Introduction: Down syndrome (DS) is the most common cause of intellectual disability among live born children which can be detected prenatally. This study aims to assess the knowledge attitude and practice of pregnant women about Down syndrome and its available prenatal diagnosis. Method: A study was conducted in Department of Obstetrics and Gynecology of Patan Academy of Health Sciences in 2021.All pregnant ladies who attended the antenatal clinic received a self-administered validated questionnaire to determine their knowledge of Down syndrome, its screening test and willingness to do prenatal testing. Result: Majority of the participants (88%) belonged to age group of 18 to 35 years.59% were primigravidas. Almost 90% were Hindus and 55% had graduate level education. More than half of the participants had poor knowledge of DS and 60 % had no idea regarding the screening tests. However, more than half (56%) of them were willing to undergo screening for DS. One fifth of the women did not want to continue the pregnancy if baby had DS. Higher income is significantly associated with good knowledge in both domain (knowledge about DS, and knowledge about its screening). Illiterates are found to have better knowledge than educated group which seems a bit contradictory, but this might have been due to our smaller sample size. Conclusion: There is a significant gap between women’s knowledge and their attitudes and practice, which has to be addressed with local and national policies and protocols. Informed decision making should be the norm after empowering pregnant women with knowledge.
Introduction: Suicide during the antenatal period is one of the major indirect causes of maternal death. This study aims to determine the prevalence of suicidal risk and its related factors among the patients attending the antenatal clinic of a tertiary care center. Method: This is a cross-sectional study conducted in the antenatal clinic Patan Hospital, Lalitpur, Nepal among 124 pregnant patients using purposive sampling and face-to-face interviews applying a semi-structured proforma and P4 suicide screener. Ethical approval was obtained. The percentage of patients with suicide risk was calculated and stratified into minimal, lower, and higher risk of suicide. The association between suicide risk and different sociodemographic and clinical variables was done using the Chi-square test. A p-values ≤0.05 was considered statistically significant. Result: The prevalence of suicide risk was 32 out of 124 patients (25.8%). When risk stratification was done a maximum of 22(17.7%) had a higher risk for suicide. The risk was associated the employment status (p=0.039), history of previous suicide attempts (p=0.04), and diagnosed mental disorder (p=0.027). Conclusion: Our study shows the suicide risk among antenatal females was 25.8% reaffirming the need for proper screening and referral.
Introduction: This study aims to analyze all the women delivering in our institute according to the Robson’s classification. Robson’s ten group classification system (TGCS) endorsed by WHO, is a global standard tool for assessing, monitoring and comparing cesarean section rates at all levels. Method: This cross sectional study was conducted in the department of obstetrics and gynecology, Patan hospital, Patan academy of health sciences (PAHS), Lalitpur, Nepal over 12 months’ period. All women who delivered during this period were classified according to the Robson’s classification (TGCS) into a specific group. Relative size and overall cesarean section rate of each group were calculated. Result: A total of 4,985 cases were analyzed. The cesarean section rate was 57.7%. Group 1+2 represented nearly half (49%) of the obstetric population served during the study period. Group 2A was found to be the highest contributor (27.4%) followed by Group 5 (22.8%) and Group 1 (13.0%). In terms of indication for cesarean section -Fetal distress and previous cesarean section were found to be the most common indications. Similarly, nulliparous women were three to four times more likely to be delivered by cesarean section when labor was induced. Conclusion: From this study, we can conclude that for an effective reduction in the overall high cesarean section rate in our Institution, we need to focus on a more stringent protocol for inducing labor especially among nulliparous women and to practice evidence based guidelines. Redefining failed induction needs to be considered critically as well.
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