Bangladesh Journal of Obstetrics & Gynaecology 2020-07-20T08:33:42+00:00 Prof. Saleha Begum Chowdhury Open Journal Systems <p>The Official Journal of the Obstetrical and Gynaecological Society of Bangladesh. Full text articles available.</p> Oxytocics and other Drugs in Prevention of Post-partum Haemorrhage 2020-07-20T08:33:16+00:00 Sameena Chowdhury <p>Abstract not available</p> <p>Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 92-94</p> 2020-07-05T05:43:24+00:00 ##submission.copyrightStatement## Catastrophic Maternal Complications of Morbidly Adherent Placenta in Patients with History of Previous Caesarean Delivery 2020-07-20T08:33:17+00:00 Mumtahena Amir Salma Rouf Saleha Begum Chowdhury <p><strong>Objective:</strong>The study is aimed to describe the grave maternal outcomes encountered inpatients having morbidly adherent placenta along with history of previous caesarean section.</p> <p><strong>Materials and Methods: </strong>This was a cross-sectional study from September 2014 to August2015. All the patients attended in the in-patient department of obstetrics &amp; gynaecology inDMCH during the study period having morbid adhesion of placenta (diagnosed antenatallyby USG or diagnosed preoperatively) along with history of previous caesarean section.</p> <p><strong>Result: </strong>Total 10,805 obstetric patients delivered during the study period, of which 6,337patients had caesarean sections. Out of them 37 pregnant patients were found to havemorbid adhesion of placenta along with history of previous C/S. The incidence is 1 in 292deliveries. All of the 37 patients needed hysterectomy for intractable per operativehaemorrhage. All the patients needed transfusion of more than 04 units of blood. Nineteenpatients needed ICU supports Ten (27%) patients died. Other grave complications werehypovolemic shock (19 patients), bladder injury (16patients), renal failure (07 patients),multiorgan failure (07 patients) and DIC (06 patients).</p> <p><strong>Conclusion: </strong>All the patients of morbidity adherant placenta with previous Caesarean Sectionneeded caesarian hysterectomy and ten patients died.</p> <p>Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 96-100</p> 2020-07-05T05:44:52+00:00 ##submission.copyrightStatement## Evaluation of Patients Satisfaction following Caesarean Section in a Secondary level District Hospital 2020-07-20T08:33:23+00:00 Sankar Kumar Basak Zannatul Ferdosh Rehena Begum Nasim Iftekhar Mahmud <p><strong>Objective: </strong>To assess the level of satisfaction with caesarean delivery and to see the relationbetween different parameters and satisfaction.</p> <p><strong>Materials &amp; Methods: </strong>This cross sectional study was done in the department of Obstetrics&amp; Gynaecology of the District Sadar Hospital, Laxmipur during the period of 1st January to30th June 2017. A total of 423 post-caesarean women were included in the study. Thestructured questionnaires were used for the collection of data from the patients and the datawere processed and analyzed with the help of software SPSS.</p> <p><strong>Results: </strong>During the study period, among the 465 caesarean delivery 423 were enrolledfor the study. The mean age of the patients was 23.99±5.29 years and mean parity was1.22±1.27. Initial negative reaction to the decision of caesaren section was expressed by71.9% of the patients, 18.4% remained indifferent and 9.7% showed positive reaction. Themajor reasons of initial negative reaction were fear of death and dislike of caesareansection. The satisfaction following caesarean delivery was significantly associated withage, educational status and initial positive and negative reaction to the decision of caesareansection. Three hundred and fifty five (83.9%) women expressed their overall satisfactionfollowing caesarean section.</p> <p><strong>Conclusion: </strong>Most patients expressed their overall satisfaction to caesarean delivery.</p> <p>Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 101-106</p> 2020-07-05T05:45:08+00:00 ##submission.copyrightStatement## Risk Factors and Maternal Outcome of Secondary Post Partum Haemorrhage in Rangpur Medical College Hospital. - A one year study 2020-07-20T08:33:27+00:00 Hasina Ferdousy Ferdousi Sultana Mst Kamrun Nahaer Mst Moon Moon Begum Mst Mahfuza Begum <p><strong>Background: </strong>Post partum haemorrhage (PPH) is one of the most common causes ofmaternal mortality worldwide. Primary PPH (which occurs within 24 hours of delivery) hasbeen studied a lot. But data regarding secondary PPH (which occurs 24 hours after deliveryupto to 6 weeks post partum) is sparse. Our aim was to find out the risk factors and maternaloutcome of secondary PPH.</p> <p><strong>Materials and Methods: </strong>A cross sectional analytic study of 32 cases admitted with secondaryPPH in Gynae and Obstetric department of Rangpur Medical College Hospital during 1 yearstudy period was carried out.</p> <p><strong>Result: </strong>Frequency of secondary PPH was 0.58%. Mean age of the patient was 25.23±2.79years; 22(69%) patients were multi para; 17 (53%) patients had education up to primarylevel. Maximum patients [18 (56%)] were from low socio economic status. Mean time ofpresentation was 13.5±2.78 days after delivery; 14(44%) patients delivered vaginally and18(56%) patients delivered by caesarean section. Most of the vaginal delivery 9 (28%) wereconducted by untrained dai or other family member. Among 32 patients, 31 were referredfrom outside the Hospital. Retained bits of placenta was the leading cause (15,47%) andcaesarean wound dehiscence was the second cause (13,41%); 13 (40%) patients had feveron presentation. All were anemic with mean hemoglobin concentration 7.4±1.4gm and 24(75%) of them required blood transfusion. Four patients was in shock. Antibiotic was givento all patients. DE&amp;C was done in 15(47%) cases and laparotomy followed by total abdominalhysterectomy was done in 12 cases and repair in 1 case. Among 15 patients who underwentsurgical evacuation there was histological evidence of placental tissue in only 6(40%) patients.</p> <p><strong>Conclusion: </strong>In present study retained bits of placenta and caesarean wound dehiscenceare found as main cause of secondary postpartum hemorrhage So care should be takenduring active management of third stage of labour (AMTSL). Choosing appropriate suturematerial, maintaining personal hygine of patient and sterility of operation theate, usingappropriate antibiotic to combat microbials and last but not list improving skillness of surgeonare the key to reduce the rate of secondary PPH.</p> <p>Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 107-112</p> 2020-07-05T05:45:31+00:00 ##submission.copyrightStatement## Carbetocin Versus Oxytocin for Prophylaxis of PPH Used During Caesarean Section: An Open Label Randomized Control Trial 2020-07-20T08:33:31+00:00 MK Nahaer AKM Nurunnobi SI Talukder H Ferdousy F Sharmin GMR Islam R Parvin <p><strong>Background</strong><strong>:</strong> Postpartum hemorrhage is the leading cause of maternal mortality; uterineatony is the most important cause. Uterotonics are used to prevent uterine atony. Carbetocin,a synthetic anallague of oxytocin seems to be an effective and safe new drug for preventionof PPH after caesarean</p> <p><strong>The Aim of Study:</strong>To find out the efficacy and safety of carbetocin over oxytocin for theprevention of PPH during caesarean section.Patients and Methods: A randomized-controlled trial was conducted in the Dept. of Obs &amp;Gyane, Rangpur Medical College and Hospital, Rangpur, Bangladesh over a period of twelvemonths from June 2016 to June 2017. One hundred admitted patients undergoing cesareansection at term were randomized into two groups receiving either 10 IU oxytocin or 100 μgcarbetocin after caesarean section. Outcome measures such as primary PPH, massiveblood loss, need for additional uterotonic drug, additional blood transfusion as well as adverseeffects were all documented.</p> <p><strong>Results</strong>: Massive blood loss occurred in 6% patients, blood transfusion needed in 20% patientsand additional uterotonic needed for 36% patients in Oxytocin group but in Carbetocin groupno massive blood lossoccurred, only 2%patients needed immediate blood transfusion and4% patients were required additional uterotonics. There were no major adverse effectsobserved in both the groups. No patients had developed PPH in carbetocin group. But 8%(4)patients had developed PPH in oxytocin group.</p> <p><strong>Conclusion</strong>: Carbetocin appears to be an effective new drug than Oxytocin for the preventionof postpartum hemorrhage following caesarean section.</p> <p>Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 113-118</p> 2020-07-05T05:46:15+00:00 ##submission.copyrightStatement## Efficacy and Safety of Carbetocin for the Prevention of Primary PPH During Caesarean Section: An Open Label Single Arm Study 2020-07-20T08:33:34+00:00 S RAZZAQUE AD KHAN <p><strong>Background: </strong>The risk of postpartum haemorrhage is much higher for women undergoingcaesarean section, particularly in developing countries where the majority of operations arecarried out as an emergency procedure. Postpartum haemorrhage is the leading cause ofmaternal mortality worldwide. Around 67–80% of cases are caused by uterine atony.Preventive measures include prophylactic drugs use to aid uterine contraction after delivery,thus avoiding severe blood loss and reducing maternal morbidity and mortality. Carbetocin asynthetic analogue of oxytocin is currently indicated for prevention of uterine atony afterdelivery by caesarean section in spinal or epidural anaesthesia.</p> <p><strong>The Aim of Study: </strong>To see the efficacy and safety of Carbetocin for the prophylaxis of PPHduring caesarean section.Patients and Methods: An open label single arm clinical trial was conducted in the BagerhatSadar Hospital, Bangladesh over a period of six months from May 2017 to October 2017.Ninety patients who had got admitted in Bagerhat Sadar Hospital, undergoing cesareansection at term were selected. Each patient obtained a single dose of 100 microgramcarbetocin intravenously during cesarean section, immediately after the delivery of the babyand prior to the delivery of the placenta. Outcome measures such as primary PPH, bloodloss was observed and measured by weighing sanitary napkin observed for six hours. Needfor additional uterotonic drug, additional blood transfusion as well as adverse effects were alldocumented.</p> <p><strong>Results: </strong>Massive blood loss occurred only in 3.3% patients. Among the study population96.7% patients did not need any additional uterotonics. No patient had developed fever,arrhythmia, pulmonary edema, tremor, abdominal pain and pruritus. Only 2.2% had nausea,only 3.3% had hypotention, only 3.3% had vomiting and only 2.2% had headache which wasnot statistically significant. Only 4.4% patients developed PPH.</p> <p><strong>Conclusion: </strong>Carbetocin appears to be an effective new drug for the prophylaxis of postpartumhemorrhage in cesarean section.</p> <p>Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 119-124</p> 2020-07-05T05:49:48+00:00 ##submission.copyrightStatement## Prophylactic use of Tranexamic Acid during Caesarean Section in Preventing Postpartum haemorrhage– a Prospective Randomised Double Blind Placebo Controlled Study 2020-07-20T08:33:35+00:00 Nazlima Nargis Farhana Dewan <p><strong>Background: </strong>Postpartum haemorrhage (PPH) is a major cause of maternal mortality,accounting for one-quarter of all maternal deaths worldwide. Tranexamic acid (TXA), anantifibrinolytic agent, has therefore been investigated as a potentially useful complement toprevention and treatment of PPH. It has been proved to reduce blood loss in elective surgery,bleeding in trauma patients, and menstrual blood loss.</p> <p><strong>Aims: </strong>To evaluate the effectiveness of TXA in reducing blood loss given just immediatelyafter delivery of baby in women undergoing cesarean section.</p> <p><strong>Methods</strong>: This was a prospective, randomized, double blind, placebo controlled studyconducted in the Department of Gynaecology and Obstetrics unit of IBN SINA Medical CollegeDhaka, Bangladesh from June 2016 to May 2017. Participants were randomly assigned toTXA group or group A (n=60) and placebo group or group B (n=60). Randomization wasdone by residents using computer generated random numbers. Group A received 1 gram(10ml) of intravenous bolus dose of TXA just after delivery of the baby, Group B received 10ml of sterile distilled water for injection intravenously at the same time. Statistical analysishas been done by SPSS.</p> <p><strong>Results: </strong>The subjective characteristics in the two groups were similar with respect to theirage, BMI, gestational age and gravidity. The duration of surgery was 40-50 minutes. Therewas no statistically significant difference in the heart rates (p&gt;0.05) and blood pressuresbetween the two groups, after 2 hours of delivery. Blood losses from both placental deliveriesto the end of cesarean section and from end of CS to 2 hours postpartum were significantlylower in the study group (p&lt;0.05). Change in hemoglobin concentration in study group wasalso significantly less than in the control group. Total amount of oxytocin required wassignificantly less in TXA group (p&lt;0.05) also the number of women requiring other oxytocics(inj. Methyl ergometrine, inj carboprost and tab misoprostol per rectally) was significantlyless in TXA group (p&lt; 0.05). The amount of intra-operative fluid required were significantlyless in TXA group (p&lt;0.005); however post – operative fluid requirement and minor sideeffects in the form of nausea and vomiting were similar in both the groups.</p> <p><strong>Conclusion: </strong>Tranexamic acid can effectively reduce blood loss in patients undergoing LSCSand its use was not associated with any side effects and or complications like thrombosis.The adoption of WHO guidelines for using uterotonic agents and prophylactically administeringTXA may significantly reduce the number of PPH incidents.</p> <p>Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 125-130</p> 2020-07-05T05:51:25+00:00 ##submission.copyrightStatement## Risk Profiles Associated with Endometriosis among Infertile Women 2020-07-20T08:33:37+00:00 Jaglul Haider Khan Saifur Rahman Chowdhury Taslima Nasreen Jahangir Alam Pervin Fatema <p><strong>Background: </strong>Endometriosis is a common gynaecological disorder which is found in about5% of women and in 30% of infertile women. Identification of risk factors and timely interventionis useful.</p> <p><strong>Methods: </strong>A case control study was conducted in the Dept. of obs &amp; gynae of BangabandhuSheikh Mujib Medical University, Shahbag, Dhaka, from October 2015 to March 2016 on50 infertile patients attending the Infertility unit of the institute with the objective to determinethe risk factors of endometriosis. Twenty five women with endometriosis was taken ascases (group-I) and twenty five women without endometriosis was taken as controls(group-II).</p> <p><strong>Result: </strong>The mean age was 32.8±5.4 years in group I and 35.1±5.7 years in group II which issimilar. Urban residents were 3.21 times (with 95% CI 0.87-12.71%) more likely to developendometriosis than rural resident which was statistically significant (p&lt;0.05).Among the study population BMI of 72% patients in group I and 68% in group II were within19-24 kg/m2. The difference was not statistically significant (p&gt;0.05) . There was notstatistically significant difference (p&gt;0.05) between two groups in OCP use (84%vs80%).Women with endometriosis had less physical activity than the women without endometriosis;the differences was statistically significant (p&lt;0.05). Consumption of caffeine, red meat,vegetables and fruits has no effect on endometriosis. Women with pain during menstruationwere 29.33 times (with 95% CI 5.17-100%) and women with heavy amount of blood flow were5.09 times (with 95% CI 1.24-22.06%) more likely to be endometriosis, which was statisticallysignificant (p&lt;0.05) . Other risk factors like- age, occupation, educational status, age atmenarche and cycle length were not significantly (p&gt;0.05) associated with endometriosis.</p> <p><strong>Conclusion: </strong>Urban residence and all types of physical activities d”1 hour per day weresignificantly higher in infertile women with endometriosis.</p> <p>Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 131-139</p> 2020-07-05T05:52:39+00:00 ##submission.copyrightStatement## Gastrointestinal Symptoms in Endometriosis 2020-07-20T08:33:39+00:00 Shakeela Ishrat Farzana Deeba Parveen Fatima <p><strong>Background</strong>: Endometriosis is frequently associated with gastrointestinal symptoms, inaddition to dysmenorrhoea, dyspareunia and infertility. Gastrointestinal tract is not alwaysinvolved when gastrointestinal symptoms are present.</p> <p><strong>Method</strong>: A cross sectional study was conducted in the department of Obstetrics &amp;Gynaecology of Bangladesh Sheikh Mujib Medical University (BSMMU) on 55 infertile womenwith surgical diagnosis of endometriosis with the objective to determine the frequency ofgastrointestinal symptoms in our population of women with endometriosis and to find outwhether they were relevant to severity of endometriosis.</p> <p><strong>Results</strong>: There was a high prevalence (37.5%) of gastrointestinal symptoms in women withendometriosis. Bloating was the most frequent gastrointestinal symptom. Among the womenwith severe stage IV endometriosis, 57.6% had gastrointestinal symptoms.</p> <p><strong>Conclusion</strong>: A gynecologist must consider the gastrointestinal symptoms while dealing withthe women with endometriosis. Further evaluation of gastrointestinal tract involvement isnecessary for counseling and comprehensive management of the women with endometriosis.</p> <p>Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 140-142</p> 2020-07-05T05:52:58+00:00 ##submission.copyrightStatement## Laparoscopic Evaluation of Primary and Secondary Subfertility 2020-07-20T08:33:40+00:00 Setara Binte Kasem Nilufer Sultana Ferdousi Begum Shaikh Abdur Razzaque Raisa Adiba Selma Anika <p><strong>Background: </strong>Prevalence of subfertility in industrialized countries has been quoted as 20%,and seems to be on the rise. Traditional way to assess the uterine cavity, tubal structure andtubal patency was hysterosalphingography but it is now been largely superseded bylaparoscopy and hysteroscopy. With the objective of this study was to highlight the role oflaparoscopy in establishing the diagnosis of primary and secondary female subfertility anddifferent therapeutic procedure done.</p> <p><strong>Method: </strong>This cross sectional study was conducted in the Subfertility and ReproductiveMedicine Unit of Gynae and Obstetrics department of Dhaka Medical College Hospital, Dhakafrom January 2015 to June 2018. Total 4256 sub fertile patients attended the Infertility OPD.Out of these 215 patients were selected for laparoscopy. Those patients who hadcontraindication for laparoscopy were excluded from study. Detailed laparoscopic findingswere recorded.</p> <p><strong>Results: </strong>Out of 125 selected sub fertile patients 136 (63.26%) patients were in primarysubfertility group while 79 (36.74%) patients were in secondary subfertility group. In primarysubfertility group(n=136), most common laparoscopic finding was PCO in 44 (32.34%) patientsfollowed by peritubal and periovarian adhesions in 24 (17.65%) patients, Bilateral tubalblock in 23(16.91%) patients, Endometriosis in 15(11.03%), Unusual tortuous and lengthytube in 15(11.03%) patients, fibroid in 11(8.09%) patients, Mullerian agenesis and hypoplasiain 3(2.21%) cases. No visible abnormality found in 22(16.18%) cases.The commonest finding by laparoscopy in patients with secondary infertility were PCO in 18(22.78%) patients and peritubal and periovarian adhesions in 18 (22.78%) patients, followedby Bilateral tubal block in 12(15.19%) patients, fibroid uterus in 12(15.19%) patients,Endometriosis in 10(12.66%), Genital tuberculosis in 3(1.40%) cases. No visible abnormalityfound in 12(15.19%) cases.Various laparoscopic procedure like Ovarian drilling. Adhesiolysis, ovarian cystectomy, cystpuncture, salphingostomy, Myomectomy.</p> <p><strong>Conclusion: </strong>Laparoscopy helped us to detect and treat important clinical condition in bathprimary &amp; secondary sub fertility.</p> <p>Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 143-148</p> 2020-07-05T05:53:12+00:00 ##submission.copyrightStatement## Active Management of the Third Stage of Labour: A Brief Review and Update 2020-07-20T08:33:19+00:00 Nahid Sultana Ferdousi Begum Shahana Shermin <p>Blood loss due to postpartum haemorrhage (PPH) and its complications constitute one ofthe major causes of maternal mortality and morbidity. Active management of third stage oflabour (AMTSL) plays an immense role in preventing maternal death due PPH. But till dateobstetricians all over the world and the concerned international bodies could not reach to asingle agreement about its universal use. This approach is practiced widely in many centresand there are some specific guidelines regarding its practical use. AMTSL as a prophylacticintervention and is composed of a package of three components or steps: 1) administrationof a uterotonic, preferably oxytocin, immediately after birth of the baby; 2) controlled cordtraction (CCT) to deliver the placenta; and 3) massage of the uterine fundus after the placentais delivered. In 2012, the results of a large WHO-directed, multi-centred clinical trial showedthat the most important AMTSL component was the administration of an uterotonic, theother two steps contributes relatively less in blood loss. But WHO recommends to continueall three steps of AMTSL for management and training of third stage of labour. This article isa brief review of the recent guidelines and evidence based practice of active management ofthe third stage of labour.</p> <p>Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 149-156</p> 2020-07-05T06:03:25+00:00 ##submission.copyrightStatement## Acute Postpartum Pulmonary edema: A Case Report 2020-07-20T08:33:20+00:00 Ahreen Akhtar Namkha Dorji Tabassum Parveen Yeshey Dorjey Firoza Begum Samira Hayee Sabina Karim <p>A 30 year old, G2P1, pregnancy complicated with moderate anaemia, preeclampsia andgestational diabetes mellitus was admitted at 37+ week pregnancy with less fetal movementand premature rupture of membrane. A healthy baby was delivered by caesarean sectionwith uneventful perioperative period. On 4th post operative day, she developed severe acutepulmonary edema where intubation was done instantly and ventilated in the intensive careunit. Patient recovered and extubation done on 6th postoperative day. A healthy mother anda healthy baby were discharged on 10th postoperative day.</p> <p>Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 157-159</p> 2020-07-05T06:04:03+00:00 ##submission.copyrightStatement## B55 Fetus Papyraceous - A Case Report With Maternal Coagulopathy And Successful Maternal and Fetal Outcome 2020-07-20T08:33:24+00:00 Mst Nazmunnaher Mina Ferdous Ara (Shuchi) Afroza Khanum Tahsin Islam Sabiha Sultana Ummul Nusrat Jahan Sufia Begum <p>Fetus papyraceous is defined as a compressed fetus, mummified, parchment-like remainsof a dead twin or triplet that is retained in-utero after intrauterine death in the second trimester.We report a case of one fetus papyraceous with maternal coagulopathy and no maternaland fetal complications in the post-partum period.</p> <p>Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 160-163</p> 2020-07-05T06:04:25+00:00 ##submission.copyrightStatement## Broad Ligament Pregnancy: A Rare Case Report 2020-07-20T08:33:28+00:00 Maruf Siddiqui Nusrat Ghafoor Fahmida Naznine Rusmila Shamim Abdullah T A Chowdhury <p>Broad ligament pregnancy is a rare obstetric condition. Its diagnosis is quite difficult andmanagement is challenging. Here we report a case of a 26 years old primi gravida conceivedfollowing laparoscopy and ovulation induction. Diagnosis of the broad ligament pregnancywas done by a transvaginal ultrasound at her 9 weeks and was proceded with laparoscopyfollowed by laparotomy. A right broad ligament pregnancy was found and the sac with fetuswas removed. Laparoscopy was converted into a laparotomy as there was an uncontrollablebleeding from the broad ligament. Here we present a case of this extreme rare type of broadligament pregnancy.</p> <p>Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 164-166</p> 2020-07-05T06:04:40+00:00 ##submission.copyrightStatement## Abstract Vol.33(2) 2020-07-20T08:33:22+00:00 Sameena Chowdhury <p>Abstract not available</p> <p>Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 167-170</p> 2020-07-05T06:29:47+00:00 ##submission.copyrightStatement## Society News Vol.33(2) 2020-07-20T08:33:26+00:00 Sameena Chowdhury <p>Abstract not available</p> <p>Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 171-172</p> 2020-07-05T06:29:55+00:00 ##submission.copyrightStatement## International News Vol.33(2) 2020-07-20T08:33:30+00:00 Sameena Chowdhury <p>Abstract not available</p> <p>Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 173</p> 2020-07-05T06:30:05+00:00 ##submission.copyrightStatement## BJOG yearly CME program Vol.33(2) 2020-07-20T08:33:33+00:00 Sameena Chowdhury <p>Abstract not available</p> <p>Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 174-177</p> 2020-07-05T06:30:15+00:00 ##submission.copyrightStatement##