BackgroundReducing neonatal death has been an emerging challenge in low and middle income countries in the past decade. The development of the low cost interventions and their effective delivery are needed to reduce deaths from birth asphyxia. This study will assess the impact of a simplified neonatal resuscitation protocol provided by Helping Babies Breathe (HBB) at a tertiary hospital in Nepal. Perinatal outcomes and performance of skilled birth attendants on management of intrapartum-related neonatal hypoxia will be the main measurements.Methods/DesignThe study will be carried out at a tertiary level maternity hospital in Nepal. A prospective cohort-study will include a six-month baseline a six month intervention period and a three-month post intervention period. A quality improvement process cycle will introduce the neonatal resuscitation protocol. A surveillance system, including CCD cameras and pulse oximeters, will be set up to evaluate the intervention.DiscussionAlong with a technique to improve health workers performance on the protocol, the study will generate evidence on the research gap on the effectiveness of the simplified neonatal resuscitation protocol on intrapartum outcome and early neonatal survival. This will generate a global interest and inform policymaking in relation to delivery care in all income settings.Trial registrationISRCTN97846009

Aim: To determine the demographic characters of patients of eclampsia and the effectiveness of Magnesium Sulphate in terms of maternal and perinatal outcome. Methods: A prospective study of the eclamptic patients was conducted from 18 th Aug -17 th Oct 2006 (1 Bhadra 2063 to 30 Ashwin 2063) attending the Obstetric Department of Janakpur Zonal Hospital (JZH). Results: Of the 50 eclamptic women [antepartum 80%, intrapartum 6 % and postpartum 14%] with overall improvement in 92% although 2 cases had to be referred to center with ICU facility and 2 cases died. The demographic characteristics were young primiparous population of low socioeconomic condtion. Caesarean was done for 48 %. Pretermaurity was seen in 50% and 76% were live birth. Conclusions: Nepal has a high maternal mortality rate and eclampsia is a big contributing factor, which could be reduced by using magnesium sulphate widely in all parts of Nepal taking, ours as one of the peripheral hospital as an example.

We hereby report a case of retained second twin presenting with vertex which was delivered vaginally after 27hours from the first birth, without any complication in 25 years old G 2 P 1 L 1 A0 detailing that such obstetric events can be smoothly handled.

DOI: http://dx.doi.org/10.3126/njog.v5i1.5067 NJOG 2010 Jul-Aug; 5(1): 61-67