Study about caeserean section In nulliparous women Introduction: Cesarean section rates in Mongolia exceed WHO recommendations of 5–15%, reaching 27.6% nationally and 34.1% at the First Maternity Hospital between 2019–2023. C-sections, while life-saving, increase risks of hemorrhage, infection, uterine complications, and reduced maternal quality of life. This study aimed to analyze emergency C-sections by Robson classification and identify associated risk factors in groups 1, 2a, 3, and 4a. Materials and methods: A retrospective case-control study was conducted using 886 medical records (443 emergency C-sections and 443 vaginal deliveries) from 2021–2023. Data were analyzed with IBM SPSS 24.0, and binary logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI). Results: Robson 2a was the most frequent category (43.8%), followed by 4a (25.7%), 1 (20.1%), and 3 (10.4%). Significant risk factors for emergency C-section included maternal age (p<0.001), early cervical dilation (<5 cm) at labor diagnosis (OR 3.54), abnormal CTG, pre-eclampsia, PROM, amniotomy, infertility, and malposition. Multivariate analysis showed PROM (aOR 14.66), amniotomy (aOR 6.85), fetal weight ≥4000 g (aOR 4.07), and maternal age (aOR 1.48) as key predictors. Conclusions: Emergency C-sections were most common in Robson group 2a. Major contributing factors included PROM, amniotomy, maternal age, macrosomia, and abnormal labor patterns. Targeted interventions to manage these risk factors could reduce unnecessary emergency C-sections.

Background and Aims: The BALAD scores are developed to provide an objective determination of prognosis for hepatocellular carcinoma (HCC) by incorporating five serum markers, namely albumin, bilirubin, alpha-fetoprotein (AFP), agglutinin-reactive alpha fetoprotein (AFP-L3), and des-γ-carboxy prothrombin. We aim to study the applicability of BALAD score and prognostication of the three tumor markers, albumin and bilirubin. Methods: Patients who were served by clinical laboratory were prospectively enrolled. All the baseline characteristics and serum albumin and bilirubin level were documented at base line. The levels of the three tumor markers (AFP, AFP-L3, and des-γ-carboxy prothrombin) were determined in serum samples. assays of AFP, AFP-L3, and DCP were conducted in the same serum sample by using a microchip capillary electrophoresis and liquid phase binding assay on a μTAS Wako i30 analyzer (Wako Pure Chemical Industries, Ltd, Osaka, Japan). To detect albumin and bilirubin amount were using the cobas 6000 analyzer series that is a fully automated, software-controlled system for immunoassay and photometric analysis intended for qualitative and quantitative in vitro determinations. Results: A total of 103 patients who were served by clinical laboratory were recruited. AFP, albumin, bilirubin, DCP and AFP-L3 levels were independent prognostic factors. When the study participants evaluated BALAD scores, 45.63% scored 0 points, 28.16% scored 1 point, 10.68% scored 2 points, 8.74% scored 3 points, 3.88% scored 4 points, 1.94% 5 points, and 0.97% 7 points. Conclusion BALAD score is applicable in the population of hepatitis B and C virus related HCC. When AFP L3% increases by one unit, BALAD scores are 0.04 times higher (P=0.0001) that is presenting statistically significance.