Please cite this paper as: Malla DS, Giri K, Karki C, Chaudhary P. Achieving Millennium Development Goals 4 and 5 in Nepal. BJOG 2011;118 (Suppl. 2):60–68. The under 5 child mortality rate in Nepal is on track to achieve the target of 54 per 1000 live births by 2015 compared with 158 per 1000 live births in 1991. The maternal mortality rate also looks set to drop to its target of 134 per 100, 000 live births by 2015 from 539 per 100, 000 live births in 1991. A 3‐year interim plan (2008–11) was established to provide free basic health care for all citizens and the safe delivery incentive programme has proved to help progression towards achieving Millennium Development Goals 4 and 5. The development of a policy targeting women, children and vulnerable populations in hard to reach places is a key feature. The principle of a primary healthcare approach is applied in the development and implementation of strategy plans and programmes. The focus is on ensuring that there are functioning facilities for essential obstetric care at health facilities and provision of trained personnel at delivery.

Aim: Aim: Aim: Aim: Aim: To compare cervical cytology in women with healthy/unhealthy cervix. Methods:Methods: Methods: Methods: Methods: A prospective study on Pap smear was performed including 200 women, 100 with healthy and 100 with unhealthy cervix, attending outpatient Gynaecology clinic of the Department of Ob/Gyn TU Teaching Hospital, Kathmandu. The cytology report was compared in the two groups.Results: Results: Results: Results: Results: Cervical dysplasia was seen in 8 women with unhealthy cervix, 7 were mild and one was severe dysplasia. In the women with healthy cervix, 5 had mild and one had moderate dysplasia. Eighty two percent of women with healthy cervix and 83% of women with unhealthy cervix had non-specific inflammation.Women who were married before 20 years (p=0.04) and had higher parity (3.3 Vs 2.8) were more likely to have unhealthy cervix (p=0.03). Excessive vaginal discharge was common in women with unhealthy cervix (p=0.0009).

Objective: The purpose of the present study is to find out the effectiveness of admission test (AT) in detecting fetal hypoxia in labour and to correlate the results of AT with perinatal outcome. Methods: This was a prospective study, conducted in the department of Ob/Gyn, TU, Teaching Hospital. A total of 100 women in labour were selected for the study. All of them were subjected to Admission test which is 15-20 minutes recording of fetal heart rate and uterine contractions on cardiotocograph machine at the time of admission in labour. The result of AT were not revealed to concerned Obstetrician in labour room and the labouring women and the results of the test were evaluated after delivery so that the clinical management is not changed according to the AT result. Result: The results of AT were: Reactive in 73%, Equivocal in 23% and Ominous in 4%. Women with reactive AT had low risk of developing intraapartum fetal distress (1%) as compared to 4.3% of equivocal and 50% of ominous group. Operative delivery for fetal distress was required in only 1.4% of reactive group in comparison to 4.3% of equivocal and 50% of ominous group. Resuscitation was required in 1.4% of reactive group, 8.7% of equivocal and 25% of ominous group. Four babies required neonatal unit and NICU admission for neonatal sepsis (2 from reactive, 2 from equivocal group) and none suffered from intranatal hypoxia. Conclusion: The AT seems to be useful to detect fetal distress already present at admission and seems to have some predictive value for fetal well being for the next few hours of labour. Key words: Admission test, Cardiotocograph, fetal heart rate, fetal distress, fetal hypoxia, perinatal outcome.   doi:10.3126/njog.v1i2.1487 N. J. Obstet. Gynaecol Vol. 1, No. 2, p. 10 - 13 Nov-Dec 2006

A 17-year-old girl had a large abdominopelvic mass (12 x 8cm) extending from vagina, due to the presence of a complete transverse vaginal septum in its middle third which on resection facilitated the drainage and disappearance of the mass finally diagnosed as a case of mucocolpos.