Background: Rectovaginal fistulas (RVFs) are abnormal, epithelialized communications between the posterior vaginal wall and the anterior rectal wall, most commonly resulting from obstetric trauma. They can lead to significant physical and psychological morbidity. Objective: To describe the clinical presentation, management strategies, outcomes, and preventive measures in patients with obstetric RVFs treated at HMA Hospital, Marrakech. Methods: A retrospective study of 10 patients with obstetric RVFs managed over a one-year period (November 2023 – November 2024). Data collected included patient demographics, obstetric history, clinical features, diagnostic findings, surgical techniques, and postoperative outcomes. All patients underwent transperineal repair using Musset’s technique, with colostomy performed when indicated. Results: Obstetric RVFs accounted for 66.6% of all RVFs operated on in the department. Mean patient age was 29 years; six patients were primiparous. Deliveries occurred at home (3), in maternity centers (3), and hospitals (4). Surgical repair was performed in all patients using Musset’s technique; nine patients received a left iliac colostomy. Postoperative recovery was uneventful in nine patients. One recurrence occurred in a patient who initially refused colostomy; she was successfully reoperated. Conclusion: Obstetric RVFs predominantly affect the lower two-thirds of the vagina. Surgical repair is highly effective, preventing major complications and facilitating patient reintegration. Prevention through patient education, prenatal care, and improved obstetric services remains essential.

Background: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder in women that affects both reproductive and metabolic systems and is characterized by insulin resistance and other metabolic disturbances. Therefore, the purpose of the study is to evaluate the clinical and metabolic characteristics of Polycystic Ovary Syndrome (PCOS) patients, focusing on anthropometry, hirsutism, and insulin resistance. Aim of the study: The aim of the study was to evaluate the clinical and metabolic characteristics of Polycystic Ovary Syndrome (PCOS) patients, focusing on anthropometry, hirsutism, and insulin resistance. Methods: This comparative cross-sectional study at the Department of Obstetrics and Gynecology, ICMH, Dhaka (Oct 2022–Sep 2023) included 66 women aged 18–35 years with PCOS (Rotterdam criteria), grouped by ovarian volume (>10 cc vs ≤10 cc). Anthropometric, clinical, and metabolic parameters—including BMI, waist-to-hip ratio, Ferriman–Gallwey score, fasting glucose, insulin, and HOMA-IR—were assessed. Data were analyzed using SPSS 27, with p < 0.05 considered significant. Results: Among 66 PCOS patients, Group A showed higher BMI (27.49 vs. 26.07 kg/m²) and HOMA-IR (4.83 vs. 3.59; p = 0.012). A strong correlation was found between HOMA-IR and ovarian volume (r = 0.685, p < 0.001). High insulin resistance (≥3.8) was more frequent in Group A (67.6% vs. 21.9%), conferring 7.5-fold higher odds of enlarged ovarian volume (OR = 7.47, 95% CI = 2.48–22.52). Conclusion: PCOS in women is closely associated with overweight, hirsutism, and insulin resistance, which in turn correlates with increased ovarian volume.

Background: Preeclampsia remains a major cause of maternal and perinatal morbidity, particularly in low-resource settings. While biological mechanisms are well documented, less attention has been paid to demographic and obstetric determinants. Understanding these factors is critical for early risk assessment and prevention. This study aimed to compare sociodemographic and obstetric characteristics between preeclamptic and normotensive pregnant women attending a tertiary care hospital in Dhaka, Bangladesh. Methods: A case-control study was conducted at Sir Salimullah Medical College Mitford Hospital from February 2022 to January 2023. One hundred pregnant women were included—50 with preeclampsia and 50 normotensive controls. Data on age, BMI, socioeconomic class, gravidity, gestational age, and family or past medical history of diabetes, hypertension, or preeclampsia were collected using a structured questionnaire. Statistical analyses were performed using SPSS version 24. Independent t-tests and chi-square tests were applied, with significance set at p<0.05. Results: Mean age and BMI did not differ significantly between preeclamptic and normotensive groups (p>0.05). Most preeclamptic women belonged to lower socioeconomic classes (44%) and were primigravida (68%), though these differences were not statistically significant. Family histories of hypertension, diabetes, or preeclampsia showed no association with disease occurrence. Gestational age was comparable across groups. Conclusion: Sociodemographic and obstetric parameters, though more adverse among preeclamptic women, did not show statistically significant differences in this cohort. Nevertheless, the predominance of low socioeconomic status and primigravidity among cases underscores the need for focused antenatal surveillance and health education in vulnerable populations.

Background: Pre-eclampsia is a hypertensive disorder of pregnancy associated with significant maternal and fetal morbidity. Identifying socio-demographic, obstetric, and biochemical risk factors is crucial for early detection and management. Objective: This study aimed to assess the socio-demographic profile and risk factors associated with pre-eclampsia at a tertiary care center in Bangladesh. Methods: This case-control study was conducted in the Department of Obstetrics and Gynecology, Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh, from March 2023 to February 2024. In this study, A total of 70 pregnant women with a gestational age of 20–40 weeks, attending the Department of Obstetrics & Gynecology, ICMH, Dhaka, during the study period, were included in this study. Among them, 35 women diagnosed with pre-eclampsia were assigned as cases, and 35 normotensive pregnant women were taken as controls. Results: Most participants were aged 18–28 years, with no significant difference in mean age between cases (26.09 ± 5.39 years) and controls (24.94 ± 4.08 years; p = 0.321). Educational level and occupation were comparable between groups (p > 0.05). Mean parity, gravidity, and gestational age were also similar (p > 0.05). Serum CRP levels were significantly higher among cases (25.37 ± 14.70 mg/dL) than controls (4.22 ± 0.92 mg/dL; p < 0.001). Significant risk factors for pre-eclampsia included family history of hypertension (37.1% vs 14.3%; p = 0.030), obesity (BMI ≥ 27 kg/m², 45.7% vs 22.9%; p = 0.046), prior history of pre-eclampsia (17.1% vs 2.9%; p = 0.049), and elevated CRP (≥6 mg/dL, 80% vs 0%; p < 0.0001). Primigravidity showed borderline significance (57.1% vs 34.3%; p = 0.057). Conclusion: Elevated CRP, obesity, family history of hypertension, primigravidity, and prior pre-eclampsia are important risk factors for pre-eclampsia. Early identification of these factors may aid in risk stratification and timely intervention.

Background: Vitamin D deficiency is associated with cardiovascular dysregulation and increased blood pressure; however, evidence in pregnant women in South Asia remains limited. This study aimed to evaluate the correlation and regression between maternal serum vitamin D levels and blood pressure components during late pregnancy. Methods: A hospital-based case–control study was conducted at Sir Salimullah Medical College Mitford Hospital, Dhaka, from March 2019 to March 2020, involving 106 pregnant women (53 preeclamptic and 53 normotensive). Serum 25-hydroxyvitamin D [25(OH)D] levels were measured using a chemiluminescence immunoassay and categorized as deficient (≤20 ng/mL), insufficient (21–29 ng/mL), or sufficient (≥30 ng/mL). Blood pressure was recorded according to standard protocols. Correlation and linear regression analyses were performed using SPSS version 23.0, with significance set at p < 0.05. Results: Serum vitamin D levels were inversely correlated with both systolic (r = –0.449, p < 0.001) and diastolic (r = –0.449, p < 0.001) blood pressures. Regression analysis indicated that each 1 ng/mL rise in serum vitamin D corresponded to a decrease of 1.68 and 1.2 mmHg in systolic and diastolic pressure, respectively. Sun exposure duration and antenatal attendance were positively associated with vitamin D sufficiency. Conclusion: Maternal serum vitamin D concentration was inversely associated with systolic and diastolic blood pressures. Maintaining adequate vitamin D levels through sunlight exposure and supplementation may support cardiovascular stability during pregnancy.