Introduction: Estimation of accurate fetal weight is essential in obstetrical management and we aim to see the accuracy of fetal ultrasound in estimating birth weight in our setting. Method: 150 women with full term singleton pregnancy leading to live birth were included in the study. Prenatal fetal ultrasound database was reviewed for the fetal biometry and fetal weight estimation and delivery records were reviewed for actual birth weight. Error in estimation was calculated.Result: The study showed that fetal ultrasound using Hadlock.s formula has error in estimation of fetal weight by about 290 gm ± 250 gm. In 40% of the cases, there is an error of estimation by more than 10% compared to actual weight. Conclusion: There is a significant error in the estimation of the fetal weight. Depending only on the fetal ultrasound for the estimation of fetal weight can lead to unnecessary obstetrical intervention. It is necessary to correlate the ultrasound findings with clinical examination.Health Renaissance; September-December 2012; Vol 10 (No.3);236-238DOI: http://dx.doi.org/10.3126/hren.v10i3.7053

Aims: To assess safety and feasibility of non-descent vaginal hysterectomy. Methods: A hospital based prospective study was conducted at the department of obstetrics and gynecology of Kathmandu Medical College Teaching Hospital from 1st January 2010 to 31st December 2011. All the patients undergoing non -descent vaginal hysterectomy for benign indication, without suspected adnexal pathology were included in the study. Vaginal hysterectomy was done in usual manner. In bigger size uterus morcellation techniques like bisection, debulking, myomectomy, slicing, or combination of these were used to remove the uterus. Data regarding age, parity, uterine size ,estimated blood loss, length of operation, complication and hospital stay were recorded. Results: A total of 50 cases were selected for non-descent vaginal hysterectomy. Among them 43 cases successfully underwent non-descent vaginal hysterectomy. Commonest age group was (41-45 years) i.e. 40%. All patients were parous. Uterus size was <10 weeks in 27 cases and >10 weeks in 23 cases. Commonest indication was leiomyoma of uterus (63%). Mean duration of surgery was two hours. Mean blood loss was 205.26ml. Reasons for failure to perform NDVH was difficulty in opening pouch of Douglas in three cases. In rest of four cases there was difficulty in reaching the myoma and transverse diameter was too large so as to prevent descent of the uterus. The most common complication was post –operative pain in 23% of cases. Febrile morbidity was present in 4.6% of cases. Blood transfusion was required in seven cases. Average duration of hospital stay was three days. Conclusions: Vaginal hysterectomy for benign gynecological causes other than prolapse is safe and feasible. For successful outcome size of uterus, size in all dimensions and location of fibroid should be taken into consideration.Today in the era of minimally invasive surgery, non descent vaginal hysterectomy needs to be considered and seems to be a safe option. DOI: http://www.dx.doi.org/10.3126/njog.v7i2.11134   Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 2 / Issue 14 / July-Dec, 2012 / 14-16

Introduction: Cancer of uterine cervix is a leading cause of mortality and morbidity among womenworldwide. In developing countries it is the most common gynaecological cancer and one of theleading causes of cancer death among women. Pap smears are commonly used as cytologicalscreening test for successful eradication of precancerous lesions, which has made it a routineprocedure worldwide.Methods: This descriptive study was conducted at Kathmandu Medical College Teaching Hospital,Kathmandu within a period of two years from January 2011 to December 2012. A total of 1369 caseswere screened.Results: In this study, cytological examination of the smears showed 944 (68.95%) inflammatorysmears, 301(21.99%) normal smears, 101(7.38%) atrophic smears, seven (0.51%) ASCUS, two (0.15%)LSIL, four (0.29%) HSIL and two (0.15%) squamous cell carcinoma. Radiation changes were seen inthree (0.22%) cases. Of all the smears studied five (0.36%) cases were inadequate. Regarding ethnicity,incidence of epithelial cell abnormalities was high in Tamang (5 cases). Eleven cases (73.33%) ofepithelial cell abnormalities were seen in patients from urban areas.Conclusions: In country like Nepal with predominant rural population, screening and awarenessprograms with co-operation of media, non-government organizations and government should beformulated for early detection of cervical cancer._______________________________________________________________________________________Keywords: Bethesda system; cervical intraepithelial lesions; pap smear___________________________________________________________________________

Aims:To study preference of gender of fetuses in present pregnancy, wish of number of children in the family, and knowledge of pre-natal sex selection by the pregnant women, and to study the impact of education level of women on preference of fetal gender and the desire of women to know the gender of fetuses. Methods:It was a descriptive study done in Obstetrics and Gynaecology Department of Kathmandu Medical College. All primigravidae, who did not know the gender of their fetuses and willing to participate in the study were enrolled in the study. The pregnant women were interviewed regarding demographic profile of the women, choice of gender of fetuses, number of children they want to have and knowledge regarding prenatal sex selection, using semi structured questionnaire.Results: Two hundred women were studied. Two third of them were educated minimum of 12th Class. Most of the pregnant women (81%) did not show preference of gender of their fetuses, only 13% of them wanted to have son in this pregnancy. About 61% of them want to have two children in their family. Regarding prenatal sex selection, only 44% knew about it. More than half (56%) of the women showed interest in knowing the gender of fetuses in present pregnancy. The education status of women did not have an effect on the choice of either gender or wish to know the gender of unborn fetuses by primigravidae. Conclusions:Most of the primigravidae had no choice of gender of fetuses. Two children in the family was regarded as ideal by most of the women

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Background: Chronic pelvic pain is a common problem in reproductive age group women. Diagnosis of chronic pelvic pain needs multidisciplinary approach. Diagnostic laparoscopy is one of the investigations which can help in reaching the diagnosis. Objective: To know the etiology in chronic pelvic pain. Methods: This was a descriptive study done in the Department of Obstetrics and Gynaecology of Kathmandu medical college teaching hospital from January 2010 to June 2012 (30 months). All the cases of laparoscopic surgery done for chronic pelvic pain were noted and details of these cases were analyzed regarding age, parity and laparoscopic fi ndings. Results: Total 48 cases of Chronic Pelvic Pain underwent diagnostic laparoscopy during the study period. Mean age of cases were 33 years, ranging from 20-46yrs. Almost half of the cases 43.75% were of parity two. Laparoscopic fi nding was negative in 29.17% and pelvic pathology was present in 70.83% of the cases. Out of the pelvic pathology endometriosis was present in 55.88% followed by pelvic adhesions, pelvic congestion and pelvic infl ammatory disease, chronic ectopic in 20.58%, 14.70%, 5.88%, 2.94% respectively. Conclusion: Diagnostic laparoscopy is a useful modality in the diagnosis of etiology and management of Chronic pelvic pain. In our study, Pelvic endometriosis was the most common pelvic pathology in cases of Chronic pelvic pain.