Background: Accurate preoperative assessment of surgicopathological factors is essential for optimal management of early cervical cancer. Magnetic resonance imaging (MRI) is widely used for preoperative staging, but its diagnostic accuracy varies across key pathological predictors. This study aimed to evaluate the sensitivity, specificity, and predictive values of MRI in determining surgicopathological factors in early-stage cervical cancer using histopathology as the gold standard. Methods: This prospective cross-sectional study was conducted at the Gynecological Oncology Unit of Dhaka Medical College Hospital from June 2021 to May 2022. Fifty histologically confirmed early-stage cervical cancer patients undergoing primary radical hysterectomy with pelvic lymph node dissection were included. Preoperative MRI assessed tumor size, vaginal extension, parametrial involvement, lymph node metastasis, deep stromal invasion, and corpus extension. MRI findings were compared with clinical examination and final histopathology. Diagnostic accuracy parameters were calculated. Results: Clinically, 94% of tumors were <4 cm, and 14% showed vaginal involvement. MRI demonstrated high accuracy for tumor size assessment with sensitivity 97.87%, specificity 100%, and overall accuracy 98%. For vaginal extension, MRI showed sensitivity 71.43% and specificity 100% with accuracy 96%. MRI detected lymph node metastasis with sensitivity 60%, specificity 91.11%, and accuracy 88%. Deep stromal invasion was identified with 72.41% sensitivity and 71.43% specificity. Corpus extension demonstrated sensitivity 55.56%, specificity 93.75%, and accuracy 80%. Conclusion: MRI is a highly sensitive and specific modality for preoperative evaluation of key surgicopathological factors in early cervical cancer. Its strong concordance with histopathology supports its essential role in guiding surgical planning and staging.

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Background: Uterine rupture is a life-threatening obstetric emergency associated with significant maternal and fetal morbidity and mortality. Changing obstetric practices have altered its etiological profile, particularly with the rising rate of caesarean section. This study aimed to compare maternal and fetal consequences of uterine rupture in scarred versus unscarred uterus. Methods: This cross-sectional descriptive study was conducted in the Department of Obstetrics and Gynaecology, Rajshahi Medical College Hospital, Rajshahi, Bangladesh, from March to September 2012. Forty-two cases of surgically confirmed uterine rupture were analyzed with respect to demographic characteristics, risk factors, clinical presentation, surgical management and outcomes. Results: The incidence of uterine rupture was 0.96% (1 in 104 deliveries). Scarred uterus rupture accounted for 71% of cases. Most patients were aged 20–25 years, multiparous, of low socioeconomic status and unbooked for antenatal care. Repair of rupture was the most common surgical procedure (61.9%). Maternal mortality was 7.1%, while perinatal mortality was 85.7%. Conclusion: Uterine rupture is increasingly associated with previous caesarean section. Although maternal survival has improved, fetal outcomes remain poor. Strengthening antenatal care, rationalizing caesarean section practices and ensuring skilled intrapartum management are critical to prevention.

Background: Labour in nulliparous women is a crucial obstetric process, and foetal head engagement is a key determinant of labour progress and clinical decision-making. The purpose of the study is to determine the incidence of foetal head engagement and non-engagement at ≥38 weeks in nulliparous women and evaluate their maternal and fetal outcomes. Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Rajshahi Medical College Hospital, Rajshahi, Bangladesh, from January to December 2009, and included 100 nulliparous women at ≥38 weeks of gestation with singletone foetus with cephalic presentation. Foetal head engagement was assessed using the rule of fifths, and participants were grouped as those with engaged head or non-engaged head. Labour was actively monitored with a partograph, and maternal and foetal outcomes were recorded. Data were collected using a standardized questionnaire and analyzed using SPSS software. Results: Among 100 nulliparous women ≥38 weeks, 69% had non-engaged and 31% had engaged foetal heads. Vaginal delivery was higher with engagement (77.42% vs 42.63%), while cesarean section was more frequent in non-engagement (57.97% vs 22.58%). Postpartum hemorrhage was higher in the non-engaged group (6.45% vs 1.45%), labour was longer, and neonatal outcomes were comparable, with APGAR scores of 7–10 in >94% of both groups and no APGAR <4. Conclusion: Non-engagement of the foetal head at term in primigravid women is common and, by itself, does not preclude successful vaginal delivery.

Background: Oligohydramnios is a clinically significant obstetric condition associated with increased intrapartum intervention and adverse perinatal outcomes. Reduced amniotic fluid volume compromises fetal well-being by increasing the risk of umbilical cord compression and uteroplacental insufficiency, thereby influencing delivery decisions and neonatal outcomes. This study aimed to evaluate the mode of delivery and fetomaternal outcomes in pregnancies complicated by oligohydramnios. Methods: A hospital-based cross-sectional observational study was conducted in the Department of Obstetrics and Gynaecology, Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh, from December 2009 to June 2010. A total of 50 pregnant women with sonographically confirmed oligohydramnios were included in this study. Cardiotocography was performed upon admission to assess the fetal status. The mode of delivery, indications for caesarean section and neonatal outcomes were recorded. Associations between oligohydramnios severity and outcomes were analyzed. Results: Non-reassuring cardiotocography patterns were observed in 64% of the cases. Caesarean section was the predominant mode of delivery (72%), with fetal distress being the leading indication (61.1%). All women with severe oligohydramnios required caesarean delivery, demonstrating a significant association between severity and delivery mode (p < 0.001). Neonates born to mothers with severe oligohydramnios had a higher incidence of Apgar scores below 7 at five minutes (p < 0.05). Conclusion: Severe oligohydramnios is strongly associated with non-reassuring fetal surveillance, increased operative delivery rates and adverse neonatal outcomes. Severity-based risk stratification and vigilant intrapartum monitoring are essential for optimizing fetomaternal outcomes.