Introduction: The complications of cesarean section are seen more commonly in emergency than in elective cases. The aim of this study was to find out the incidence of cesarean section in Nepal Medical College Teaching Hospital and to compare the maternal and fetal outcome in elective and emergency cesarean section. Methods: A prospective study of all the cases undergoing cesarean section in Nepal Medical College Teaching Hospital was carried out during the period of six months from Asar 2069 to Mangsir 2069. Results: The incidence of cesarean section was 254 (22.30%) out of which emergency cesarean section accounted for 167 (65.7%) and elective cesarean section for 87 (34.3%). The usual indications of emergency cesarean section were fetal distress, previous cesarean section in labour, non progress of labour and prolonged second stage of labour. The usual indications of elective cesarean section were previous cesarean section, breech, cephalopelvic disproportion and cesarean section on demand. There was found to be no significant difference in age, period of gestation, blood loss and blood transfusion in emergency vs. elective cesarean section. There was significant difference seen in the length of hospital stay, fever, urinary tract infection, wound infection and low APGAR in five minutes indicating that these were more common in emergency cesarean section. Significant difference was also seen in the incidence of postpartum haemorrhage indicating that it was seen more in elective cesarean section. Conclusions: The incidence of cesarean section in Nepal Medical College Teaching Hospital is high and the overall complication rate is higher in emergency cesarean section than in elective cesarean section.Keywords: cesarean section; fetal and maternal outcome.

Unsafe abortion is a major health issue. Therefore safe abortion services which is effective. acceptable and techniquely easy to perform should be available. AimAim Aim Aim Aim-To confirm effectiveness, side effects, safety and patient satisfaction with medical termination of early pregnancy.MethodsMethods-MethodsMethods-Methods-It was a prospective study 150 women who were less than 63 days pregnant and consented for medical termination of pregnancy were given! 200mg 0 Mefepristone orally and 48 hrs later 800 micro gram Misoprostol was inserted vaginally. They were followed up in 14 days. Bleeding, pain G.I symptoms any other side effects were recorded. Abortion was complete or not was confirmed clinically and by USG. Failure and success was documented depending upon need for surgical evacuation.ResultsResults-ResultsResults-Results-The success rate with this regime was 92.6% and failure rate was 7.3%. There were no major side effects with Mifepristone. The average bleeding after misoprostol insertion was 10 days and 80% women had more bleeding than normal period. All of them had pain. Only 13.3% needed analgesic. women (96%) were satisfied with the method. Conclusion Conclusion ConclusionConclusion Conclusion-combination of mifepristone and misoprostol is a safe and effective of early pregnancy K K K

Background: Caesarean section performed for appropriate obstetric or medical indications are life saving for both mother and new born. But its advantage does not justify its continuous increase as it is a major surgical procedure associated with maternal and fetal complications. The main objective of this study was to study the indications of primary caesarean section and its maternal and fetal complications in Nepal medical college teaching hospital (NMCTH).Methods: This is a hospital based cross sectional study carried out for a period of one year from 1st October 20113 to 30th September 2014 in department of obstetrics and gynecology in NMCTH Nepal. The study included 183 primary caesarean cases enrolled as per the inclusion criteria. The indications for caesarean section, associated maternal and fetal complications were noted.Results: The rate of caesarean section during the study period was 21.40%. The study included 183 patients who underwent primary caesarean section, 162 (88.5%) cases were emergency cases and 21 (11.5%). Cases were elective cases. The most common indications were fetal distress (n-74, 40.4%) followed by cephalo pelvic disproportion (n-27, 14.8%). The maternal complications seen were urinary tract infection (n-34, 68%), wound infection (n-12, 24%), post-partum hemorrhage (n-3, 6%). The common fetal complications noted were apgar score of less than 7 (n-7, 31.8%), transient tachypnea of newborn (n-6, 27.27%) and meconium aspiration syndrome (n-4, 18.18%).Conclusions: Emergency primary caesarean section was proportionally higher than elective caesarean section. It was also associated with more maternal and fetal complications.

Gonadal dysgenesis is a rare genetically heterogeneous disorder characterized by underdeveloped ovaries with consequent, impuberism, primary amenorrhea, and hypergonadotropic hypogonadism .Mullerian agenesis or Mayer‑Rokitansky‑Kuster‑Hauser syndrome is characterized by congenital aplasia of the uterus and the upper part (2/3) of the vagina in a woman with normal development of secondary sexual characteristics and a normal 46 XX karyotype. The association of gonadal dysgenesis and Mayer-Rokitansky-Kuster-Hauser syndrome is very rare and appears to be coincidental. We report the case of a 24-year-old woman who presented with primary amenorrhea. The endocrine study revealed hypergonadotrophic hypogonadism. The karyotype was normal, 46XX. Internal genitalia could not be identified on the pelvic ultrasound and pelvic MRI. There were no other morphological malformations.

Introduction: Menopause is the permanent cessation of menstruation for more than a year resulting from the loss of follicular activity of the ovaries. It is manifested by vasomotor, psychological, and urogenital symptoms which can be assessed by an internationally accepted scale known as Menopause Rating Scale. This study was conducted to find out the issues of perimenopausal women and proceed for management and proper counseling. Methods: A descriptive cross-sectional study was conducted among women visiting the gynecological outpatient department of a tertiary care hospital from June 2017 to May 2018 using the Menopause Rating Scale. Ethical approval was taken from the Institutional Review Committee (reference number: 20122016). Convenient sampling was done. Statistical Package for the Social Sciences version 20.0 was used for data analysis. Point estimate at 90% confidence interval was calculated along with frequency and proportion for binary data. Results: Out of 189 perimenopausal women interviewed, the mean age of menopause was found to be 50.2±2.1 years. The most common gynecological symptoms among the study population was abnormal uterine bleeding 66 (34.9%) followed by abnormal vaginal discharge 50 (26.5%). Among symptoms in Menopause Rating Scale, the depressive mood was found in 99 (52.4%) cases followed by joint and muscular discomfort 88 (46.6%) and bladder problems in 87 (46%). None of the women had a score on the Menopause Rating Scale more than 16 and did not require management for their problem. Conclusions: Most of the women didn't know menopausal symptoms. However, none required intervention from gynecologists for their problems reflecting better quality of life.

This was a prospective study done in Marie Stope clinic, Chabhill, Kathmandu. One hundred women who had Norplant insertion between May 1996 to April 1997 were followed up for a year for its side effects. The age, ethnic group, number of living children, literacy, socioeconomic status of the women who has Norplant insertion were also analyzed. Norplant was found to be most popular in age group of 21-30 years (68%). Maximum number of acceptors were in Chetri community (32%). It was a popular contraceptive in women who had two or more children and those who came from low socioeconomic group and were illiterate. Among side effects, menstrual irregularity was commonest (67%) headache was present in 12%, weight gain and depressive symptoms each was present in 10% of women. 2% had local infection at insertion site and 1% of woman had allergic reaction. SHRIVASTAVA V. 2ABSTRACT:

Abstract

Background: Induction of labour has now become a common practice; this study was conducted to find the outcome of induction of labour in pregnant women in relation to: induction delivery interval, mode of delivery, maternal complications and fetal outcome.Methods: It was a hospital based prospective study conducted from April 2012 to March 2013. Singleton pregnancy of gestational age ≥37 weeks, with vertex presentation and Bishops Score <6 were the cases included for induction. Dinoprostone (0.5mg) intracervically was used for induction. The different outcome parameters were analyzed.Results: Of 100 cases enrolled, majority 93% were below 30 years, mean gestational age of induction was 40.7± 0.7weeks and 58% were primi gravida. Ante natal care visit of ≥3 was present only in 66%. At induction 55% had bishop score of (0-3) and rest had score of (4-5). Postdated pregnancy (67%) followed by hypertension (13%) were the two most common causes for induction. 58% required second dose of dinoprostone, and the induction delivery interval was 24.3±9.6 hrs. 63% of the induced labour progress for vaginal delivery. Fetal distress (56.4%) was the commonest indication for caesarean section (CS). 6% of the cases had postpartum hemorrhage. 13% of the delivered neonate required NICU care, of which 53.8% was moderately asphyxiated. There was no maternal or neonatal death.Conclusions: In pregnancy undergoing induction of labour, CS is not uncommon, and there are few chances of maternal and neonatal morbidities. Therefore, obstetrician should be vigilant to avoid any untoward events.