Background: Gestational weight gain (GWG) is a key determinant of maternal and fetal outcomes, particularly in pregnancies complicated by diabetes. Both excessive and inadequate GWG have been associated with adverse outcomes, yet data on the impact of GWG in diabetic mothers in Bangladesh remain limited. This study aimed to evaluate the association between GWG and maternal and fetal complications in women with gestational diabetes mellitus (GDM) and pregestational diabetes mellitus (PGDM). Methods: A cross-sectional analytical study was conducted at the Department of Obstetrics and Gynecology, BIRDEM General Hospital, Dhaka, from August 2022 to June 2024. A total of 102 pregnant women at ≥37 weeks of gestation, including 51 with GDM and 51 with PGDM, were enrolled. Participants were categorized into excessive, normal, and inadequate GWG groups. Maternal and fetal complications, as well as mode of delivery, were analyzed using appropriate statistical tests. Results: Among GDM patients, 49.02% had normal GWG, 31.37% excessive, and 19.61% inadequate. Cesarean section was significantly higher in the excessive GWG group (93.7%) compared to normal (40.0%) and inadequate (60.0%) GWG groups (p=0.006). Maternal complications were more frequent in PGDM than GDM across all GWG categories but without statistical significance. Fetal complications were significantly higher in PGDM mothers with normal GWG (57.9% vs. 28.0%, p=0.046), while other GWG groups showed no significant differences. Type-specific fetal complications in inadequate GWG were not statistically different between GDM and PGDM. Conclusion: Both excessive and inadequate GWG in diabetic pregnancies are associated with increased maternal and fetal complications, with PGDM mothers at higher risk. Appropriate monitoring and management of GWG is crucial to optimize perinatal outcomes.

Menstrual irregularities are common among subfertile women and often reflect underlying endocrine dysfunctions. Thyroid hormones and prolactin play key roles in the regulation of menstruation, and abnormalities in their levels may disrupt ovulation and fertility. This study aimed to investigate the association between thyroid dysfunction and hyperprolactinemia with menstrual irregularities in subfertile women attending a tertiary care hospital. Methods: A case–control study was conducted at BIRDEM General Hospital, Dhaka, from January 2022 to March 2024. A total of 100 women were enrolled in the study: 50 with primary subfertility (cases) and 50 fertile women (controls). Menstrual history and clinical features were also recorded. Serum TSH, FT3, FT4, and prolactin levels were measured using a chemiluminescent magnetic microparticle assay. Anovulation was assessed using mid-cycle ultrasonography. Data were analyzed using SPSS version 27.0. Results: Acyclical menstruation (42.0% vs. 28.0%) and oligomenorrhea (26.0% vs. 14.0%) were more frequent in the cases than in the controls. Anovulation was significantly more common in subfertile women than in fertile women (24.0% vs. 8.0%, p=0.029). Biochemical analysis revealed higher TSH (4.92 ± 5.35 vs. 3.83 ± 6.04 µIU/mL, p=0.041) and prolactin levels (38.09 ± 29.3 vs. 22.27 ± 12.6 ng/mL, p=0.005), and lower FT4 (5.45 ± 3.44 vs. 16.92 ± 3.28 pmol/L, p=0.032) in cases. Galactorrhoea was also more frequent among subfertile women, though not statistically significant. Conclusion: Thyroid dysfunction and hyperprolactinemia are strongly associated with menstrual irregularities in subfertile women. Routine hormonal screening may enable early diagnosis and treatment, thereby improving reproductive outcomes of patients.

Background: Despite evidence supporting the use of MCA/UA Doppler ratios in detecting fetal compromise, most studies have focused on high-risk pregnancies or specific populations, with limited data from broader clinical settings, particularly in Bangladesh; therefore, the purpose of the study was to evaluate the diagnostic accuracy of the Middle Cerebral Artery to Umbilical Artery Resistance Index Ratio in predicting adverse perinatal outcomes. Aim of the study: The aim of the study was to evaluate the diagnostic accuracy of the Middle Cerebral Artery to Umbilical Artery Resistance Index Ratio in predicting adverse perinatal outcomes. Methods: A prospective cohort study of 106 pregnant women at 29–38 weeks gestation was conducted at the Department of Obstetrics and Gynecology, BIRDEM General Hospital, Dhaka (Nov 2022–Feb 2024). Maternal and fetal outcomes were recorded, C/U ratio was assessed, participants were grouped by a 1.01 cut-off, and data were analyzed using SPSS v26.0 (p < 0.05). Results: The C/U ratio predicted adverse perinatal outcomes with an ROC AUC of 0.827 (95% CI: 0.749–0.905; p < 0.0001). At a cut-off of 1.01, sensitivity was 77.8%, specificity 84.6%, PPV 46.2%, NPV 95.7%, and accuracy 83.6%. Low C/U (<1.01) was associated with higher rates of complicated outcomes (84.0% vs 21.4%), 5-min APGAR <7 (68.0% vs 19.6%), NICU admission (74.0% vs 21.4%), respiratory distress (60.0% vs 12.5%), and FGR (18.0% vs 0.0%) compared to C/U ≥1.01 (P <0.05). Conclusion: A C/U ratio below 1.01 reliably predicts adverse perinatal outcomes, supporting its use for early identification of at-risk fetuses.

Background: Management of mid-trimester missed abortion in women with a scarred uterus poses unique challenges. Both pharmacological and mechanical methods are used. Misoprostol is widely used for second-trimester termination, while Foley’s catheter aids cervical ripening through prostaglandin and oxytocin release. The combination of mifepristone and misoprostol has been shown to reduce the induction-to-abortion interval compared to Foley’s catheter alone. This study aimed to compare the maternal safety, effectiveness, and side-effect profile of these two methods in women with mid-trimester missed abortion and a scarred uterus. Methods: This comparative observational study was conducted in the Department of Obstetrics & Gynaecology, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh, including 80 women with missed abortion and prior cesarean section. Participants were divided into two groups: Group A (n = 40) received combined mifepristone and misoprostol, and Group B (n = 40) received Foley’s catheter alone. Results: The mean age was comparable between groups (27.0 ± 4.1 vs. 27.2 ± 4.0 years). Mean gestational age was significantly lower in Group A (16.2 ± 2.6 weeks) than Group B (23.1 ± 2.0 weeks). Success rates were high in both groups (97.5% vs. 95.0%, p=0.558). The mean induction–expulsion interval was significantly shorter in Group A (10.1 ± 2.1 hours) compared to Group B (18.5 ± 2.9 hours, p<0.0001). Surgical interventions were rarely required, with manual vacuum aspiration being the only method used. Side effects differed between groups: Group A experienced nausea/vomiting (50.0%) and fever (19.4%), while Group B reported psychological upset (8.3%) and mild pain (19.4%). Conclusion: Mifepristone with misoprostol was more effective in reducing induction–expulsion time compared to Foley’s catheter, with different but tolerable side effect profiles in both groups.

Background: Fetal movement is an early sign of life and indicates well-being. Reduced fetal movement is common in pregnant women, affecting perinatal outcomes and increasing risks of stillbirth, growth restriction, distress, and preterm birth. The biophysical profile (BPP) assesses fetal well-being in the last trimester. This study evaluated the association between BPP scores, delivery mode, and neonatal outcomes in women with reduced fetal movement at term. Methods: This analytical cross-sectional study was conducted at the Department of Obstetrics and Gynaecology, Dhaka Medical College and Hospital, Bangladesh, from August 2019 to July 2020. One hundred women at ≥37 weeks of gestation with reduced fetal movement were enrolled and divided into normal (≥8/10) and abnormal (≤6/10) BPP groups. Maternal demographics, mode of delivery, and perinatal outcomes were recorded. Data were analyzed using SPSS version 20.0. Results: Caesarean section rates were significantly higher among women with abnormal BPP (80.95%) compared to those with normal scores (46.55%) (p=0.002). Vaginal deliveries predominated in the normal group. Perinatal outcomes were generally favorable, but neonatal death and stillbirth occurred more frequently in the abnormal BPP group (7.14%) compared to the normal group (1.72%), though this difference was not statistically significant. Conclusion: Abnormal BPP scores correlated with higher caesarean rates and adverse outcomes. However, no significant difference in mortality was observed. Findings suggest BPP helps identify at-risk fetuses, but delivery decisions should combine test results and clinical judgment to balance intervention with outcomes.

Background: Polycystic ovary syndrome (PCOS) is a leading cause of anovulatory subfertility. While letrozole is widely used for ovulation induction, treatment response varies and predictors beyond anti-Müllerian hormone (AMH) require further evaluation. This study aimed to investigate the association of demographic and clinical factors with ovarian response in subfertile PCOS patients treated with letrozole. Methods: A cross-sectional analytical study was conducted at the Center for Assisted Reproduction, BIRDEM-II Hospital, Dhaka, from April 2022 to September 2023. A total of 116 women with PCOS, aged 18–35 years, underwent letrozole induction (5 mg/day). Participants were categorized as responders (dominant follicle ≥16 mm, n=58) and non-responders (<16 mm, n=58). Demographic variables, BMI, type of subfertility, and baseline serum FSH and LH were compared between groups. Statistical analyses were performed using SPSS v26, with p<0.05 considered significant. Results: No significant associations were found between ovarian response and age (p=0.743), education (p=0.121), occupation (p=0.356), or income (p=0.576). BMI distributions did not differ significantly (p=0.331), nor did the type of subfertility (p=0.550). Serum FSH was significantly higher among non-responders (9.28±5.6 vs. 7.19±3.64, p<0.001), while serum LH showed no significant difference (p=0.102). Conclusion: Demographic and socioeconomic factors did not influence the ovarian response in patients with PCOS treated with letrozole. Elevated basal FSH levels were associated with poor responsiveness, indicating its role as a predictor. These findings support FSH assessment in individualized treatment planning for women with PCOS.

Background: Eclampsia remains a significant contributor to maternal and perinatal morbidity and mortality in developing countries. This study aimed to evaluate the maternal and fetal outcomes of eclampsia patients admitted to Dinajpur Medical College Hospital. Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology at Dinajpur Medical College Hospital, Dinajpur, Bangladesh, from July 2008 to December 2008. In this study, we included 52 patients who were admitted with eclampsia at Dinajpur Medical College Hospital during the specified study period. Results: Most patients were aged 21–25 years (48.1%), primigravida (65.4%). Nearly half (48.1%) delivered between 33–37 weeks of gestation. Most of the patients had the antepartum eclampsia (55.8%), followed by postpartum (25.0%) and intrapartum (19.2%) eclampsia. Regarding morbidity, 44.2% experienced complications, most commonly wound infection (15.4%) and raised blood pressure (15.4%). Maternal mortality was 5.8%, with stroke (66.7%) and pulmonary edema (33.3%) as the leading causes. Among 54 neonates, 88.9% were live births and 11.1% stillbirths. Of the 26 neonates referred for pediatric evaluation, prematurity (46.2%) and birth asphyxia (34.6%) were the predominant causes. Early neonatal death occurred in 23.1% of referred cases, mainly due to birth asphyxia (50%) and prematurity (33.3%). Overall, 77.8% of neonates were discharged healthy, while perinatal death accounted for 22.2%. Conclusion: Eclampsia remains a significant cause of maternal and perinatal complications. Maternal morbidity was common, though mortality was relatively low, while perinatal death and neonatal morbidity were substantial, largely due to birth asphyxia and prematurity.