Background. Breech presentation is associated with increased rates of maternal and perinatal morbidity regardless of mode of delivery. After the results of Term Breech Trial, most of the countries adopted the protocol of cesarean section for term breech delivery because of which breech vaginal delivery is becoming rare. The aim of this study is to evaluate short-term maternal and perinatal outcomes of breech vaginal delivery at a tertiary care hospital in Nepal. Methods. A retrospective review of case records of all women who had vaginal breech delivery from April 13, 2016, to April 12, 2018, was conducted, over a period of two years. Available demographic variables, obstetric characteristics, details of labor, postpartum complications, and perinatal complications were recorded and analyzed. Results. Out of 21,768 cases of deliveries during the study period, the incidence of term breech deliveries was 528 (2.4%) among which the mode of only 84 (17.8%) deliveries was vaginal. Most of the deliveries were unplanned and were conducted because emergency cesarean section could not be performed. Three (3.6%) women had postpartum hemorrhage, and four (4.8%) had entrapment of aftercoming head, two of them requiring Dührssen incisions. Adverse perinatal outcomes were seen in 23.8% of such deliveries with <7 APGAR score at 5 minutes in 20.2%, neonatal admission in 17.7%, and perinatal mortality in 8.3%. The perinatal mortality was significantly associated with birthweight less than 2500 grams as compared to birthweight ≥2500 grams (21.1% versus 4.6%; P = 0.043 ). Conclusion. The perinatal outcomes for vaginal breech delivery are grave with our existing health facilities, especially when the deliveries are not well planned.

Background: Menopause poses a big challenge during middle age and to the healthy aging of woman. Majority of women face various problems and disturbances in daily living leading to decrease in quality of life. This study focuses on menopause related symptoms and quality of life in relation to the symptoms. Method: This descriptive cross-sectional study was conducted among 200 women of age 40-60 years at Dharan Sub-metropolitan City of Nepal selected through snowball sampling technique. The data were collected over the period of four weeks. Semi- structured questionnaire for demographic variables and menopause specific quality of life (MENQOL) questionnaire were used to collect data. Interview technique was adapted. Descriptive and inferential statistics were used to interpret data. Result: Mean menopausal age of the study group was 47.14 years. The most common symptoms of vasomotor, psychosocial, physical and sexual domains were hot flushes, experiencing poor memory, feeling tired or worn out and change in sexual desire respectively. The overall score of menopausal quality of life for each domain reported that highest the mean score in sexual domain (3.58 ± 1.62) and least score in vasomotor domain (2.08 ± 1.67). The score of physical domain was significantly high in late postmenopausal group than early postmenopausal group. Significant association was obtained with age, ethnicity, menopause status, physical activity and marital status in relation to the domains of quality of life. Conclusions: The results conclude that all the menopausal women were having at least one menopausal symptom from each domain. The menopausal women scored highest in sexual domain and least in vasomotor domain suggesting decrease quality of life in relation to sexual domain. Menopausal symptoms were associated with decrease in quality of life. Thus awareness regarding the menopausal changes should be focused in premenopausal age group of women

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