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Introduction: Tubal ectopics if large, uncontrollably bleeding or severely damaged need radical surgery (salpingectomy), otherwise conservative surgery (salpingotomy, salpingostomy) is the way of operative management. Laparoscopic surgery usually done in case of haemodynamically stable condition. Objective: To explore the different ways of surgical management of ectopic pregnancy in a tertiary care hospital. Materials and methods: This cross sectional study was carried out in the Department of Obstetrics and Gynaecology, Shaheed Suhrawardy Hospital and Dhaka Medical College Hospital during August 2005 and June 2006. The study population consisted of 50 women with ectopic pregnancy. Selected women underwent meticulous history taking and physical examinations. Some investigations like ultrasonography, culdocentesis, urine for pregnancy tests were done. Patients were treated by either radical or conservative surgery. Results: All (100%) women had abdominal tenderness. Ectopic pregnancy was diagnosed by history, physical examination and culdocentesis (84%), ultrasonography (12%) and laparotomy (4%). Two (4%) women were treated by conservative surgery, while the rest by radical surgery; 40 (80%) underwent unilateral salpingectomy, 3 (6%) unilateral salpingectomy with contralateral tubectomy, 2 (4%) unilateral salpingo oophorectomy, 1 (2%) total abdominal hysterectomy and 2 (4%) resection of rudimentary horn. Conclusion: Most common diagnostic tools were by history, physical examination and culdocentesis and common management was unilateral salpingectomy. Bangladesh J Obstet Gynaecol, 2013; Vol. 28(1) : 21-25

Objectives: To find out the proportion and maternal outcome of placenta accreta.Materials and Methods: Total 10579 deliveries were served during January 2013 to 31st December 2013 in the Department of Obstetrics and Gynecology of Addin Women Medical College Hospital, Dhaka. All patients who needed postpartum or cesarean hysterectomy for postpartum hemorrhage and diagnosed as placenta accreta after postpartum hysterectomy were included for the study. Among them who were antentally diagnosed as placenta previa with having other risk factors of placenta accreta, were evaluated by Doppler Sonography. All these cases such as diagnosed, suspected or only had multiple risk factors of placenta accreta were managed by a team approach and proper counseling of the patient’s guardian about need of massive transfusion, hysterectomy, Intensive Care Unit (ICU) admission .Results: Among the total 10579 deliveries 22 cases were diagnosed as placenta accreta after postpartum hysterectomy. On histopathology 8 of these cases were placenta percreta, 7 cases were placenta increta and 7 cases were placenta accreta vera. Almost ninety one (90.90%) patient had placenta previa and 90.90% patient had past H/O one or two cesarean section. Placenta percreta cases were more common in patients with H/O two previous C/S or one C /S and dilatation & curettage (D&C). In all preoperatively diagnosed cases, Right lower paramedian incision was given and hysterectomy was done leaving the placenta in situ.Conclusion: Placenta accreta is associated with previous two or more cesarean deliveries, or multigravidae with past H/O repeated D&C or M/R or combined. History of of these operations are diagnosed as having anterior or central placenta previa.Bangladesh J Obstet Gynaecol, 2013; Vol. 28(2) : 71-75

The high serum uric acid concentration correlates with the degree of severity of the pregnancy induced hypertension (PIH) and perinatal outcome. In this context, maternal serum uric acid level is reported to be one of the prognostic factor for determination of perinatal outcome. Based on the existing data, the present prospective study was undertaken in the Department of Obstetrics and Gynaecology, BIRDEM Academy, from January to December, 2010. Out of 120 women, 60 suffering from PIH (severe preeclampsia and eclampsia) served as group I and 60 normotensive women at third trimester of pregnancy served as group II. This study showed that mean (±SD) serum uric acid was significantly elevated in group I PIH patients (7.21±1.81 mg/dl) compared to group II normotensive pregnancy (4.40±0.84 mg/dl). In group I PIH patients, 39 (86%) had adverse perinatal outcome (preterm, IUGR, stillbirth), and 6 (13.3%) term and healthy deliveries when serum uric acid level was >6 mg/dl. Current study showed that there was positive and statistically significant relationship between diastolic blood pressure and hyperuricaemia in group I PIH patients (r = +0.359, P

The incidence of preeclampsia is high in the developing countries. Since this condition is preventable if detected and treated at an early stage, it is essential to diagnose the disease at an early stage, and to institute proper medical care on time. The present study carried out in the Department of Obstetrics and Gynaecology, BIRDEM, and Dhaka Medical College Hospital during January 2009 and June 2010, was aimed to find out concentration of serum C reactive protein (CRP) in preeclamptic women. The study included 60 pregnant women; 30 normal (control) and 30 preeclamptic (case) pregnant women in their third trimester. Estimation of CRP was done by immunoprecipitation assay turbulometry method for both groups. The mean (±SD) age was 23.23±4.58 (control) and 23.90±3.20 (case) years (no significant difference). However, BMI, SBP and DBP were significantly (P0.8 mg/dl) in 5 (16.7%) and 28 (93.3) (P

Background: Preeclampsia is a multisystem disorder of unknown etiology characterized by development of hyperten­sion to the extent of 140/90 mm of Hg or more with proteinuria after the 20th gestational week in a previously normoten­sive and non protein uric women. According to the National High blood presure Working group (NHBPEP) and Ameri­can college of obstetricans and Gynecologiests (ACOG) hypertension in pregnancy is defined as a diastolic blood pressure of 90 mm Hg or higher after 20 weeks of gestation in a woman with previously normal blood pressure (NHBPEP, 2000; ACOG, 2002). If the disease is allowed to progress to the HELLP syndrome or eclampsia, maternal morbidity and mortality increases. The majority of perinatal losses are related to placental insufficiency, which causes intrauterine growth retardation, prematurity associated with preterm delivery, or abruptio placentae. Objectives: This study tried to explore the effect of serum C reactive protein concentration in preeclamptic women and its effect on pregnancy outcome.Methods: This case control study included 60 third trimester pregnant women (30 normotensive and 30 preeclamptic) who attended Department of Obstetrics and Gynaecology, BIRDEM and DMCH, during July 2009 and June 2010. Estimation of serum C reactive protein (CRP) concentrations was done by liquid phase immunoprecipitation assay and turbulometry at DMC.Results: Mean (±SD) age showed no significant difference between groups; however, BMI, SBP, DBP and CRP were significantly (PConclusion: CRP concentration was high in preeclamptics resulting in adverse pregnancy outcome.