We hereby disseminate a case of a baby girl, who at ten months of age received MMR vaccine but was discovered to later have unilateral congenital cataract at eight years of age. At 25 years, she was married giving birth to a baby boy who had normal vision. Unfortunately, the second baby girl was detected to have bilateral cataract for which the baby at four months of age underwent lens aspiration and anterior vitrectomy of both eyes at a gap of one week. A month later a glass with bilateral +21 Diopters were prescribed. She is planned for intraocular lens implant at around four years of age. She is on currently on visual rehabilitation and treatment for amblyopia Learning lesson from this case being the fact that congenital cataract may run in family and may impart vision deprivation in the offspring; therefore, the importance of preconception counseling is important.
{"title":"A Baby Girl Born with Bilateral Congenital Cataract to A Mother with Unilateral Congenital Cataract Treated in Childhood","authors":"Apariharya Rana, Srijana Adhikari, Chandika Pandit","doi":"10.59881/jpeson9","DOIUrl":"https://doi.org/10.59881/jpeson9","url":null,"abstract":"We hereby disseminate a case of a baby girl, who at ten months of age received MMR vaccine but was discovered to later have unilateral congenital cataract at eight years of age. At 25 years, she was married giving birth to a baby boy who had normal vision. Unfortunately, the second baby girl was detected to have bilateral cataract for which the baby at four months of age underwent lens aspiration and anterior vitrectomy of both eyes at a gap of one week. A month later a glass with bilateral +21 Diopters were prescribed. She is planned for intraocular lens implant at around four years of age. She is on currently on visual rehabilitation and treatment for amblyopia Learning lesson from this case being the fact that congenital cataract may run in family and may impart vision deprivation in the offspring; therefore, the importance of preconception counseling is important.","PeriodicalId":158871,"journal":{"name":"Journal of Perinatal Society of Nepal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134613103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
U. Khanal, Akash Kumar Chaurasia, Birendra Raj Joshi, A. Jha
Introsution: Gestational age of fetus is estimated by including various biometric parameters. Newer parameters like fetal kidney length have not been studied in Nepalese population. Objective: To determine gestational age by fetal kidney length measurement after the 20th week of gestation in healthy women with uncomplicated pregnancy. Method: Obstetric sonography was performed in 108 pregnant women with regular menstrual cycles, known menstrual age and uncomplicated pregnancy from 20 weeks to term. Fetal kidney length was evaluated as a measure to calculate the predicted gestational age. Results: The study showed mean fetal kidney length at 20-24, 25-29, 30-34 and 35-37 weeks gestation 22.5 ± 0.5, 26.9 ± 0.7, 32.32 ± 0.7 and 36.3 ± 0.6 mm, respectively. Overall, in second and third trimester, fetal kidney length showed strong linear correlation with gestation age with highest significant Pearson correlation coefficient of 0.989 as compared to other parameters (BPD=0.986, HC=0.976, AC= 0.971, FL= 0.984). Conclusion: Fetal kidney length can be used as a reliable parameter for determination of gestational age.
{"title":"Determination of Gestational Age by Fetal Kidney Length Measurement in Uncomplicated Pregnancy in a Tertiary Care Centre","authors":"U. Khanal, Akash Kumar Chaurasia, Birendra Raj Joshi, A. Jha","doi":"10.59881/jpeson7","DOIUrl":"https://doi.org/10.59881/jpeson7","url":null,"abstract":"Introsution: Gestational age of fetus is estimated by including various biometric parameters. Newer parameters like fetal kidney length have not been studied in Nepalese population. \u0000Objective: To determine gestational age by fetal kidney length measurement after the 20th week of gestation in healthy women with uncomplicated pregnancy. \u0000Method: Obstetric sonography was performed in 108 pregnant women with regular menstrual cycles, known menstrual age and uncomplicated pregnancy from 20 weeks to term. Fetal kidney length was evaluated as a measure to calculate the predicted gestational age. \u0000Results: The study showed mean fetal kidney length at 20-24, 25-29, 30-34 and 35-37 weeks gestation 22.5 ± 0.5, 26.9 ± 0.7, 32.32 ± 0.7 and 36.3 ± 0.6 mm, respectively. Overall, in second and third trimester, fetal kidney length showed strong linear correlation with gestation age with highest significant Pearson correlation coefficient of 0.989 as compared to other parameters (BPD=0.986, HC=0.976, AC= 0.971, FL= 0.984). \u0000Conclusion: Fetal kidney length can be used as a reliable parameter for determination of gestational age. ","PeriodicalId":158871,"journal":{"name":"Journal of Perinatal Society of Nepal","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124345287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Department of obstetrics and gynecology is one of the busiest departments amongst hospital visits. The aim of this study was to determine the disease pattern prevailing in out-patients of department of obstetrics and gynecology and their segregation with respect to infectious and non-infectious etiology. Methods: This hospital based cross-sectional study was conducted in outpatients attending obstetrics and gynecology department of Kathmandu National Medical College, Kathmandu, Nepal from 17th August 2017 to 16th August 2018. A sum of 1504 patients attending the department was enrolled in the study which included cross referrals for out-patient consultations as well. Diagnosis was based on history, examination and/or investigations (urine, cervical discharge, blood and/or ultrasonography- abdomen and pelvis). Results: More than half (n=803, 53.4%) out-patient department consultation was observed in age group of 20-30years with mean age of 24years. Noninfectious etiology accounted for most out-patient visits (n=1016, 67.6%). The top five out-patient department visits noted were vaginal discharge syndrome (n=325, 21.6%) followed by abnormal uterine bleeding (n=202, 13.4%), ante-natal visits (n=147, 9.8%), non-specific pain lower abdomen/backache (n=108, 7.2%) and urinary tract infection (n=98, 6.5%). Among the total 82 cross-referrals, the order for referral was Medicine (n=34, 41.5%), Dermatology (n=22, 26.8%), Pediatrics (n=12 14.6%), Surgery (n=8, 9.8%) followed by Dental (n=6, 7.3%). Conclusions: The patterns of gynecological problems observed were vaginal discharge followed by abnormal uterine bleeding, non-specific pain lower abdomen/backache and urinary tract infection in descending order. The most common infectious problem being vaginal discharge and non-infectious being abnormal uterine bleeding. The result of this study will be helpful for health planners and policy makers for launching programs to reduce gynecological morbidity and improve overall women’s health.
{"title":"Disease Pattern of Out-Patient Department Visits in The Department of Obstetrics and Gynecology at A Tertiary Care Hospital","authors":"Pramod Kattel","doi":"10.59881/jpeson2","DOIUrl":"https://doi.org/10.59881/jpeson2","url":null,"abstract":"Background: Department of obstetrics and gynecology is one of the busiest departments amongst hospital visits. The aim of this study was to determine the disease pattern prevailing in out-patients of department of obstetrics and gynecology and their segregation with respect to infectious and non-infectious etiology. \u0000Methods: This hospital based cross-sectional study was conducted in outpatients attending obstetrics and gynecology department of Kathmandu National Medical College, Kathmandu, Nepal from 17th August 2017 to 16th August 2018. A sum of 1504 patients attending the department was enrolled in the study which included cross referrals for out-patient consultations as well. Diagnosis was based on history, examination and/or investigations (urine, cervical discharge, blood and/or ultrasonography- abdomen and pelvis). \u0000Results: More than half (n=803, 53.4%) out-patient department consultation was observed in age group of 20-30years with mean age of 24years. Noninfectious etiology accounted for most out-patient visits (n=1016, 67.6%). The top five out-patient department visits noted were vaginal discharge syndrome (n=325, 21.6%) followed by abnormal uterine bleeding (n=202, 13.4%), ante-natal visits (n=147, 9.8%), non-specific pain lower abdomen/backache (n=108, 7.2%) and urinary tract infection (n=98, 6.5%). Among the total 82 cross-referrals, the order for referral was Medicine (n=34, 41.5%), Dermatology (n=22, 26.8%), Pediatrics (n=12 14.6%), Surgery (n=8, 9.8%) followed by Dental (n=6, 7.3%). \u0000Conclusions: The patterns of gynecological problems observed were vaginal discharge followed by abnormal uterine bleeding, non-specific pain lower abdomen/backache and urinary tract infection in descending order. The most common infectious problem being vaginal discharge and non-infectious being abnormal uterine bleeding. The result of this study will be helpful for health planners and policy makers for launching programs to reduce gynecological morbidity and improve overall women’s health.","PeriodicalId":158871,"journal":{"name":"Journal of Perinatal Society of Nepal","volume":"23 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125947301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Preterm births accounts for about 11.1 % of births worldwide. Infection accounts for 20% – 40% of these cases and Bacterial vaginosis has been found in 15 % of preterm labor group. Objective: To find the prevalence of Bacterial vaginosis among the cases who presented with preterm labour and to determine its maternal and neonatal outcome. Methodology: A prospective cross- sectional analytical study on 100 preterm labour cases conducted over a year in the obstetric ward in Manipal Teaching Hospital. Three high vaginal swabs from posterior fornix were taken and tested in Microbiology laboratory. The maternal and neonatal outcome of women with preterm labour due to bacterial vaginosis were noted. The data were analyzed using SPSS 21. Chi2 test was used for comparing maternal and neonatal complications positive or negative with Bacterial Vaginosis. Results: In the study period, 584 women had preterm deliveries. The total deliveries during that period was 2,531. The prevalence of Bacterial vaginosis in PTB was found to be 17 %.The accuracy of Gram stain was found to be 90% (sensitivity-57%, specificity-92%, PPV-36%, NPV-96%). The accuracy of wet mount was 90 % (sensitivity-42.85%, specificity-93.5%, PPV-33.3%, NPV95.6%). There were increased cases of chorioamnionitis among women who were BV positive (p-value=0.02). Newborn born to women with BV positive had increased chance of poor Apgar score at 5 minutes (p-value <0.05). Conclusion: Maternal and neonatal complications were more common in women with preterm labour associated with Bacterial Vaginosis. Gram stain and wet mount are fairly accurate and can be used as an adjunct to culture for the diagnosis of Bacterial Vaginosis.
{"title":"Prevalence of Bacterial Vaginosis in Preterm Labour and Its Fetal and Maternal Outcome","authors":"S. Gurung, J. Shrestha, A. Subedi","doi":"10.59881/jpeson5","DOIUrl":"https://doi.org/10.59881/jpeson5","url":null,"abstract":"Introduction: Preterm births accounts for about 11.1 % of births worldwide. Infection accounts for 20% – 40% of these cases and Bacterial vaginosis has been found in 15 % of preterm labor group. \u0000Objective: To find the prevalence of Bacterial vaginosis among the cases who presented with preterm labour and to determine its maternal and neonatal outcome. \u0000Methodology: A prospective cross- sectional analytical study on 100 preterm labour cases conducted over a year in the obstetric ward in Manipal Teaching Hospital. Three high vaginal swabs from posterior fornix were taken and tested in Microbiology laboratory. The maternal and neonatal outcome of women with preterm labour due to bacterial vaginosis were noted. The data were analyzed using SPSS 21. Chi2 test was used for comparing maternal and neonatal complications positive or negative with Bacterial Vaginosis. \u0000Results: In the study period, 584 women had preterm deliveries. The total deliveries during that period was 2,531. The prevalence of Bacterial vaginosis in PTB was found to be 17 %.The accuracy of Gram stain was found to be 90% (sensitivity-57%, specificity-92%, PPV-36%, NPV-96%). The accuracy of wet mount was 90 % (sensitivity-42.85%, specificity-93.5%, PPV-33.3%, NPV95.6%). There were increased cases of chorioamnionitis among women who were BV positive (p-value=0.02). Newborn born to women with BV positive had increased chance of poor Apgar score at 5 minutes (p-value <0.05). \u0000Conclusion: Maternal and neonatal complications were more common in women with preterm labour associated with Bacterial Vaginosis. Gram stain and wet mount are fairly accurate and can be used as an adjunct to culture for the diagnosis of Bacterial Vaginosis. ","PeriodicalId":158871,"journal":{"name":"Journal of Perinatal Society of Nepal","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115534733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miki Shah, B. Panta, Asmita Pantha, Benju Nepal, Kopila Sunar, Sunita Thapa, D. Shrestha
Introduction: Hypothyroidism is a common endocrine problem in pregnant women with a reported prevalence of 1.5 to 4.4%. Both overt and subclinical hypothyroidism have adverse effects on perinatal outcome. Aim and Objective: To find the prevalence of hypothyroidism in pregnancy and its impact on perinatal outcome and neonatal hypothyroidism in a tertiary centre in western Nepal. Methods: This is a retrospective descriptive study conducted from April 2018 to April 2022 involving 75 hypothyroid pregnant women during their antenatal check-ups. It also included known cases of hypothyroidism. The hospital records of all the hypothyroid women who delivered in this centre were reviewed. The prevalence of subclinical and overt hypothyroidism were calculated. The relationship between the status of hypothyroidism and perinatal outcome in terms of mode of delivery, APGAR scores, birth weight and admission to neonatal intensive care unit were evaluated. Results: The prevalence of maternal hypothyroidism was 0.92% with subclinical hypothyroidism being 0.29% and overt hypothyroidism being 0.63%. The perinatal outcomes in terms of mode of delivery, APGAR scores, birth weight and admission to neonatal intensive care unit were not statistically significant between subclinical and overt hypothyroidism. Conclusion: The prevalence of maternal hypothyroidism, especially subclinical hypothyroidism was low. There were no significant adverse effects on perinatal outcome.
{"title":"Study of Perinatal Outcome and Neonatal Hypothyroidism in Pregnant Women with Hypothyroidism Delivering in a Tertiary Care Centre in Western Nepal","authors":"Miki Shah, B. Panta, Asmita Pantha, Benju Nepal, Kopila Sunar, Sunita Thapa, D. Shrestha","doi":"10.59881/jpeson3","DOIUrl":"https://doi.org/10.59881/jpeson3","url":null,"abstract":"Introduction: Hypothyroidism is a common endocrine problem in pregnant women with a reported prevalence of 1.5 to 4.4%. Both overt and subclinical hypothyroidism have adverse effects on perinatal outcome. \u0000Aim and Objective: To find the prevalence of hypothyroidism in pregnancy and its impact on perinatal outcome and neonatal hypothyroidism in a tertiary centre in western Nepal. \u0000Methods: This is a retrospective descriptive study conducted from April 2018 to April 2022 involving 75 hypothyroid pregnant women during their antenatal check-ups. It also included known cases of hypothyroidism. The hospital records of all the hypothyroid women who delivered in this centre were reviewed. The prevalence of subclinical and overt hypothyroidism were calculated. The relationship between the status of hypothyroidism and perinatal outcome in terms of mode of delivery, APGAR scores, birth weight and admission to neonatal intensive care unit were evaluated. \u0000Results: The prevalence of maternal hypothyroidism was 0.92% with subclinical hypothyroidism being 0.29% and overt hypothyroidism being 0.63%. The perinatal outcomes in terms of mode of delivery, APGAR scores, birth weight and admission to neonatal intensive care unit were not statistically significant between subclinical and overt hypothyroidism. \u0000Conclusion: The prevalence of maternal hypothyroidism, especially subclinical hypothyroidism was low. There were no significant adverse effects on perinatal outcome. ","PeriodicalId":158871,"journal":{"name":"Journal of Perinatal Society of Nepal","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130100178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The incidence of cerebral palsy (CP) before the age of 2 years is highest among the preterm babies. Neuroprotection in preterm babies is challenging. There are various proposed mechanisms but antenatal magnesium sulphate (MgSo4 ) infusion for 4 to 24 hours predelivery has shown to reduce the incidence of CP at the cost of bearable minor maternal and fetal side-effects. The practice of antepartum infusion of MgSo4 is adopted by various guidelines and societies, including World Health Organization (WHO).
{"title":"Antenatal Magnesium Sulphate Infusion for Neuroprotection of Preterm Babies","authors":"Bashu Dev Parajuli","doi":"10.59881/jpeson11","DOIUrl":"https://doi.org/10.59881/jpeson11","url":null,"abstract":"The incidence of cerebral palsy (CP) before the age of 2 years is highest among the preterm babies. Neuroprotection in preterm babies is challenging. There are various proposed mechanisms but antenatal magnesium sulphate (MgSo4 ) infusion for 4 to 24 hours predelivery has shown to reduce the incidence of CP at the cost of bearable minor maternal and fetal side-effects. The practice of antepartum infusion of MgSo4 is adopted by various guidelines and societies, including World Health Organization (WHO).","PeriodicalId":158871,"journal":{"name":"Journal of Perinatal Society of Nepal","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121356077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We report a case of primigravida at 26 weeks of pregnancy with intrauterine fetal death (IUFD) on ultrasound who underwent repeated unsuccessful attempts at medical induction of abortion until exploratory laparotomy with right intact rudimentary horn removal was undertaken with nonviable female fetus . This is an example of unicornuate uterus with rudimentary horn pregnancy (RHP) which has an overall incidence of 1 in 1, 50000 to 1 in 76000 and stresses the understanding of the sonographic appearance of early pregnancy within the rudimentary horn of unicounuate uterine configuration being imperative for appropriate and timely clinical management. In Conclusion: Rudimentary horn pregnancy (RHP) must be kept as strong clinical suspicion if there is no response to repeated failed attempts at the induction of abortion.
{"title":"Failed Successive Attempts at Medical Abortion of A 26 Weeks Intrauterine Fetal Death and The Discovery of Rudimentary Horn Pregnancy","authors":"Radhika Kunwar","doi":"10.59881/jpeson10","DOIUrl":"https://doi.org/10.59881/jpeson10","url":null,"abstract":"We report a case of primigravida at 26 weeks of pregnancy with intrauterine fetal death (IUFD) on ultrasound who underwent repeated unsuccessful attempts at medical induction of abortion until exploratory laparotomy with right intact rudimentary horn removal was undertaken with nonviable female fetus . This is an example of unicornuate uterus with rudimentary horn pregnancy (RHP) which has an overall incidence of 1 in 1, 50000 to 1 in 76000 and stresses the understanding of the sonographic appearance of early pregnancy within the rudimentary horn of unicounuate uterine configuration being imperative for appropriate and timely clinical management. In Conclusion: Rudimentary horn pregnancy (RHP) must be kept as strong clinical suspicion if there is no response to repeated failed attempts at the induction of abortion.","PeriodicalId":158871,"journal":{"name":"Journal of Perinatal Society of Nepal","volume":"123 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123836905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The use of prenatal care prevents maternal complications and perinatal adverse outcomes by early identification of high risk pregnancies, assessment of growth and well being of the fetus, prompt diagnosis and management of complications, with safe delivery. Objectives: This study aims at comparing the obstetrical complications and perinatal outcomes in delivered booked and unbooked mothers to determine the correlation of booking status and maternal and perinatal outcome. Methodology: In this prospective study, 350 patients admitted for delivery at Manipal Teaching Hospital, Pokhara during March 2014 to May 2015 were included. Antenatal complications of the mothers, postnatal complications, neonatal outcome and the mode of delivery were compared amongst the booked and unbooked cases. Results: There was an increased prevalence of preeclampsia (6.3% in unbooked vs. 1.6% in booked); eclampsia (2.5% in unbooked vs. nil in booked); antepartum haemorrhage (5.06% in unbooked vs. 2.1% in booked); Preterm premature rupture of membrane (5.1% in unbooked vs. 2.1% in booked); Rh-isoimmunization (06% in unbooked vs. nil in booked); Intrauterine growth restriction (5.7% in unbooked vs. 3.6% in booked ); and Intrauterine fetal death (7.6% in unbooked vs. 0.5% in booked) in unbooked mothers as compared to booked mothers. The unbooked mothers were prone to postpartum hemorrhage (6.9% vs 2.6% in booked mothers). Assisted breech delivery and ventouse delivery were recorded higher in unbooked cases than in booked case (3.2% vs. 0.5% and 3.8% vs. 3.1% respectively). Conclusion: The poorer maternal and fetal outcome in unbooked cases in comparison to booked cases can be reduced with the best utilization of the prenatal care.
前言:产前护理可通过早期发现高危妊娠、评估胎儿生长和健康状况、及时诊断和处理并发症以及安全分娩来预防产妇并发症和围产期不良后果。目的:本研究旨在比较预约分娩和未预约分娩的产妇的产科并发症和围产儿结局，以确定预约状态与产妇和围产儿结局的相关性。方法:在这项前瞻性研究中，纳入了2014年3月至2015年5月期间在博卡拉马尼帕尔教学医院住院分娩的350例患者。比较了预定和未预定病例中母亲的产前并发症、产后并发症、新生儿结局和分娩方式。结果:子痫前期患病率增加(未预约组为6.3%，预约组为1.6%);子痫(未预订组2.5%，预订组为零);产前出血(未预约者5.06%，预约者2.1%);早产胎膜早破(未预定组5.1% vs.预定组2.1%);rh等免疫(未登记为06%，登记为零);宫内生长受限(未登记5.7% vs.登记3.6%);未登记母亲的宫内胎儿死亡率(未登记母亲为7.6%，登记母亲为0.5%)与登记母亲相比。未预约的产妇易发生产后出血(6.9% vs . 2.6%)。辅助臀位分娩和静脉分娩在未预约病例中的记录高于预约病例(分别为3.2%对0.5%和3.8%对3.1%)。结论:通过充分利用产前护理，可降低未预约病例的母胎结局较预约病例差。
{"title":"Maternal Complications and Perinatal Outcome in The Booked and Unbooked Cases of Pregnancy at Manipal Teaching Hospital","authors":"R. Tuladhar, J. Sharma","doi":"10.59881/jpeson4","DOIUrl":"https://doi.org/10.59881/jpeson4","url":null,"abstract":"Introduction: The use of prenatal care prevents maternal complications and perinatal adverse outcomes by early identification of high risk pregnancies, assessment of growth and well being of the fetus, prompt diagnosis and management of complications, with safe delivery. \u0000Objectives: This study aims at comparing the obstetrical complications and perinatal outcomes in delivered booked and unbooked mothers to determine the correlation of booking status and maternal and perinatal outcome. \u0000Methodology: In this prospective study, 350 patients admitted for delivery at Manipal Teaching Hospital, Pokhara during March 2014 to May 2015 were included. Antenatal complications of the mothers, postnatal complications, neonatal outcome and the mode of delivery were compared amongst the booked and unbooked cases. \u0000Results: There was an increased prevalence of preeclampsia (6.3% in unbooked vs. 1.6% in booked); eclampsia (2.5% in unbooked vs. nil in booked); antepartum haemorrhage (5.06% in unbooked vs. 2.1% in booked); Preterm premature rupture of membrane (5.1% in unbooked vs. 2.1% in booked); Rh-isoimmunization (06% in unbooked vs. nil in booked); Intrauterine growth restriction (5.7% in unbooked vs. 3.6% in booked ); and Intrauterine fetal death (7.6% in unbooked vs. 0.5% in booked) in unbooked mothers as compared to booked mothers. The unbooked mothers were prone to postpartum hemorrhage (6.9% vs 2.6% in booked mothers). Assisted breech delivery and ventouse delivery were recorded higher in unbooked cases than in booked case (3.2% vs. 0.5% and 3.8% vs. 3.1% respectively). \u0000Conclusion: The poorer maternal and fetal outcome in unbooked cases in comparison to booked cases can be reduced with the best utilization of the prenatal care. ","PeriodicalId":158871,"journal":{"name":"Journal of Perinatal Society of Nepal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129121875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Hypothermia is a major problem in newborns particularly among low birth weight (LBW) babies and it is one of the major cause of mortality and morbidity among LBW babies. Kangaroo Mother Care (KMC) is a simple method of maintaining temperature by keeping the LBW babies normothermic and indicated especially for LBW babies without using costly equipment. Dr Edgar Rey Sanabria introduced Kangaroo Mother Care (KMC) in Bogotá, Colombia in 1978 as an alternative to incubators for LBW infants to keep small babies warm. WHO defines KMC with its four components: early, continuous, and prolonged skin-to-skin contact between the newborns and mother; exclusive breastfeeding; early discharge from the health facility and close follow-up at home. Objective: To share the experience of Kangaroo Mother Care (KMC) at Kathmandu Medical College Teaching Hospital (KMCTH) Materials and Methods: At neonatal unit, 5 bedded an air-conditioned room were allocated as the KMC room and the temperature of this room was maintained at 28 0C. Before starting KMC, orientation on KMC, its procedures and benefits were explained to the mother or caregivers. Premature /LBW babies were kept over the mother’s chest with the help of cotton-made slings (Nyano Angalo wrap). The study period was of a one-year duration (Nov 2018- October 2019) . Results: 35 babies born in KMCTH received KMC during 12 months period (Nov 2018- October 2019) using Nyano Angalo wrap. The mean birth weight of babies kept on KMC was 1340 gms and mean gestational age was 33.6 wks. Each baby received KMC for 14.5 hrs average duration. Conclusion: Kangaroo mother care is a simple, feasible and non expensive intervention. It enhances breast feeding and bonding between the mother and the newborn babies. Its extensive use will help in the reduction of present high neonatal mortality, particularly among LBWs due to hypothermia.
低温症是新生儿尤其是低出生体重儿的一个主要问题，也是低出生体重儿死亡和发病的主要原因之一。袋鼠妈妈护理(KMC)是一种简单的保持低体重婴儿体温的方法，特别适用于低体重婴儿，不需要使用昂贵的设备。1978年，Edgar Rey Sanabria博士在哥伦比亚波哥大引入了袋鼠妈妈护理(KMC)，作为低体重婴儿保温箱的替代方案。世卫组织将KMC定义为四个组成部分:新生儿与母亲之间早期、持续和长期的皮肤接触;纯母乳喂养;尽早从卫生机构出院并在家中密切随访。目的:分享加德满都医学院附属医院(KMCTH)实施袋鼠妈妈护理(KMC)的经验。材料与方法:在新生儿病房设置5张床、空调房为袋鼠妈妈护理室，室温维持在28℃。在开始护理前，向母亲或护理人员解释护理的基本情况、程序和好处。早产儿/LBW婴儿在棉质吊带(Nyano Angalo wrap)的帮助下被放在母亲的胸前。研究期为一年(2018年11月- 2019年10月)。结果:在12个月内(2018年11月- 2019年10月)，在KMCTH出生的35名婴儿使用Nyano Angalo包装接受了KMC。平均出生体重1340克，平均胎龄33.6周。每个婴儿接受KMC的平均时间为14.5小时。结论:袋鼠妈妈护理是一种简单、可行、费用低廉的干预措施。它增强了母乳喂养和母亲与新生儿之间的联系。它的广泛使用将有助于降低目前高新生儿死亡率，特别是低体温新生儿死亡率。
{"title":"Experience of Providing Kangaroo Mother Care at a Tertiary Hospital","authors":"Sunil Raja Manadhar","doi":"10.59881/jpeson8","DOIUrl":"https://doi.org/10.59881/jpeson8","url":null,"abstract":"Introduction: Hypothermia is a major problem in newborns particularly among low birth weight (LBW) babies and it is one of the major cause of mortality and morbidity among LBW babies. Kangaroo Mother Care (KMC) is a simple method of maintaining temperature by keeping the LBW babies normothermic and indicated especially for LBW babies without using costly equipment. Dr Edgar Rey Sanabria introduced Kangaroo Mother Care (KMC) in Bogotá, Colombia in 1978 as an alternative to incubators for LBW infants to keep small babies warm. WHO defines KMC with its four components: early, continuous, and prolonged skin-to-skin contact between the newborns and mother; exclusive breastfeeding; early discharge from the health facility and close follow-up at home. Objective: To share the experience of Kangaroo Mother Care (KMC) at Kathmandu Medical College Teaching Hospital (KMCTH) \u0000Materials and Methods: At neonatal unit, 5 bedded an air-conditioned room were allocated as the KMC room and the temperature of this room was maintained at 28 0C. Before starting KMC, orientation on KMC, its procedures and benefits were explained to the mother or caregivers. Premature /LBW babies were kept over the mother’s chest with the help of cotton-made slings (Nyano Angalo wrap). The study period was of a one-year duration (Nov 2018- October 2019) . \u0000Results: 35 babies born in KMCTH received KMC during 12 months period (Nov 2018- October 2019) using Nyano Angalo wrap. The mean birth weight of babies kept on KMC was 1340 gms and mean gestational age was 33.6 wks. Each baby received KMC for 14.5 hrs average duration. \u0000Conclusion: Kangaroo mother care is a simple, feasible and non expensive intervention. It enhances breast feeding and bonding between the mother and the newborn babies. Its extensive use will help in the reduction of present high neonatal mortality, particularly among LBWs due to hypothermia. ","PeriodicalId":158871,"journal":{"name":"Journal of Perinatal Society of Nepal","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114193675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sanu Maiya Shrestha Pradhan, Renee Pradhan, M. Bajracharya, A. Karki, Namuna Ghimire
Introduction: Globally, an increasing number of babies have been born with the help of Assisted Reproductive Technology (ART) treatment. While most births after ART are uncomplicated, sometimes it is associated with adverse perinatal outcomes such as preterm birth, low birth weight and increased risk of congenital anomalies. Therefore, the objective of this study was to assess the perinatal outcomes in children born after assisted reproductive technologies at a tertiary fertility center in Nepal. Methodology: This was a descriptive study which analyzed retrospective data collected from the medical record of a tertiary fertility center at Lalitpur, Nepal. Perinatal outcomes of total 201 births that resulted from various ART treatment that was conducted in the center from November 2015 till April 2021 have been included in this study. Univariate analysis was done in SPSS version 20. Results: Altogether, there were 201 total births out of which 199 were live births and 2 were stillbirths. Among the live births around two-third (69.7%) were singleton deliveries and remaining one- third (30.4%) were multiple deliveries. More than 90% of study population had undergone Lower Segment Caesarean Section (LSCS). There were 263 live born babies resulting from 199 live births. More than half of the babies were born prematurely (50.19%). Low birth weight (LBW) and very low birth weight (VLBW) was seen among 36.50% and 7.22% babies respectively. Congenital abnormality was identified in 13 babies (4.94%) Four stillborn babies and eight neonatal deaths were reported. More adverse perinatal outcomes were seen among twins and triplets than singleton babies. Conclusion: While most births were uncomplicated, certain extent of adverse perinatal outcomes among the ART conceived babies cannot be ignored. Vigilant monitoring of pregnancy conceived by ART treatment helps in improving the perinatal outcome.
导言:在全球范围内，越来越多的婴儿在辅助生殖技术(ART)治疗的帮助下出生。虽然抗逆转录病毒治疗后的大多数分娩并不复杂，但有时它与不良的围产期结局有关，如早产、低出生体重和先天性异常风险增加。因此，本研究的目的是评估在尼泊尔三级生育中心辅助生殖技术后出生的儿童的围产期结局。方法:这是一项描述性研究，分析了从尼泊尔拉利特普尔一家三级生育中心的病历中收集的回顾性数据。本研究纳入了2015年11月至2021年4月期间在该中心接受各种ART治疗的共201例分娩的围产期结局。单因素分析采用SPSS version 20进行。结果:共出生201例，其中活产199例，死产2例。在活产婴儿中，约三分之二(69.7%)为单胎分娩，其余三分之一(30.4%)为多胎分娩。超过90%的研究人群接受了下段剖宫产术(LSCS)。199名活产婴儿中有263名活产婴儿。超过一半的婴儿早产(50.19%)。低出生体重(LBW)和极低出生体重(VLBW)分别占36.50%和7.22%。先天性异常13例(4.94%)，死产4例，新生儿死亡8例。双胞胎和三胞胎的不良围产期结局多于单胎婴儿。结论:虽然大多数新生儿的出生并不复杂，但ART妊娠婴儿的围产儿不良结局也不容忽视。警惕监测ART治疗妊娠有助于改善围产期结局。
{"title":"Perinatal Outcome Following Assisted Reproductive Technology Treatment at A Tertiary Fertility Center In Nepal.","authors":"Sanu Maiya Shrestha Pradhan, Renee Pradhan, M. Bajracharya, A. Karki, Namuna Ghimire","doi":"10.59881/jpeson6","DOIUrl":"https://doi.org/10.59881/jpeson6","url":null,"abstract":"Introduction: Globally, an increasing number of babies have been born with the help of Assisted Reproductive Technology (ART) treatment. While most births after ART are uncomplicated, sometimes it is associated with adverse perinatal outcomes such as preterm birth, low birth weight and increased risk of congenital anomalies. Therefore, the objective of this study was to assess the perinatal outcomes in children born after assisted reproductive technologies at a tertiary fertility center in Nepal. \u0000Methodology: This was a descriptive study which analyzed retrospective data collected from the medical record of a tertiary fertility center at Lalitpur, Nepal. Perinatal outcomes of total 201 births that resulted from various ART treatment that was conducted in the center from November 2015 till April 2021 have been included in this study. Univariate analysis was done in SPSS version 20. \u0000Results: Altogether, there were 201 total births out of which 199 were live births and 2 were stillbirths. Among the live births around two-third (69.7%) were singleton deliveries and remaining one- third (30.4%) were multiple deliveries. More than 90% of study population had undergone Lower Segment Caesarean Section (LSCS). There were 263 live born babies resulting from 199 live births. More than half of the babies were born prematurely (50.19%). Low birth weight (LBW) and very low birth weight (VLBW) was seen among 36.50% and 7.22% babies respectively. Congenital abnormality was identified in 13 babies (4.94%) Four stillborn babies and eight neonatal deaths were reported. More adverse perinatal outcomes were seen among twins and triplets than singleton babies. \u0000Conclusion: While most births were uncomplicated, certain extent of adverse perinatal outcomes among the ART conceived babies cannot be ignored. Vigilant monitoring of pregnancy conceived by ART treatment helps in improving the perinatal outcome. ","PeriodicalId":158871,"journal":{"name":"Journal of Perinatal Society of Nepal","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114213847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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