Background: Missed abortion is a common complication (1-5% of pregnancies) involving the retention of a non-viable embryo or fetus within utero. Diagnosis relies on ultrasound, revealing halted development and absent fetal heartbeat. If untreated it poses emotional distress and infection risk. Treatment options are surgical evacuation or medical management with abortifacients. Vaginal misoprostol is preferred for higher efficacy and quicker results, while oral misoprostol is more convenient but slightly less effective with longer treatment times. Both the rotes offer non-invasive alternatives to surgery, in management option of missed abortion. Objective: To compare the effectiveness of vaginal misoprostol over oral misoprostol in the medical management of missed abortion during the first trimester of pregnancy. Methods: The randomized controlled trial (RCT) was carried in the Department of Obstetrics and Gynecology, Institute of Child and Mother Health (ICMH), Matuail, Dhaka. The sampling method was random selection according to the availability of the patients. Data were collected from women aged 18-35 years. Patients diagnosed with missed abortion through ultrasonography (USG) and received medical management with vaginal misoprostol were considered as group I (n=36), while those received oral misoprostol comprised as group II (n=36). The outcome of termination of pregnancy in between group I and II were measured. The descriptive and inferential analysis was carried out using SPSSv26. p-value < 0.05 was considered as statistically significant. Results: This study found that vaginal misoprostol was significantly more effective than oral misoprostol, with a success rate of 80.6% compared to 55.6% (p=0.042). Vaginal misoprostol also required fewer doses and shorter induction-expulsion times (p=0.028, p=0.004). Surgical intervention was needed less frequently in the vaginal group (19.4% vs. 44.4%, p=0.042). Adverse effects differed, with more nausea/vomiting and fever in the oral group and more severe cramps and diarrhea in the vaginal group. Hemoglobin levels decreased similarly in both groups. The duration of bleeding favored vaginal misoprostol, but patient satisfaction significantly favored it as well (75.0% vs. 44.5%, p=0.029). Conclusion: Vaginal misoprostol is more effective than oral misoprostol in the medical management of missed abortion during the first trimester of pregnancy.

Background: Niger remains one of the countries with the highest maternal mortality burden worldwide. Approximately one in 23 women is at risk of dying from complications related to pregnancy, childbirth, or the postpartum period. Despite the implementation of the Millennium Development Goals (MDGs), the Sustainable Development Goals (SDGs), and substantial investments in maternal health over the past 15 years, progress has remained modest. The maternal mortality ratio declined from 700 deaths per 100,000 live births in 2005 to 553 in 2015 and 509 in 2017. Methods: We conducted a retrospective descriptive and analytical study at Issaka Gazoby Maternity Hospital, a tertiary referral maternity hospital in Niamey, Niger. The study covered a 12-month period from 1 January to 31 December 2025 and included all maternal deaths that met the World Health Organization (WHO) definition of maternal death. Results: During the study period, 8,002 live births and 175 maternal deaths were recorded, corresponding to a maternal mortality ratio of 2,186.9 per 100,000 live births. Maternal mortality was significantly associated with hypertensive disorders of pregnancy, grand multiparity, and lack of formal education. Direct obstetric complications accounted for most maternal deaths, with eclampsia/severe pre-eclampsia being the leading cause. Conclusion: Maternal mortality in this tertiary referral hospital remains unacceptably high and is driven by the combined effects of socioeconomic, health system, cultural, and biological factors. Strengthening antenatal care, improving timely referral systems, and ensuring rapid management of obstetric emergencies are essential to reduce preventable maternal deaths in Niger and other low-resource settings.

Background: Carcinoma of the cervix remains a leading cause of cancer-related morbidity and mortality among women in developing countries, where organized screening coverage is limited and most patients present only after the disease becomes symptomatic. Objective: To describe the pattern of clinical presentation, disease stage and clinical findings among women with histologically confirmed carcinoma cervix attending a tertiary-level teaching hospital in Bangladesh. Methods: This cross-sectional, prospective study was conducted in the Department of Obstetrics and Gynaecology, Rangpur Medical College Hospital, over one year. Fifty consecutive patients diagnosed with carcinoma cervix who fulfilled the inclusion criteria were enrolled after informed consent and data on presenting symptoms, clinical stage, general and local examination findings and imaging correlates were recorded on a structured questionnaire and analyzed as frequencies and percentages. Results: Most patients (60%) were 41-50 years old. Blood-stained per-vaginal discharge (94%), foul-smelling discharge (50%) and post-coital bleeding (50%) were the commonest complaints. Forty-eight patients (96%) presented in stage IIB or beyond. Nearly all patients (100%) were anaemic, 80% had a cauliflower-like cervical growth and 92% had squamous cell carcinoma on histopathology. Ultrasonography showed cervical growth in 52%, hydronephrosis in 44% and pelvic lymphadenopathy in 22% of patients. Conclusion: Carcinoma cervix in this tertiary-hospital population presents predominantly with abnormal vaginal bleeding and discharge at an advanced clinical stage, underscoring the continued need for symptom awareness and organized early-detection services.