Introduction: Second stage caesarean section is usually associated with the deeply engaged head, less liquor, and thinned out the lower uterine segment. This can lead to a high risk of maternal morbidities like an extension of the lower uterine segment incision, uterine atony, and injury to urinary bladder as well as neonatal morbidities such as birth asphyxia, NICU admission, and meconium aspiration syndrome. This study aims to observe the maternal and neonatal outcomes of caesarean delivery performed in the second stage of labor. Materials and Methods: This was a retrospective study of the fetomaternal outcome of all women with singleton, a cephalic fetus at term delivered by caesarean section in the second stage of labor over one year at Tribhuwan University Teaching Hospital. Results: During this study period, there were 4653 deliveries. A total of 2274(48.88%) were born by caesarean section, out of which 1739 (76.5%) were elective and 535(23.5%) were emergency. Among emergency LSCS 36(6.72%) were performed in the second stage of labor. Most of the indications were nondescent of head 34(93.5%) followed by intraoperative maternal complications (hematuria; n=14; 38.88%). Postoperative maternal who had complications were prolong catheterization: 14(38.88%), postoperative fever : 10 (27.77%), prolong hospitalization: 5(13.88%). In perinatal complications meconium stain liquor : 10(27.77%), NNU admissions : 5(13.88%), Apgar score <5 at 5 min : 5 (13.55%), NICU admission : 2(5.54%), fresh stillbirth : 1(2.77%) were observed. Conclusions: Caesarean sections done in the second stage of labor are associated with severe maternal and neonatal complications.

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An infrequent form of ectopic pregnancy, pregnancy in an isthmocele can be hazardous due to hemorrhage or uterine rupture. With no clear guidelines for the management of this condition, surgery is the preferred option.

Introduction: Adolescence is the period between the ages of 10-19 years that encompasses time from onset of puberty to full legal ages (WHO 2002). Objective: The objective of the study was to explore effect of maternal ages on fetomaternal and perinatal outcome. Methods: This is a hospital based retrospective case-control study conducted over 1 year (March 2017 to February 2018) in the department of Obstetrics and Gynaecology in Tribhuvan University Teaching Hospital to study the antenatal complications and perinatal outcome in adolescent pregnant women as compared to pregnant women of age 20-30 years. Results: During this study period, there were 4980 deliveries out of which adolescent pregnancy were 140(2.8%). Anemia was significantly more in teenage group (16.42% vs 8.57%, p=0.047). Incidence of hypertensive disorders was 5.71% and 1.42% (p=0.05) in teenage and adult group. Proportion of babies with intrauterine growth restriction was 5.71% in teenage and 1.42% (p=0.05) in adult group. Low birth weight babies were significantly higher in teenage group than adult group 16.42% vs 8.57% (p=0.047). NNU admission and apgar score were significantly higher in teenage group 5.71% vs 1.42%. Conclusion: Teenage pregnancies are associated with adverse obstetric and perinatal outcome.

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Synchronous ovarian and endometrial tumor is a rare entity. We report a case of a 38-year woman with an endometrioid variant of synchronous primary endometrial and left ovarian carcinoma. Patient underwent total abdominal hysterectomy with bilateral salphingo-oophorectomy with lymphadenectomy and is disease free till 9 months.

Synchronous tumors of the female genital tract are rare and should be differentiated from primary endometrial or ovarian tumors with metastasis as the two entities have different therapeutic and prognostic implications.

Introduction: Gynecological malignancies include malignancies affecting the female reproductive organs ovary, cervix, body of uterus, vulva, vagina, and gestational trophoblastic neoplasia. Materials and Methods: This is a hospital-based retrospective observational study of histopathological confirmed gynecological malignancies conducted in the department of Obstetrics and Gynecology, TUTH, Maharajgunj, Kathmandu for 3 years from April 2016 to March 2018. Results: Among 314 cases enrolled in the study, the most common gynecological malignancy was of ovary (50.63%), followed by the cervix (30.25%), endometrium (9.23%), (4.77%) gestational trophoblastic neoplasia (3.82%), and fallopian tube (1.27%). 71% of the gynecological malignancies presented in early-stage and 29% in late-stage. The most common histopathological diagnosis of ovarian cancer was serous cystadenocarcinoma (30.18%), cervical cancer was squamous cell non-keratinizing type (46.3%), endometrial carcinoma was endometrioid adenocarcinoma (55%), vulval carcinoma was squamous cell carcinoma (86%), fallopian tube carcinoma (100%). The mean age of gynecological malignancy was 49.06 +- 10.08 years. Conclusions: Screening of gynecological malignancy is necessary to identify the disease in early-stage to decrease maternal morbidity and mortality.