 years. Most of the patients 150 (75.00%) were housewife and 50 (25.00%) patients were service holder. About 55 (27.5) patients were completed their graduation, 50 (25.00%) were completed higher secondary and 20 (10) were illiterate, most of the patients 145 (72.5%) came from rural area and 55(27.5) patients came from urban area. Nullipara was found in 75 (37.5%) patients and multigravida was found in most of the patients 110 (55.00%). Antenatal care was found irregular in 105 (52.5%) patients. Preterm pregnancy was found in majority 145 (72.5%) of the patients. Systolic and diastolic blood pressure were found higher and hsCRP was also found higher in PE with severe features. APGAR score was found less in 65 (32.5%) neonate at birth and APGAR score was found good in 55 (27.5%) neonate at 5 minutes. Average birth weight was found in 75 (37.5%) neonates, LBW was found in 85 (42.5) neonates and very LBW was found in 40 (20.00%) neonates of PE with severe features patients. Intrauterine growth retardation and prematurity were found in 75 (37.5%) and 20 (10.00%) neonates, admission to NICU was needed for 45 (22.5%) neonates, birth asphyxia was found in 15 (7.5%) neonates and stillbirth was occured in 35 (17.5%) cases. Conclusion: An exaggerated systemic inflammatory response, which may produce reactive oxygen species and worsen endothelial dysfunction, is present in preeclampsia. Clinical signs of hypertension and proteinuria in preeclampsia result from this. Preeclampsia-related maternal mortality and systemic complications may be reduced with early identification. hsCRP may therefore be a valuable gauge of preeclampsia severity.

Background: Uterine rupture is linked to high rates of maternal mortality, especially in developing countries. Thus, this study aimed to evaluate the factors contributing to uterine rupture and the resulting neonatal outcomes in Sudan. Methodology: This study comprised of a series of 26 women presented with uterine rupture to the department of maternity at El-Obeid Teaching Hospital, El-Obeid, North Kordofan state, Sudan. The patients presented within one-year time. Results: In this particular group of patients, the neonatal population exhibited the following distribution: 19.2% (5 out of 26) were classified as Alive and well (WA), 23% (6 out of 26) required admission to the neonatal intensive care unit (NICU), 46.2% (12 out of 26) presented with Fresh Still Birth (FSB), and 11.6% (3 out of 26) displayed manifestations of Macerated Still Birth (MSB). Conclusion: Various factors can impact the outcomes of neonates following uterine rupture, such as the availability of facilities and demographic factors. The majority of newborns delivered showed unfavorable conditions.

Repeat caesarean sections increase the possibility of maternal morbidity. Worldwide, the need for a trial of labor after caesarean delivery is gaining more ground in selected cases. Here, we report a case of an unbooked 37-year-old multigravida, with a history of five (5) previous lower-segment caesarean sections who presented in spontaneous labor. A live male baby of 2900 grams was delivered following episiotomy. Post-partum, she was observed with normal findings and a serial follow-up ultrasound scan showed normal uterine contours and surrounding structures. As the evidence for the practice of vaginal delivery in women who underwent 2 or more previous LSCS are still fewer, this report intends to highlight the possibility of successful vaginal birth after multiple caesarean sections putting into consideration the optimal care of the parturient. The term ''V-back" was coined from the Roman numeral 'v' meaning five (5), the case here has had five (5) previous lower segment cesarean sections come "back" for spontaneous vaginal delivery.

Introduction: Influenced by cultural, spiritual and religious beliefs. A lot of couples suspend sexual activities and resume at various different times due to influences by different factors. Materials and Method: This was a descriptive cross-sectional study among 376 postpartum women and nursing mothers visiting the immunization/infant welfare clinic, postnatal and family planning clinic at the University of Port Harcourt Teaching Hospital. Data were obtained using pretested semi-structured interviewer-administered questionnaire, which was designed based on variables from existing literature pretested and revised to ensure the quality of information collected. The data retrieved was analysed and variables presented in tables. Results: Approximately 2/3rd (66.0%) of the women had a tertiary level of education. The result show 200(53.19%) of the women started sexual activity less than 6 weeks after delivery, with about 43.6% of the participants reporting various sexual dysfunctions like loss of desire, dyspareunia, vaginal dryness and others. The majority of the women (89.9%) were knowledgeable about contraception and the majority of those who knew about contraception 222(59%), made use of it. A higher proportion of women who had puerperal complications used contraception. Logistic regression analysis showed that women on contraception were about 12 times more likely to resume sexual activity after 6 weeks. Conclusion: Early resumption of sexual intercourse is common to women irrespective of sociodemographics and obstetric characteristics.

Lymphangiectasia is a secondary phenomenon that results from obstruction of previously normal lymphatic systems leading to dilation of the lymphatic vessels. Its occurrence in women is very rare. We report the clinical case of vulvar lymphangiectasia observed in a patient seen in gynecological consultation. The symptomatology was dominated by the appearance of vulvar swelling that had been evolving for 6 months and gradually increased in volume; the patient benefited from an exploration assessment which came back in favor of vulvar lymphangiectasia and was referred to a dermatological consultation for further treatment.

Endometrial cancer is one of the most common gynaecological tumours in the world. Its incidence is increasing, especially in industrialised countries. Treatment is mainly surgical but there are other alternatives. We report Retrospective study carried out in the Gynaecology and Obstetrics II Department of the Hassan II University Hospital, Fez, between January 2019 and August 2022 on 62 cases of endometrial cancer looking for concording between clinical, investigation, histology, classification FIGO, and grade after surgy.