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Objective: To assess the impact of fibroids on pregnancy outcome. Study Design: A retrospective descriptive study. Place and Duration of Study: The study was conducted at department of Obstetrics & Gynecology during a period of 2 years from 1 January 2017 to 31 December 2018. Materials and Methods: All pregnant patients with fibroids > 3cm either diagnosed during antenatal period or incidentally during cesarean section were included in this study. Data regarding obstetrical outcome was extracted from the maternity ward record. Maternal age, parity, obstetrical complications, mode of delivery and indications for caesarean section were noted. Neonatal outcomes were ascertained from the maternity record and chart review. Results were summarized as %age, average and presented as tables using MS Excel version 13. Results: During the study period 38 pregnant women with fibroid are included in the study. Major proportion of patients with fibroid were in age group of 30-35 years. Obstetrical complications observed were; placental abruption (5.26%), PPH (15.78%), Obstructed labor (5.26%), prolonged labor (28.94%), abdominal pain (10.52%), preterm labor (2.63%) and malpresentation (2.63%). Miscarriages during early 2 trimester were recorded in (5.26%) cases. Caesarean section was required in 69.44% cases. One lady ended up in Cesarean Hysterectomy due to intractable bleeding during c/section. During the course of pregnancy (21.05%) women with fibroid uterus remained asymptomatic. Fetal outcome was good with (88.88 %) alive babies, (5.55%) NND,(2.77%) IUD and (2.77%) neonatal intensive care unit (NICU) admission were recorded. Conclusion: Pregnancies with fibroids are associated with increased risk of fetomaternal complications. Pregnant women with myoma may have frequent antenatal visits in a consultant led clinic and well defined care pathways. Significant number of still birth due to placental abruption associated with large myoma may warrant elective caesarean section at relatively earlier gestational age.

Objective: To determine the risk factors, fetal outcome and maternal outcome of placental abruption. Study Design: Retrospective observational study Place and Duration of Study: January 2017 to June 2018, Gynaecology Department, Bolan medical complex Quetta. Materials and Methods: During the study, 189 patients with placental abruption Data wes collected from records of labor room, obstetrical ward and Neonatal Intensive Care Unit. All diagnosed placental abruption cases were included in this study. The clinical data of the patients presented with placental abruption in our facility was reviewed and the fetomaternal outcome was analyzed. Information collected from record included demographics, parity, gestational age, HB% at arrival and risk factors for placental abruption. Data was analyzed using MS Excel version 13 and results were presented as averages and percentages. Results: During study period 189 cases of placental abruption were recorded. Grandmultiparity (94.17%) and Anemia (83.59%) were identified as major risk factors for placental abruption. The frequency of PIH as a risk factor for placental abruption was recorded in (8.9%) cases and history of trauma was noted in [2.6%] cases. Maternal deaths were found to be (2.11%) and the women undergone surgical intervention were (15.87%) with (14.28%) developed PPH. Only (28.57%) fetuses survived in this study population. Intrauterine death was diagnosed at arrival in (60.84%) cases. Early neonatal deaths were recorded in (13.22%) cases. Conclusion: Abruption is a frequent and major cause of maternal morbidity and perinatal mortality. Anemia and grand multiparty are identified as major risk factors. The frequency of PIH and Trauma as a risk factor for placenta abruption is found lower than expectation.