Background: Preterm birth is a major contributor to perinatal morbidity and mortality, with substantial immediate and long-term consequences for newborns. The present study was undertaken to assess the association between multiple pregnancy and preterm birth and to compare gestational age at delivery between singleton and multiple pregnancies among women attending a tertiary-care hospital in Bangladesh. Methods: This hospital-based observational study was conducted at the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital, Dhaka, Bangladesh, from January to June 2019 among 60 pregnant women. Sociodemographic and pregnancy-related data were collected, and preterm birth was defined as delivery before 37 completed weeks. Data were analyzed using frequencies, percentages, and the chi-square test, with p<0.05 considered statistically significant. Results: Among 60 participants, most were aged 21–25 years (35.0%), urban residents (56.7%), had secondary education (41.7%), and were multigravida (55.0%). Singleton pregnancies comprised 75.0%, while multiple pregnancies comprised 25.0%. Overall, 41.7% delivered preterm, predominantly at 32–36 weeks (28.3%). Preterm birth was significantly higher in multiple than singleton pregnancies (80.0% vs. 28.9%, p<0.001), with multiple pregnancies showing a greater concentration of deliveries before 37 weeks. Conclusion: Multiple pregnancy was significantly associated with an increased risk of preterm birth and earlier gestational age at delivery.

Infertility affects a significant proportion of reproductive-age couples worldwide, with multifactorial etiologies including hormonal imbalance, structural abnormalities, endometriosis, and psychosocial stress. Despite advancements in assisted reproductive technologies such as in vitro fertilization (IVF), repeated implantation failure remains a major clinical concern, often associated with both physiological and psychological determinants. This case report describes a 31-year-old female with primary infertility and underlying endometriosis who experienced two unsuccessful IVF cycles. Prior to a subsequent IVF attempt, corrective hysteroscopic intervention for cervical factors was performed. In addition, Yoga Prana Vidya (YPV), a non-touch, biofield-based complementary therapy, was introduced alongside conventional treatment. The YPV intervention included structured energy-based protocols aimed at emotional regulation, stress reduction, and targeted energizing of reproductive-related energy centers. During this cycle, the patient demonstrated improved psychological stability and reduced perceived stress. The third IVF cycle resulted in successful conception. The observed temporal association suggests that YPV may have a supportive role in modulating psychophysiological parameters relevant to implantation success

Background: Infertility affects approximately one in seven couples worldwide. IUI is a commonly used assisted reproductive technique, with success influenced by maternal age, ovarian response, infertility duration, and sperm quality. As evidence on age-related IUI outcomes in Bangladesh is limited, this study assessed IUI success according to maternal age among patients attending an infertility center in Rangpur. Methods: A retrospective observational study was conducted at LAB a One Infertility and IUI Center, Rangpur, Bangladesh, from July 2025 to June 2026. A total of 48 women aged 21–40 years undergoing IUI were included. Ovarian stimulation was performed using letrozole, clomifene, or FSH/HMG, followed by hCG triggering. Post-wash sperm count and motility were recorded. Maternal age was categorized as <30 and ≥30 years, and pregnancy following IUI was the primary outcome. Data were analyzed using IBM SPSS Statistics version 27 and presented as frequencies and percentages; p<0.05 was considered statistically significant. Results: Among 48 patients, 62.5% were <30 years, with 25–29 years being the most common age group (47.9%). Letrozole-based stimulation was most frequently used (52.1%), followed by clomifene (27.1%) and FSH/HMG (20.8%); all patients received hCG triggering. The overall pregnancy rate was 20.8%, with a higher rate among women <30 years than those ≥30 years (26.7% vs. 11.1%). Of the 10 pregnancies, 80.0% occurred in women <30 years. Overall, younger women showed more favorable observed IUI pregnancy outcomes. Conclusion: IUI demonstrated a 20.8% overall pregnancy rate, with more favorable outcomes observed among women younger than 30 years. Maternal age may be an important consideration when counseling couples regarding expected IUI success.

Background: Abnormal uterine bleeding describes any variation from normal bleeding patterns in nonpregnant, reproductive-aged women beyond menarche lasting for at least 6 months. The management of abnormal bleeding can involve many decisions about diagnosis, aetiology and treatment, which often occur simultaneously and without the benefit of comprehensive, evidence-based guidelines. The purpose of the study was to evaluate and detect the causes of Abnormal Uterine Bleeding and its Management in a Tertiary Level Hospital. Methods: This is a cross-sectional type of descriptive study, conducted in Shaheed Suhrawardy Medical College Hospital over six-month duration. Sample was selected by purposive sampling technique. Women with abnormal uterine bleeding admitted in Obstetrics and Gynaecology Department, Shaheed Suhrawardy Medical College Hospital were included. Total100 patients were included. Results: In this study, the maximum numbers of cases (52.0%) were between 36-45 years age group. Mean age was 34.57 ± 9.27 years. Per vaginal bleeding was most common symptoms, present in 100% cases; next common symptoms were abdominal pain (76%), lump in lower abdomen (26%). On evaluation of types & causes of AUB, maximum patient belongs to AUB-L (leiomyoma) group (40%) followed by AUB-A (adenomyosis) (20%); AUB-P (polyp) (8%); AUB-O (ovulatory) (30%) and AUB-M (malignancy) (2%). Total abdominal hysterectomy only done in 31.0% patients, total abdominal hysterectomy with unilateral salpingo-oophorectomy was done in 9.0% patients and total abdominal hysterectomy with bilateral salpingo-oophorectomy was done in 60% patients. Conclusion: Present study concluded that most common cause of AUB was leiomyoma followed by adenomyosis. This classification system helps in understanding various exact etiological causes of AUB and can be used by the clinicians, investigators and even patients themselves to facilitate communication, clinical care and research. For this reason we strongly recommend adoption of this classification for AUB and HMB.

Background: Preterm prelabour rupture of membranes (PPROM) is an important obstetric complication associated with maternal morbidity, prematurity and adverse neonatal outcomes. Identification of associated risk factors and assessment of pregnancy outcomes are essential for improving maternal and neonatal care. Objective: To evaluate the potential risk factors and pregnancy outcomes among women with PPROM admitted to a tertiary-level hospital. Methods: A descriptive observational study was conducted in the Department of Obstetrics & Gynaecology, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh, over six months from 27 February 2019 to 26 August 2019. Fifty pregnant women with PPROM between 28 and 36⁺⁶ weeks of gestation were enrolled consecutively and followed until delivery. Sociodemographic characteristics, obstetric history, clinical presentation, potential risk factors, mode of delivery, maternal complications and neonatal outcomes were recorded and analyzed using descriptive statistics. Results: The mean maternal age was 23.5 ± 9.54 years, and 42.0% were aged 21–25 years. Most women were multigravida (62.0%) and presented at 34–36⁺⁶ weeks (74.0%). Anaemia (28.0%), urinary tract infection (26.0%) and previous caesarean section (24.0%) were the most frequently identified potential risk factors. Caesarean section was performed in 82.0% of cases. Urogenital infection (34.0%) was the most common maternal complication. All newborns were premature, while neonatal sepsis occurred in 30.0% and birth asphyxia in 24.0%. Neonatal mortality was 8.0%. Conclusion: PPROM was associated with substantial maternal and neonatal morbidity. Early identification of associated factors, appropriate antenatal care, prompt management and adequate neonatal support are important to improve outcomes.

Introduction: Cervical cancer is a major public health issue, especially in low- and middle-income countries. Visual inspection with acetic acid (VIA) is simple and affordable, but a positive result cannot confirm cervical precancerous lesions, requiring further diagnostics. This study compared colposcopy and cytology among VIA-positive women, using histopathology as the standard. Aim of this study: To compare the sensitivity, specificity, predictive values, and overall diagnostic accuracy of colposcopy and Pap smear for detecting cervical pre-invasive lesions in VIA-positive women. Methods & Materials: A cross-sectional study was conducted at Shaheed Suhrawardy Medical College Hospital (SSMCH), Dhaka, Bangladesh, from July 14, 2019, to January 15, 2020. It included 150 VIA-positive women selected by purposive sampling. Participants underwent Pap smear, colposcopy with 3% acetic acid, Lugol’s iodine, and Swede Score. Colposcopy-guided biopsy was performed when needed, with histopathology as the reference. Diagnostic performance was measured by sensitivity, specificity, PPV, NPV, and accuracy. Results: The mean age of the participants was 36.4 ± 11.5 years. Pap smear detected epithelial abnormalities in 69 (46.0%) women, whereas colposcopy identified suspected premalignant lesions in 58 (38.6%). Histopathology confirmed premalignant lesions in 51 (34.0%) women. The sensitivity, specificity, PPV, NPV, and accuracy of Pap smear were 78.4%, 70.7%, 58.0%, 86.4%, and 73.3%, respectively. For colposcopy, the corresponding values were 94.1%, 89.9%, 82.8%, 96.7%, and 91.3%. Conclusion: Colposcopy outperformed conventional cytology in VIA-positive women, showing higher sensitivity, specificity, predictive values, and accuracy. It can help evaluate women with positive VIA, but histopathology is still essential for a definitive diagnosis.

Background: Extremes of weight could have an effect on the mother and her newborn. Obesity is no longer a problem of only Caucasian women, as it is also now a public health concern in women of African descent. Maternal underweight appears to also affect pregnancy and perinatal outcomes. The aim of this study was therefore to examine the effect of overweight and obesity on maternal and perinatal outcomes. Methods: This is a retrospective descriptive study among women who delivered at the Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital (UBTH), Benin City, Nigeria, from January 1, 2022 to December 31, 2022. Results: The mean age of the women was 30.7 years (standard deviation 5.1). Most of the low-birth-weight babies were born to overweight women, and the relationship was statistically significant (p = < 0.001). Among the eight neonates who died, seven were born to normal-weight and overweight mothers. Many of the neonates admitted into SCBU were born to overweight mothers, and the test of association was statistically significant (p = < 0.001). A significantly large proportion of those who had complications during the antenatal and postpartum period were obese women (p = 0.053). Conclusion: The odds of low birth weight were significantly higher among overweight mothers compared to mothers who had healthy weight. Obese women were significantly more likely to have antenatal and postpartum complications relative to normal healthy weight women.

Background: Adenomyosis is an estrogen-dependent uterine disorder commonly associated with heavy menstrual bleeding, dysmenorrhea, uterine enlargement and anemia. In perimenopausal women, hormonal treatment is often preferred to preserve the uterus and avoid surgery. However, real-world evidence on treatment outcomes in this age group remains limited, particularly in Bangladeshi clinical settings. This study evaluated clinical outcomes, satisfaction and tolerability of hormonal therapy. Methods: This retrospective observational study was conducted at the Department of Obstetrics and Gynaecology, Mugda Medical College & Hospital, from June 2023 to July 2024. A total of 150 women aged 40–52 years with ultrasonography-confirmed adenomyosis received LNG-IUS, dienogest, or GnRH agonists and had a six-month follow-up. Clinical, hematological, satisfaction and adverse-effect data were extracted from records. McNemar’s test was used for paired outcomes, with p<0.05 considered significant. Results: At six months, menorrhagia decreased from 92.0% to 4.0%, severe pelvic pain/dysmenorrhea from 78.7% to 12.0%, uteromegaly from 49.3% to 14.7% and anaemia from 69.3% to 17.3% (all p<0.001). Amenorrhea was achieved by 58.7% of participants, while 86.7% were satisfied or highly satisfied with treatment. Irregular spotting/breakthrough bleeding was the most frequent adverse effect (29.3%), followed by weight gain (17.3%). Overall, adverse effects were manageable. Conclusion: Hormonal therapy was associated with six-month improvement in bleeding, pain, uterine enlargement and anemia, with high treatment satisfaction and tolerable adverse effects. These findings support hormonal therapy as a uterus-conserving option for symptomatic adenomyosis in perimenopausal women.

Background: Maternal hyperglycaemia is the central pathophysiological driver of adverse perinatal outcome in gestational diabetes mellitus (GDM), yet the comparative magnitude of risk between well-controlled and poorly controlled disease remains under-documented in South Asian tertiary-care settings. This study aimed to evaluate the association between the level of glycaemic control and perinatal outcome among women with GDM. Methods: This cross-sectional observational study included 100 women with GDM managed at a tertiary hospital in Dhaka between March and August 2017. Patients were classified as well-controlled (HbA1c <6.5, n=58) or poorly controlled (HbA1c ≥6.5, n=42) and perinatal outcomes were compared between the two groups using the chi-square test in SPSS version 20, with p<0.05 considered significant. Results: Low birth weight (<2.5 kg) and macrosomia (>4.0 kg) were each roughly twice as frequent among poorly controlled mothers (66.67%) as among well-controlled mothers (33.33%), whereas birth weight in the 3.1–3.5 kg range predominated in the well-controlled group (72.00% versus 28.00%). Postnatal maternal complications, including postpartum haemorrhage, wound infection and urinary tract infection, were markedly concentrated among poorly controlled patients (p=0.001). Neonatal morbidity, encompassing hypoglycaemia, hyperbilirubinaemia, respiratory distress syndrome, birth asphyxia and prematurity, was substantially higher among poorly controlled cases (p=0.001) and all six perinatal deaths recorded in the cohort (6%) occurred exclusively among poorly controlled patients. Conclusion: Glycaemic control status was strongly and significantly associated with neonatal morbidity, postnatal maternal complications and perinatal mortality in GDM, confirming strict glycaemic control as the principal modifiable determinant of favourable perinatal outcome.

Background: Preeclampsia remains a leading cause of severe maternal morbidity worldwide and its early- and late-onset phenotypes are increasingly recognised as differing in severity and complication profile. This study aimed to compare the pattern of severe maternal morbidity between women with early-onset preeclampsia (EOP) and late-onset preeclampsia (LOP) and to contrast these outcomes with normotensive pregnancies. Methods: A hospital-based case control study was conducted in the Department of Obstetrics and Gynaecology, BIRDEM General Hospital, Dhaka, over six months (March to August 2019). One hundred women with preeclampsia (50 EOP and 50 LOP) and 50 normotensive controls were enrolled consecutively. Structured interview, clinical examination and review of laboratory records were used to document severe maternal complications, including HELLP syndrome, acute kidney injury (AKI) and disseminated intravascular coagulation (DIC). Data were analysed using SPSS, with the chi-square or Fisher exact test applied as appropriate and p<0.05 considered significant. Results: Baseline maternal age, height and weight were comparable between EOP and LOP groups (p>0.05). DIC occurred in 5 (10.0%) women with LOP versus none with EOP (p=0.056) and AKI occurred in 1 (2.0%) LOP case versus none in EOP. No maternal deaths occurred. Compared with controls, HELLP syndrome (10.0% vs 0%, p=0.016) and AKI (8.0% vs 0%, p=0.034) were significantly more frequent among women with EOP, while DIC was significantly more frequent among women with LOP than controls (10.0% vs 0%, p=0.022). Conclusion: Severe maternal morbidity differs qualitatively between early- and late-onset preeclampsia, with EOP more strongly associated with HELLP syndrome and acute kidney injury and LOP more strongly associated with disseminated intravascular coagulation, when each phenotype is compared with normotensive pregnancy.

Background: Caesarean section rates continue to rise worldwide, and emergency caesarean delivery is typically undertaken to avert serious maternal or fetal complications. The spectrum of indications leading to emergency caesarean section varies across countries and institutions, and local data from Bangladeshi tertiary hospitals remain limited. This study aimed to determine the common indications for emergency caesarean section among women managed at Kurmitola General Hospital, Dhaka. Methods: This cross-sectional observational study was conducted in the Department of Obstetrics and Gynaecology, Kurmitola General Hospital, from July 2019 to December 2019. One hundred women with a singleton pregnancy beyond 28 weeks who underwent emergency caesarean section were enrolled by purposive sampling. Data were collected using a pre-tested, observation-based questionnaire and analysed using SPSS version 23. Results: The highest proportion of mothers (62%) were aged 21-25 years, with a mean age of 24.63±5.31 years. Forty-three percent were primigravida, and 54% had a gestational age of 37 weeks or more. Among fetal indications, fetal distress was the leading cause (22%), followed by severe intrauterine growth restriction (5%) and cord prolapse (1%). Among maternal indications, obstructed labour or failure to progress accounted for 21% of cases, malpresentation and pregnancy-induced hypertension each accounted for 13%, antepartum haemorrhage for 11%, previous caesarean section with scar tenderness for 9%, failed induction for 7%, and primary dysfunctional labour and cephalopelvic disproportion each for 4%. Conclusion: Fetal distress was the single most important indication for emergency caesarean section, while obstructed labour, pregnancy-induced hypertension and antepartum haemorrhage represented the principal maternal indications at this tertiary care center.

Background: Diagnostic delay is an important barrier to timely management of gynaecological malignancies and may result from patient-, provider-, and health-system-related factors. Identifying referral patterns and stages of delay may help improve timely diagnosis. Objective: To assess the patterns of referral and diagnostic delay among women with newly diagnosed gynaecological malignancies attending a tertiary care hospital. Methods: This prospective observational study was conducted from January 2026 to June 2026 among 150 women with newly diagnosed, histopathologically confirmed gynaecological malignancies attending the Department of Gynaecological Oncology, National Institute of Cancer Research & Hospital, Dhaka. Sociodemographic characteristics, presenting symptoms, initial healthcare contact, referral source, number of healthcare visits, diagnostic investigations, and reasons for delay were recorded. Diagnostic intervals were assessed from symptom onset to first healthcare contact, referral, specialist consultation, and histopathological confirmation. Results: The mean age of participants was 48.5 ± 13.8 years. Cervical cancer was the most common malignancy (52.0%), followed by ovarian (21.3%) and endometrial cancer (16.0%). Private clinics/hospitals were the most common initial healthcare facility (32.0%), while government hospitals were the leading referral source (31.3%). The mean overall diagnostic interval was 95.6 ± 48.3 days, and 39.3% of participants had an interval exceeding 90 days. Lack of awareness (36.0%), financial constraints (31.3%), delayed referral (27.3%), and repeated consultations (25.3%) were the major reported contributors to delay. Conclusion: A considerable diagnostic interval was observed, with delays occurring at multiple stages of the healthcare pathway. Strengthening awareness, referral systems, and timely diagnostic services may facilitate earlier diagnosis.