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Mullerian anomalies are a relatively uncommon occurrence with implication for adolescents and adults as they may result in specific gynaecologic, fertility and obstetrical issues. Uterus didelphys with blind hemivagina and ipsilateral renal agenesis is a rare congenital anomaly. Patient may be asymptomatic and unaware of having double uterus or may present with severe dysmenorrhoea or dyspareunia or a palpable mass due to unilateral haematocolpos. We report a case of 12 year old girl with this condition who was diagnosed as uterus didelphys with unilateral haematocolpos with ipsilateral renal agenesis on the basis of clinical association, physical examination and sonography and intravenous urogram.

The study was undertaken to determine socio-demographic and reproductive risk factors associated with Chlamydia trachomaties IgM seropositivity during pregnancy. This cross sectional comparative study was carried out in the obstetrics outdoor of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh in collaboration with the department of Virology between the periods from July 2007 to December 2008. Pregnant women at their first visit to the hospital were approached consecutively and asked to complete a questionnaire and 2cc blood was collected from each subject for Chlamydia trachomatis IgM antibody testing using ELISA method. The study population was divided into two groups according to the presence and absence of serum Chlamydia trachomatis IgM antibody. Finally socio-demographic and reproductive risk factors were compared between the groups. Among 172 women the sero-prevalence of Chlamydia IgM was 41%. The multiple logistic regression model (step wise) finally extracted for characteristics correlated with seropositivity. Ten years or less (≤SSC) education (OR 2.6 95% CI 1.1to 5.9), history of adverse pregnancy outcome (OR 2.8 95% CI 1.2 to 6.5) and multiple sex partner of husband (OR 4.1 95% CI 1.2 to 14.8) were associated with chlamydia infection. The use of condom (OR 0.28 95% CI 0.12 to 0.63) was associated with decreased risk of infection. Chlamydia trachomatis infection during pregnancy is associated with risk factors on the basis of which selective screening can be done.

This cross sectional observational study was done in Department of Obs & Gynae, General Hospital Tangail, to find out the maternal and fetal outcome of eclamptic admitted patient in secondary care hospital in Bangladesh. Study period was Jan 2008 to Dec 2008. Sample size was 100. During this period total 4727 patients were admitted among them 124(2.62%) were eclamptic patients. From that 124 patients 100 cases were randomly included. Among all patients 80% had age <25 years and 62% were primigravidae. Maximum (75%) patients had antepartum eclampsia. Postpartum and intrapartum eclampsia were 18% and 7% accordingly. Among all patients, 45% had primary education and 36% were illiterate. Most of the patients (73%) were from below average class family. Fifty two percent (52%) patients had >37 weeks completed pregnancy. Maximum patients (91%) had no or infrequent antenatal check-up. All the patients had convulsion before admission and 85% were unconscious. Among total patients 55% were delivered by lower uterine caesarian section and 45% were delivered by vaginal route. Maximum 74(74%) patients could not reached hospital within 4 hours of first convulsion. Time interval between the first convulsion and delivery was <12 hours in 72% cases. In 98(98%) cases magnesium sulphate (MgSO₄) and in 2% of cases diazepam was used as anticonvulsant. Complications of eclampsia were found in 30% cases. Complications were pulmonary edema, PPH, CVA, HELLP syndrome, obstetric shock, DIC, acute renal failure. Among all 9(9%) patients were expired. Causes of maternal death were pulmonary edema, heart failure, CVA, HELLP syndrome. Maternal morbidities after delivery were observed in 53% cases. Recorded morbidities were infection, CVA and hypertension. Among 100 cases 87 were live born and 13 were still born. Out of 87 live born babies 50 were needed admission. Among admitted neonates 11 were died in the first week. Causes of early neonatal death were perinatal asphyxia, septicemia and prematurity. Among 100 deliveries 66% had low birth weight (LBW). Among 11 neonatal death, 9(81%) had low birth weight. In this study we observe maternal mortality, still born, early neonatal death and perinatal mortality rates are still high. So, this study implicates to improve the existing management of eclampsia.

During normal pregnancy there is an increase in the maternal blood volume leading to portal hypertension with some changes in liver functions. However, in an apparently healthy woman without known liver cirrhosis or other advanced liver disease, severe oesophageal varices with along with repeated variceal bleeding during pregnancy is rare. In this paper we described a case of severe oesophageal variceal bleeding in a young woman without having any pre-existing liver pathology. Due to repeated pregnancy with short intervel bleeding the patient developed severe anaemia. Packed cell transfusion was done repeatedly and oesophageal variceal ligation (EVL) was done three times. In spite of these measures variceal bleeding continued and patient's condition was deteriorating progressively; so caesarean section was at 33rd week of gestation and a preterm but healthy baby was delivered. The puerperium was uneventful with no haematemesis and there was gradual improvement of the condition. A brief review of the literature on pregnancy with oesophageal varices is also presented.

Cesarean delivery has become a commonly used measure for delivery of the fetus. In the recent years incidence of Cesarean section (CS) has increased dramatically with massive pubic interest. It is called Primary Cesarean section when it is performed for the first time on a pregnant woman. This is a cross sectional study conducted on primary cesarean section from January to December 2004 in Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital, Dhaka. A total of 100 cases were selected for the study. The major findings of the study were as follows: Overall cesarean section rate was 57.87 percent and among them 74.34 percent were primary cesarean section. The median age group of patients being operated was 20 to 25 years. Most of the operations were carried out on primigravid patient due to various indications. The main indications were fetal distress (35%), pre-eclampsia (14%) and cervical dystocia (12%). The rate of emergency Cesarean section rate was 70% while elective Cesarean section was 30%. Most of the Cesarean section was performed under spinal anesthesia (96%). Maternal morbidity was 20%. Among those, post-operative infections (45%) and UTI (25%) were the most common. The less common complications were Post Partum Haemorrhage (PPH), puerperal-pyrexia, urinary bladder injury and spinal headache. 88% of the babies were born with good APGAR score (Appearance, Pulse, Grimace, Activity, and Respiration). Perinatal mortality was found to be 4%. The death cases were severe perinatal asphyxia, very LBW (Low Birth Weight) and stillborn. Most of the patients (69%) were discharged from hospital within 8 days of operation.

Pregnancy induced hypertension (PIH) is a major complication of pregnancy and is associated with high maternal and perinatal morbidity and mortality. The aim of this study was to investigate the possible causal association of PIH with maternal serum PAPP-A and urinary protein-creatinine ratio (UPCr) as well as to evaluate the usefulness of these two variables as predictive markers of PIH. A total 200 women of 8-16 weeks of pregnancy were enrolled in this study. All the patients were followed up till delivery for the development of pregnancy induced hypertension. Thirty patients were lost in the follow up, 3(1.76%) developed preeclampsia (PE) and 14(8.23%) gestational hypertension (GH). By a nested case-control design the 17 pregnancy induced hypertension cases were compared with 48 Controls with normal pregnancy outcome. Maternal serum PAPP-A was significantly lower in the pregnancy induced hypertension group compared to Control [mIU/ml, median (range) 1.8(0.70-4.1) vs. 5.45(2.7-10), p<0.001]. UPCr was significantly higher in the pregnancy induced hypertension group compared to Control (mg/mmol, mean+/-SD, 6.86+/-1.56 vs. 4.75+/-0.96, p<0.001). When tested as a predictive marker of pregnancy induced hypertension the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of maternal serum PAPP-A in the lowest 25th percentile were 82%, 95%, 87% and 93%. At 75th percentile the sensitivity, specificity, PPV and NPV of UPCr were 52%, 85%, 56% and 83% respectively.