Uterine arteriovenous malformation (UVM) is a very rare abnormality resulting from anomalous arterio-venous connections in the uterus. Although rare, it causes potential life-threatening vaginal bleeding postpartum or following uterine curettage or abortions. Only a few cases have been reported in literature (less than 100). However, the incidence is assumed to be increasing due to increased availability of ultrasound scan and colour doppler studies for better detection. We present a case of a 39-year-old Para 3 woman with three previous caesarean sections (CS) who presented to our facility with vaginal bleeding associated tiredness, heart racing, lightheadedness of four days duration following surgical evacuation for missed abortion at nine weeks gestation.

Background: Diabetes during pregnancy, including gestational diabetes mellitus (GDM) and pre-gestational diabetes mellitus (PGDM), is associated with increased maternal morbidity. While both conditions pose risks, comparative data on maternal complications remain limited. This study compares maternal complications among non-diabetic pregnant women, those with GDM, and those with PGDM to identify differences in complication rates and inform risk-specific clinical care. Methods: This prospective cross-sectional observational study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU) and BIRDEM Hospital, Dhaka, Bangladesh, from January 2004 to December 2005. A total of 150 pregnant women were enrolled and divided into three equal groups: Group A (non-diabetic), Group B (pregestational diabetes mellitus, PGDM), and Group C (gestational diabetes mellitus, GDM). Data were collected through questionnaires, clinical assessments, and medical records. Maternal complications during pregnancy, labor, and postpartum were recorded. Statistical analysis used SPSS, employing Chi-square and t-tests; p-values less than 0.05 were considered significant. Results: Maternal complications were significantly higher in diabetic groups (66% in GDM, 68% in PGDM) compared to non-diabetics (28%). Cesarean delivery was more frequent in PGDM (60%) and GDM (52%) than in non-diabetics (20%). Postpartum complications, particularly wound infection and endometritis, were more prevalent in the PGDM group. Intra-partum interventions, such as instrumental and operative deliveries, were also higher among diabetic pregnancies. Conclusion: Both GDM and PGDM significantly increase maternal complication rates, with PGDM posing a higher risk. Early screening, strict glycemic control, and multidisciplinary management are essential for improving maternal outcomes.

Introduction: One key aspect of fetal assessment is the measurement of amniotic fluid volume (AFV) which has been linked to various pregnancy complications. Postdated pregnancies those extending beyond 40 weeks of gestation present significant risks such as fetal distress, oligohydramnios, meconium staining, macrosomia and fetal post-maturity syndrome. Management of these pregnancies varies with some advocating expectant monitoring while others recommend induction of labor to mitigate risks. Ultrasound assessments like the amniotic fluid index (AFI) are crucial in guiding decisions about timing and mode of delivery, balancing the risks of prolonged pregnancy with those of premature birth. The aim of this study was to evaluate the AFI in postdated pregnancies and assess the associated maternal and fetal outcomes at Pravara Rural Hospital (PRH), Loni. Materials and Methods: This descriptive cross-sectional study was conducted at PRH, Loni with a sample size of 220 postdated pregnant women over two years. The inclusion criteria were women aged 18-35 years with a single live intrauterine gestation, cephalic presentation, and gestational age >40 weeks, who provided informed consent. The women underwent history-taking, obstetric examination and investigations including ultrasound and fetal Doppler. Delivery outcomes, including Apgar scores, birth weight, NICU admissions, and perinatal follow-up were recorded. Results: Among 220 participants, 92.72% were under 20 years old, with a mean age of 19.49 ± 1.44 years. Meconium-stained liquor occurred in 55.91% of cases. Most deliveries were vaginal (79.55%), followed by LSCS (16.36%). The mean birth weight was 3.03 ± 0.37 kg with 50.45% of infants having an Apgar <7. Maternal complications included atonic PPH (2.73%) and perineal tear (2.27%). Fetal complications included meconium aspiration syndrome (4.09%) and perinatal mortality (4.09%). Conclusion: Postdated pregnancies carry significant risks. Early assessment and

The impact of endometrial thickness on pregnancy rates in women undergoing IVF with donor oocytes has significant implications for public health. Successful implantation during in vitro fertilization (IVF) is crucially dependent on both a healthy endometrium and a viable blastocyst. The measurement of endometrial thickness (EMT) via ultrasound scan has emerged as a non-invasive means to evaluate endometrial receptivity. Nonetheless, its significance in clinical practice for women using donor oocytes remains unclear. This study aims to examine how endometrial thickness influences pregnancy outcomes in women undergoing IVF with donor oocytes in Makurdi, with the goal of providing valuable insights for public health action. We conducted a cross-sectional study involving 265 women who underwent IVF and embryo transfer using donor oocytes. Participants were divided into three groups based on their EMT: Group 1 (EMT < 7 mm), Group 2 (EMT between 7 - 14 mm), and Group 3 (EMT > 14 mm). Key demographic and clinical data—including age, height, weight, number of oocytes transferred, and pregnancy rates—were gathered and analyzed using SPSS version 25.0. Statistical methods included Student’s t-test for continuous variables, Pearson’s Chi-square (χ²) test for categorical data, logistic regression to control for confounding factors, and Receiver Operating Characteristic (ROC) curve analysis to evaluate the predictive value of EMT. The average age of participants was 42.4 years, with chemical and clinical pregnancy rates recorded at 75.5% and 53.6%, respectively. Notable findings include a significant association between age and clinical pregnancy rates (p = 0.008). While other factors such as parity, BMI, previous IVF cycles, hormone treatments, and embryo grading did not show a significant relationship with pregnancy outcomes but endometrial thickness demonstrated a significant correlation (p = 0.000). Specifically, pregnancy rates were lower for women with EMT < 7.0 mm (37.3%) compared to those with EMT between 7 - 14 mm (49.0%) and > 14 mm (51.7%). Logistic regression confirmed that age-adjusted EMT significantly impacts pregnancy outcomes. ROC curve analysis revealed an area under the curve (AUC) of 0.63, with an EMT cut-off value of 8.0 mm providing a sensitivity of 75.4% and a specificity of 48.8%. These findings highlight the significant influence of endometrial thickness on clinical pregnancy rates in IVF cycles using donor oocytes. While increased EMT correlates with improved outcomes, its overall predictive accuracy is limited. The results advocate for personalized approaches in IVF treatment protocols, emphasizing informed decision-making among healthcare providers and patients. Recognizing the importance of endometrial thickness in reproductive health can inform public health initiatives aimed at enhancing awareness of IVF practices among potential candidates, tailoring IVF treatments based on individual patient profiles, and promoting research into factors affecting endometrial receptivity. Ultimately, these efforts can lead to improved pregnancy rates and reproductive success in assisted reproductive technologies.

Introduction: Prenatal consultation is a preventive medical act used to detect and treat possible complications arising during pregnancy. The aim of our study was to evaluate the quality of prenatal consultations in a rural community health center. To do this, we assessed the quality of services, determined prenatal consultation procedures and determined the degree of satisfaction of pregnant women who come to this community health center for prenatal consultations. Methodology: This was a prospective, descriptive study in 2022, involving 98 pregnant women systematically surveyed from October 1 to December 31, 2022, to assess the quality of care and services. All pregnant women who came to the Sido Community Health Center for a prenatal consultation during the study period and who agreed to take part in the study were included in the study. Pregnant women who refused to comply with the recruitment conditions, and those who came for reasons other than a prenatal consultation, were not included in the study. Results: At the end of our study, we found that the majority of our pregnant women were aged between 20-29 years, i.e. 56.8%, with an average age of 23.23 years. Antenatal consultation activities were carried out by midwives in 50% of cases, obstetric nurses in 19.4% of cases and matrons (unqualified personnel) in 36.6% of cases. Hand washing before examining a new gestational carrier was 18.36%, and gestational carrier satisfaction was 94.9%. Conclusion: There are certain areas for improvement, such as the omission of certain procedures, either through ignorance of their importance, or through negligence and inadequate technical facilities, in this case the absence of an ultrasound scanner in the health area.

Background: Endometriosis is a chronic inflammatory condition affecting women of reproductive age, with a notably higher prevalence in those experiencing infertility. Given this association, the study aimed to assess how socio-demographic and clinical factors relate to the severity of endometriosis based on laparoscopic findings in infertile women. Aim of the study: The aim of the study was to evaluate the association between socio-demographic and clinical factors with the severity of endometriosis based on laparoscopic evaluation in infertile women. Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology at CARE, BIRDEM General Hospital, Dhaka (July 2013-June 2015) involving 127 infertile women. Data were collected regarding sociodemographic characteristics and clinical factors using a structured data collection sheet. BMI was calculated from weight and height and included in the data collection sheet. Laparoscopic diagnosis and staging used the Revised American Fertility Society criteria. Data analysis employed SPSS 20 (descriptive statistics, t-tests, chi-square tests). Results: In a study of 127 infertile women, Stage I endometriosis was most common, with Stage IV less frequent. Older age was linked to Stage I (p=0.016), and upper-class women had a higher prevalence (p=0.003). Lower BMI was associated with Stage IV (p=0.043). Severe stages, especially Stage IV, were significantly linked to dysmenorrhoea, menorrhagia, dyspareunia, and chronic pelvic pain. Conclusion: Socioeconomic background, age, BMI, and symptom profiles may serve as valuable indicators of endometriosis severity in infertile women undergoing laparoscopic evaluation.

Background: Abnormal uterine bleeding in peri- and postmenopausal women often raises concern for underlying pathology such as endometrial hyperplasia or carcinoma. This study aimed to evaluate the correlation between endometrial thickness on transvaginal ultrasonography and histopathological findings in postmenopausal bleeding. Aim of the study: The aim of the study was to evaluate the correlation between endometrial thickness on transvaginal ultrasonography and histopathological findings in postmenopausal bleeding, identifying predictive relationships for clinical assessment. Methods: This cross-sectional study was conducted at the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh, from June 2022 to May 2023, including 65 postmenopausal women with vaginal bleeding. Transvaginal ultrasonography (TVS) was performed to measure endometrial thickness, followed by fractional curettage for histopathological analysis at the Department of Pathology, DMC. Data were analyzed using SPSS version 26, and patients were categorized by endometrial thickness (≤5 mm or >5 mm), with statistical significance set at p < 0.05. Results: Among 65 postmenopausal bleeding patients, 58.5% had endometrial thickness >5 mm (mean 9.1 ± 6.1 mm). Histopathology showed 70.8% had abnormal findings, mainly endometrial hyperplasia (47.8%). A significant association (p = 0.001) was found between endometrial thickness and pathology, with >5 mm thickness linked to hyperplasia, carcinoma, and polyp, and ≤5 mm thickness linked to atrophy. Conclusion: Endometrial thickness on transvaginal ultrasonography is a significant predictor of endometrial pathology in postmenopausal bleeding, aiding in clinical assessment.

Occipital encephalocele, a rare congenital malformation resulting from defective neural tube closure, accounts for 20.4% of cerebral encephaloceles, with surgical repair being the only effective treatment. This retrospective study presents four cases diagnosed at Mohammed VI University Hospital in Marrakech, highlighting prognostic variability based on lesion characteristics. The four patients, who had not received periconceptional folic acid supplementation and had inadequate prenatal follow-up, were incidentally diagnosed between 34 and 39 weeks of gestation. The first case involved an isolated encephalocele containing only cerebellar herniation, surgically treated on day 5 with a favorable outcome despite mild neurodevelopmental delay. The second case presented a massive encephalocele associated with spina bifida and clubfoot, requiring combined neurosurgical and orthopedic management, resulting in moderate sensorimotor deficits. The third case exhibited a giant encephalocele with severe cerebral herniation and secondary microcephaly, while the fourth case showed associated craniofacial anomalies; both of these latter cases resulted in early neonatal demise. This study underscores several key aspects: the importance of ultrasound as an initial screening tool, supplemented by fetal MRI for precise prognostic evaluation; the critical need for early multidisciplinary management involving obstetricians, radiologists, neurosurgeons, and pediatricians; and the essential role of periconceptional folic acid supplementation, particularly in populations at risk of nutritional deficiency or consanguinity.

Background: Preterm labor remains a leading cause of neonatal morbidity and mortality worldwide. Emerging evidence suggests that maternal iron status, particularly elevated serum ferritin levels, may be associated with preterm labor through mechanisms involving inflammation or oxidative stress. Methods: This case-control study was conducted at the Department of Obstetrics & Gynaecology, Dhaka Medical College Hospital, from June 2022 to May 2023. A total of 88 pregnant women were enrolled, with 44 cases in the preterm labor group and 44 in the term labor (control) group. Maternal serum ferritin levels were measured and compared between the two groups. Sociodemographic and obstetric data were also analyzed. Statistical significance was determined using appropriate tests, with a p-value < 0.05 considered significant. Results: The mean maternal age was 25.59 ± 5.80 years in the preterm labor group and 24.56 ± 5.41 years in the term group (p = 0.076). A higher proportion of preterm labor cases were multiparous (59.1%), whereas most term deliveries were in primiparous women (52.3%), though this was not statistically significant (p = 0.285). Serum ferritin levels were significantly elevated in the preterm labor group (89.09 ± 106.07 ng/mL) compared to the term group (32.13 ± 31.40 ng/mL), with a p-value of 0.004. A significant negative correlation was found between ferritin levels and gestational age (r = -0.313, p < 0.05). Conclusion: Elevated maternal serum ferritin levels are significantly associated with preterm labor and inversely correlated with gestational age. Serum ferritin may serve as a potential biomarker for identifying women at risk of preterm delivery.