Journal of The Society of Obstetricians and Gynaecologists of Pakistan

Comparison of Effect of Antenatal Dexamethasone Versus Betamethasone on Antepartum Cardiotocography

Ifra Shafique — 2026-04-17

Objective: To compare the outcome of antenatal dexamethasone versus betamethasone on antepartum cardiotocography in terms of mean number of accelerations and long-term variability at day 0, 2 and 4 following drug administration

Methodology: This single blind Randomized Controlled Trial was carried out at Department of Obstetrics & Gynecology, Holy Family Hospital, Rawalpindi from 13th July 2025 to 15th October 2025. The trial was registered with clinicaltrials.gov (NCT07078786). The study enrolled 110 patients with 55 in each group. In Group A, patients received a 24 mg intramuscular injection of dexamethasone, administered as two doses of 12 mg 24 hours apart. In diabetic patients, the total dose was administered in four equal divided doses 12 hours apart. In Group B, patients received a 24 mg intramuscular injection of betamethasone, administered as two doses of 12 mg 24 hours apart.

Results: Baseline characteristics were comparable between groups (all p>0.05). Acceleration counts were similar at baseline (p=0.881) but were significantly higher in the dexamethasone group at day 4 (p<0.001), with significant within-group decline from baseline in both groups (p<0.001). Fetal heart rate variability was significantly better with dexamethasone at day 2 (p=0.006) and day 4 (p=0.013).

Conclusion: Administration of both Dexamethasone and Betamethasone to mother causes transient decrease in both fetal heart rate accelerations and variability with greater effect seen in case of Betamethasone

Association between maternal height and mode of delivery among nulliparous pregnant women delivered at tertiary care hospital

Uzma Afreen — 2026-03-31

Objective: To observe the impact of maternal height upon mode of delivery among nulliparous women. Maternal and neonatal morbidities are secondary aims associated with this study.

Material and Methods: This study is prospective observational study which is carried out at Department of Obstetrics and Gynaecology, Combined Military Hospital, Rawalpindi, from 1^st January 2024 to 31^st December 2024. A total of 350 pregnant women, with age range 20 years to 30 years selected who were admitted with labor pain in between 38 weeks to 40 weeks of gestation. Mode of delivery with different height of patient was obtained. Data was analyzed by using SPSS version 23 and p value of <0.05 was considered statistically significant.

Results: The mean maternal age of patients is 25.06±5.07 years, with the majority (61.71%) having a height between 150–159 cm. , The percentage of normal vaginal delivery increases with increasing maternal height 51.3% (<150cm), 60.2% (150-159cm) and 74.7% (>159cm). The chi- square test indicates a statistically significant association between maternal height and the mode of delivery. The rate of caesarean section decreases with increasing maternal height, 38.5% (<150cm), 36.1% ( 150-159cm) and 23.2% (>159cm). Our study demonstrates the significant association between low maternal height (<150 cm) and increased likelihood of cesarean delivery (CD).

Conclusion:This study highlights the significant associations between maternal height and various delivery outcomes, emphasizing the need for further investigation into how these factors can influence clinical practices to improve maternal and neonatal health.

Evaluating the adequacy of tissue using manual vacuum aspiration (MVA) versus metal curettage method in endometrial sampling in abnormal uterine bleeding

qurat nauman — 2026-03-31

ABSTRACT

Objective: To compare the adequacy of endometrial tissue obtained through Manual Vacuum Aspiration (MVA) versus Metal Curettage Method in females with abnormal uterine bleeding.

Study design: Quasi-experimenta1 study

Study place and duration: Obstetrics & Gynecology Department, Sir Ganga Ram Hospital, Lahore from April to October 2024.

Methodology: All 160 patients, presenting with AUB were included and were divided into two groups. Group A was undergoing endometrial sampling using MVA, while Group B was using sharp metal curettage. Samples from both groups were sent for histopathology, and adequacy was recorded. All the data were analyzed in SPSS version 25.

Results: Total 160 patients, the mean age was 56.49 years, and the mean BMI was 28.39 kg/m². There were 68 cases of adequacy (46.9%) in Group A and 77 cases (53.1%) in Group B. There was a significant relationship of adequacy between study groups. (P<0.05).

Conclusion: The conclusion of the study that adequacy of endometrial sampling was significantly higher in the metal curettage group (Group B) compared to the MVA group (Group A). These findings suggest that metal curettage may be more effective in obtaining adequate samples for histopathological analysis.

Endoscopic evaluation of refractory gastrointestinal symptoms in pregnant patients unresponsive to conservative and medical therapy

Mugheera Hussain — 2026-03-31

Background: Gastrointestinal (GI) symptoms are common in pregnancy, but a subset of patients remains refractory to conservative and medical management. Evidence on the role and outcomes of endoscopy in such patients, particularly in Pakistan, remains limited.
Objective: To evaluate the diagnostic yield and clinical outcomes of endoscopy in pregnant patients with refractory gastrointestinal symptoms that persist despite conservative and medical treatment.
Methods: This prospective observational study was conducted at Combined Military Hospital (CMH), Kharian, Pakistan, from June to August 2025. Pregnant patients with persistent GI symptoms despite conservative and medical therapy were enrolled. Endoscopic procedures were performed under strict maternal-fetal safety protocols. Data on patient demographics, symptom profile, trimester, endoscopic findings, and post-procedure clinical outcomes were systematically collected. Associations between patient characteristics and endoscopic findings were analyzed using chi square test, while symptom improvement before and after endoscopy was assessed with McNemar’s test.
Results: A total of 40 patients were included, with a mean age of 28.4±4.6 years. The most common presenting symptoms were dyspepsia (55%) and nausea/vomiting (35%), while 20% had upper GI bleeding. Endoscopy revealed abnormalities in 29 patients, giving a diagnostic yield of 72.5%. Gastritis (27.5%) and reflux esophagitis (15%) were the most frequent findings, followed by duodenal ulcer (10%), esophageal varices (10%), and Mallory–Weiss tear (5%). Symptom improvement after endoscopy-guided management was significant (100% vs. 25%, p = 0.0001). No maternal or fetal complications were observed.
Conclusion: Endoscopy is a safe and effective diagnostic modality for selected pregnant patients with refractory GI symptoms, enabling timely management and improved clinical outcomes.

Comparison of Surgical Site Infections Using Absorbable and Non-Absorbable Sutures during Skin Closure in Patients Undergoing Caesarean Section

Hajra Bibi — 2026-03-31

Background: Cesarean section (CS) is the most frequently performed surgical procedure worldwide. Surgical site infections (SSIs) become a source of additional maternal morbidity after this surgery. Different surgical techniques and materials influence the risk of developing SSI. The existing body of literature does not prioritize one suture material over the other for skin closure during CS.

Aim: To determine the rates of SSIs between patients undergoing subcuticular skin closure during CS using absorbable (polyglactin) or non-absorbable (polypropylene) suture materials.

Methodology: This randomized clinical study was conducted in the Department of Obstetrics and Gynecology of Federal Government Polyclinic (FGPC) Hospital, Islamabad from 1^st April, 2025 to 30^th September, 2025. Two hundred and one eligible gravid females were randomized into groups of absorbable (A; n=100) and non-absorbable (B; n=101) skin closure groups. The randomization method employed was alternating suture material type every other day. Group A patients underwent skin closure using polyglactin 2-0 in a subcuticular running manner, whereas those of group B received subcuticular skin closure with polypropylene 2-0 suture. Subsequently, they were prospectively followed until the 10^th postoperative day for the development of SSIs and their signs (redness, pus discharge, and swelling).

Results: The mean age of the population was 28.32 ± 5.46 years, the median parity was 2, and the mean BMI was 24.26 ± 3.39kg/m². The rates of SSI were 7% in group A and 18.8% in group B (odds ratio [OR] 3.078, 95% confidence interval [CI] 1.232 - 7.694, p=0.013). The group A patients with SSIs showed erythema and swelling in 42.8%, compared to 78.9% (p=0.003) and 73.7% (p=0.006) in group B.

Conclusion: Patients with skin incision closure by absorbable suture had not only a low risk of SSI, but also a lower severity of wound infection. Hence, we recommend preferring the absorbable suture material over the non-absorbable for this purpose.

Keywords: SSI, Prolene^©, Vicryl^©, Cesarean section

Association of Vitamin D with Uterine Fibroid in Women of Reproductive Age

Shamila Ijaz — 2026-03-31

Objectives: The objective of the study was to determine the mean change in fibroid size after vitamin D supplementation in Vitamin D deficient women visiting a tertiary care hospital of Lahore.

Study Design: Quasi-experimental trial.

Settings: Department of Obstetrics and Gynaecology, Sir Ganga Ram hospital, Lahore.

Study Duration: one year from 18^th July 2022 to 17^th January 2023.

Materials & Methods: This was Quasi- experimental study done in Department of Obstetrics and Gynaecology, Sir Ganga Ram hospital, Lahore for a period of 6 months from 18^th July 2022 to 17^th January 2023. A total of 115 premenopausal women between 40 and 45 years of age having fibroids of less than 5 cm by ultrasound were checked for vitamin D levels. The women having vitamin D levels less than 20ng/ml were included. Vitamin D 200,000IU oral supplementation, once weekly was given till the vitamin D level reached 50ng/ml or above or for 12 weeks duration whichever was earlier. After 12 and 24 weeks all women had an ultrasound and difference in size and volume of the uterine fibroid was noted.

Results: The mean fibroid size at baseline and post-treatment was 34.23 Â± 9.66 mm and 27.18 Â± 9.39 mm respectively (p-value <0.0001). Mean change in fibroid size after vitamin D Supplementation in Vitamin D deficient women was 6.79 Â± 1.98 mm.

Conclusion: This study concluded that Serum vitamin D level inversely correlated with size of uterine fibroid and possibly supplementation of vitamin D reduces size of fibroid in vitamin deficient women.

Comparison of the Mean Duration of 3rd Stage of Labour between Intraumbilical and Intravenous Oxytocin

Anam Javed — 2026-04-18

Objective: To compare the mean duration of third stage of labour (TSL) between intraumbilical (IU) and intravenous (IV) oxytocin.

Methodology: This randomized controlled trial was conducted at the Department of Obstetrics and Gynecology, Sadiq Abbasi Hospital, Bahawalpur, Pakistan, from October 2024 to March 2025. One hundred women aged 18–40 years with term singleton pregnancies and spontaneous vaginal delivery were enrolled and randomly allocated to receive either IU (10 U in 10 mL saline) or IV oxytocin (20 U in 500 mL saline). Data were analyzed using SPSS version 26.0, with group comparisons performed using appropriate statistical tests, considering p<0.05 as significant.

Results: A total of 100 women were enrolled, with mean age of 27.6±4.4 years. The mean gestational age was 38.6±1.2 weeks in the IU group and 38.7±1.0 weeks in the IV group (p=0.652). There were 63 (63.0%) women who were booked cases, with no significant difference between groups (p=0.534). Obesity was present in 36.0% of the IU group, and 42.0% of the IV group (p=0.539). The median duration of TSL was significantly shorter in the IU group (2.5 minutes, IQR: 2.1–3.2) compared to IV group (3.4 minutes, IQR: 3.0–3.8; p<0.001). Postpartum hemorrhage occurred in 2 (4.0%) IU and 4 (8.0%) IV cases (p=0.400). Need for additional uterotonics (p=0.558), maternal tachycardia (p=0.646), and hypotension (p=0.558) were low and similar between groups.

Conclusion: Intraumbilical oxytocin significantly shortens the duration of the TSL compared to intravenous oxytocin.