Severe maternal outcomes and their predictors among Pakistani women in the WHO Multicountry Survey on Maternal and Newborn Health.

Objective: To determine the incidence of, and the demographic and obstetric factors associated with, severe maternal outcome (SMO) among women presenting at healthcare facilities in Pakistan.

Methods: A cross-sectional study was conducted in 16 healthcare facilities across Pakistan that had been selected for the WHO Multicountry Survey on Maternal and Newborn health. The hospital records of women who delivered at a participating facility or were admitted with SMO (defined as maternal death or near miss) within 7 days of delivery/abortion were reviewed for a period of 2-3 months in 2011.

Validation of verbal autopsy tool for ascertaining the causes of stillbirth.

Objective: To assess performance of the WHO revised verbal autopsy tool for ascertaining the causes of still birth in comparison with reference standard cause of death ascertained by standardized clinical and supportive data.

Methods: All stillbirths at a tertiary hospital in Karachi, Pakistan were prospectively recruited into study from August 2006- February 2008. The reference standard cause of death was established by two senior obstetricians within 48 hours using the ICD coding system.

Pelvic spleen with uterovaginal prolapse.

A case of wandering (pelvic) spleen associated with third degree uterovaginal prolapse and ascaris in the biliary and intestinal tract is being presented here. On laparotomy; congested splenomegaly was found in the pelvis. Splenectomy, total abdominal hysterectomy and bilateral salpingo-ophrectomy was performed.

Placenta percreta causing acute abdomen in the second trimester of pregnancy.

Two cases of acute abdomen due to haemoperitoneum caused by placenta percreta in the second trimester are presented. Both had a history of previous lower segment caesarean section, a factor well-known to predispose the condition. However, the rarity of the condition, presenting in mid pregnancy makes diagnosis and management difficult.

Acute puerperal uterine inversion.

Objective: To determine the frequency, causes, clinical presentations, management and maternal mortality associated with acute puerperal inversion of the uterus.

Design: Cross-sectional analytical study.

Place And Duration Of Study: The Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre (JPMC), Karachi, over eight years period from 1st January 1995 to 31st December 2002.