Introduction: Gestational weight gain is an important predictor of the health of the newborn. It is affected by body mass index of the women. This study was conducted to find out gestational weight gain according to Institute of Medicine 2009 recommendation and relationship of newborn birth weight to body mass index and gestational weight gain of the women. Methods: It was cross sectional, hospital based study. The women, who attended at term pregnancy for delivery and having recorded first trimester body weight, were included in the study. Their body mass index was calculated and they were stratified into 4 groups according to body mass index. The gestational weight gain was calculated by subtracting first trimester body weight from body weight at the time of admission for delivery. All the women were followed till delivery. The newborn birth weight was taken immediately after delivery. Results: A total of 227 women were enrolled in the study. More than half of the women had normal body mass index. There were 36% overweight and obese women. Mean gestational weight gain was 10.21 kg, and mean weight of the newborn was 3.05 kg.  There were equal number of women who had adequate weight gain and less weight gain according to the recommendation. Excess weight gain was seen in 15% of women. Women of higher body mass index and women who had gain more weight during pregnancy had larger newborns. Conclusions: Body mass index and gestational weight gain of the women were important predictors of birth weight of the newborn.

Aim: To determine maternal and neonatal morbidities associated with instrumental vaginal delivery. Methods: This retrospective study consisted of 233 women undergoing instrumental vaginal deliveries from April 2020 to March 2021 at Paropakar Maternity and Women Hospital, a tertiary care hospital in Kathmandu, Nepal. Neonatal and maternal complications were analyzed. Results: Of 233 women, 102 (43.7%) and 131 (56.2%) had vacuum and forceps deliveries, respectively. The use of instruments was more frequent in infants with higher birth weight and gestational age. There were no significant differences in Apgar scores between the two groups. Two main indications of instrumental deliveries were fetal distress and prolonged second stage labor. Forceps, compared with vacuum, more often caused 3 rd /4 th perineal tears, tear extending to fornices, and postpartum hemorrhage. Neonatal outcomes were similar in both types of instrumental deliveries. Conclusion: Instrumental vaginal delivery caused maternal morbidity and procedure/judgment training for it is essential.

Background: Leiomyomas are benign smooth muscle neoplasm that typically occurs from the myometrium. Most of the women with uterine leiomyoma remain asymptomatic. Various degeneration including hyaline, cystic, myxoid and red degeneration and dystrophic calcification occur in leiomyoma, among them myxoid degeneration occurs rarely. Here is a case report of 40 years with one living child and two abortions who came with complaints of feeling of heaviness and pain at lower abdomen for six months, palpable lower abdominal mass for four months and difficulty in passing urine since 15 days. Multiple fibroids with cystic degeneration were suspected in Computed Tomography scan report. The patient underwent Total Abdominal Hysterectomy with Bilateral Salphingectomy. On cut section there was a cystic area on the body of uterus containing 1. 1 liter of straw coloured fluid. Final histopathological findings concluded multiple leiomyoma with myxoid degeneration.

Aim: To find out the relationship between gestational weight gain among women with different  early pregnancy Body Mass Index and birth weight of neonates. Methods: This is an analytical observational hospital based study. Singleton pregnancy within 10 weeks of gestation were included in the study and they were followed at term. First trimester Body Mass Index was calculated and the women were divided in to underweight, normal weight, overweight and obese according to World Health Organization classification. Total gestational weight gain was calculated and compared according to the American College of Obstetrics guideline. The birth weight of neonate was recorded soon after the delivery and the relation between gestational weight gain and birth weight of the neonate was studied. Results: Total 228 women were analyzed. Most of the women (69%) had normal Body Mass Index with the mean gestational weight gain of 10.59±4.317 kg and the mean birth weight 3.03±0.487 kg. Underweight and normal weight women had less pregnancy weight gain; overweight women had slightly higher weight gain whereas obese women had weight gain as per the recommendation. The birth weight of neonate was higher in overweight and obese women (p=0.004) but without positive correlation. Conclusions: The gestational weight gain is not related to the birth weight of neonates but related to the early pregnancy BMI.