bluuebunny/crossref_metadata_2025_split huggingface dataset:
Importance of placental localisation in early pregnancy
Authors: Agrawal Veena , Kulshresta Sonal 
Published: November 2008

Objectives: To determine the incidence and rate of persistence of placenta praevia diagnosed as low lying placenta in d" 20 weeks' gestation using sonography (USG) and to establish its' co-relation with pregnancy outcome. Methods: Randomized 230 pregnant women studied by USG at d" 20weeks gestation. Among them 42 were recruited for study as they were having low lying placenta. These cases were rescanned at e" 28 weeks. Results: In 230 cases, the incidence of low lying placenta at d" 20weeks was18.26% (42/230); 90.5% had lateral, 2.4% had marginal and 7.1% had total placenta praevia. A total of 26 (61.9%) cases, had threatened abortion and two patients aborted. On longitudinal follow-up, 80% of remaining 40 cases had normally situated placenta at rescan. However those with total placenta praevia at d" 20weeks persisted as such with 100% persistence while only 10.5% with lateral low lying placenta persisted. APH was presentation in 3(7.1%), all of them undergoing cesarean sections for placenta praevia. Conclusion: Ultrasonography at < 20 weeks gestation showing low lying placenta has been useful in predicting placenta praevia at third trimester. Total placenta at this gestation has invariably persisted as placenta previa at third trimester. Key words: Placenta, Low lying Placenta, Placenta Praevia, APH doi:10.3126/njog.v2i2.1449 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 16 - 19
Active management of third stage of labour: comparison between prophylactic intramuscular methylergometrine and intramuscular oxytocin
Authors: Adhikari Shilu , Rana Ashma , Bista Kesang D 
Published: November 2008

Aim: Aimed at comparing the efficacy of prophylactic intramuscular methylergometrine with intramuscular oxytocin in reducing blood loss in the third stage of labour (TSL). Methods: This is a randomized, comparative, clinical trial to compare the efficacy of intramuscular methylergometrine with intramuscular oxytocin in the third stage of labour for the prevention of postpartum hemorrhage Two hundred women undergoing normal vaginal delivery were recruited, 100 in each group- Group A receiving .2mg methylergometrine intramuscularly and Group B receiving 10U oxytocin intramuscularly immediately after the delivery of the anterior shoulder of the baby. The efficacy and the safety of these two drugs were analyzed on the basis of percentages fall in haemoglobin (Hb) and haematocrit (Hct) level from before delivery to 24 completed hours after delivery, need for additional uterotonic agents, need for exploration and uterine evacuation, need for blood transfusion, duration of third stage of labour and the numbers of retained placenta and need for MRP. Results: Intramuscular methylergometrine was observed to be equally effective as intramuscular oxytocin in prevention of post partum haemorrhage (PPH) [defined as fall in Hb and /or Hct level³ 10% from before delivery to 24 hours after delivery]. There was no difference in the risk of prolonged third stage, need for additional uterotonic agents, need for exploration and uterine evacuation and need for blood transfusion in the two groups. The side effects were all mild in nature and the overall incidence was too low for statistical significance to be elicited. Conclusion: Intramuscular methylergometrine is as efficacious as intramuscular oxytocin in the prevention of third stage blood loss with comparable side effects. Keywords: Third stage of labour, postpartum hemorrhage, methylergometrine, oxytocin. doi:10.3126/njog.v2i2.1451 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 24 - 28
Female genital tract tuberculosis in Tribhuvan University Teaching Hospital: A retrospective one year histopathological study
Authors: Jha Abhimanyu , Sayami Gita , Adhikari Ram , Jha Roona , Chaudhari Rashmi 
Published: November 2008

Aim: To determine frequency of female genital tract (FGT) tuberculosis (TB) in the gynecological biopsies received in the Department of Histopathology of Tribhuvan University Teaching Hospital. Methods: This is a retrospective study conducted in the Department of Pathology of Tribhuvan University Teaching Hospital. Histopathology records of one year (14th April 2006 to 13th April 2007) were retrieved and searched for the cases of female genital tract TB. Relevant histopathological findings and clinical data were recorded and analyzed. Results: We analyzed 5696 histopathological cases during one year period for FGT tuberculosis. There were 1565 cases of gynecological biopsy and 9 cases were diagnosed as FGT tuberculosis based on histopathological and clinical findings. Ovarian tuberculosis was seen in three cases, bilateral fallopian tubes were involved in 2 cases and endometrial tuberculosis was diagnosed in 2 cases. 3 cases of omental biopsy and 1 case of peritoneal biopsy showed tubercular granulomas. Conclusion: FGT tuberculosis was usually seen in age 16-28 years and constituted 0.57% of total gynecological cases and 0.15% of total biopsies. Fallopian tubes, ovaries and endometrium were affected with the involvement of peritoneum or omentum, common event being tubercular endosalpingitis. Histopathology in association with clinical findings still remains gold standard for the diagnosis of FGT tuberculosis in our country despite advancement in diagnostic modalities; however, incidental histological detection in clinically unanticipated cases is not an uncommon event. Key Words: Female genital tract TB, histopathology, clinical findings. doi:10.3126/njog.v2i2.1452 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 29 - 34
Pelvic organ prolapse in rural Nepalese women of reproductive age groups: What makes it so common?
Authors: Gurung Geeta , Rana Ashma , Amatya Archana , Bista Keshang D , Joshi Ananda B , Sayami Jamuna 
Published: November 2008

Aim: To find out the prevalence, aetiopathogenesis and the magnitude of problems of pelvic organ prolapse (POP) among married women of reproductive age (MWEA) in the rural Nepalese community. Methods: A cross-sectional descriptive study conducted in eight selected districts (mountain/ hills to terai region) of Nepal linking community to health services. Proportionate samples of MWRA (15-49 years) in total samples of 2849 were interviewed using questionnaires and clinical examinations were made in health facililities. Results: Among 2849 women who agreed to take part on the study when interviewed (by enumerators with pretested questioners) 2070 (72.6%) came for assessment. POP was diagnosed in 207/2070 giving the incidence as 10% being commoner in the planes (8:1) than mountains. POP formed 2.8% of adolescent due to early marriage d" 15 years in (50%) and unsupported delivery by skilled birth attendant (SBA) out of health facilities (99.2%). Resumption of manual labor after delivery less than a month was (83.8%) and parity was responsible to some extent as P(1-3) occupied by T!. Mean duration of suffering being 7.8 years (e" 10 years in ¼.) having II°/III° or procidentia rectovaginal/ vesicovaginal fistula, urinary incontinence (stress/urge), bleeding, discharge from sore and ulceration, coital problem, urination/ defecation problem walking, sitting, back ache and chronic abdominal pain S!. Conclusion: In this large reproductive morbidity study including women in the rural community of varied ethenic groups from diverse ecology, basic community survey linked to clinical assessment in the health facility found the incidence of POP to be much higher in planes than hills giving unusually lower prevalence rate for POP as 10% than other clinic based studies. doi:10.3126/njog.v2i2.1453 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 35 - 41
Cervical cytological study in unhealthy and healthy looking cervix
Authors: Pradhan Neelam , Giri Kanti , Rana Ashma 
Published: November 2008

Aim: To compare cervical cytology in women with healthy/unhealthy cervix. Methods: A prospective study on Pap smear was performed including 200 women, 100 with healthy and 100 with unhealthy cervix, attending outpatient Gynaecology clinic of the Department of Ob/Gyn TU Teaching Hospital, Kathmandu. The cytology report was compared in the two groups. Results: Cervical dysplasia was seen in 8 women with unhealthy cervix, 7 were mild and one was severe dysplasia. In the women with healthy cervix, 5 had mild and one had moderate dysplasia. Eighty two percent of women with healthy cervix and 83% of women with unhealthy cervix had non-specific inflammation. Women who were married before 20 years (p=0.04) and had higher parity (3.3 Vs 2.8) were more likely to have unhealthy cervix (p=0.03). Excessive vaginal discharge was common in women with unhealthy cervix (p=0.0009). Conclusion: Dysplasia was slightly higher among the women with unhealthy cervix in comparision to healthy cervix but the difference was not statistically significant. Hence this study emphasizes on the importance of universal screening of both the healthy and unhealthy looking cervix. Key Words: carcinoma cervix, visual screening, Pap smear, cervical cytology, cervical dysplasia doi:10.3126/njog.v2i2.1454 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 42 - 47
Safety, efficacy and acceptability of medical abortion with mifepristone and misoprostol in Nepalese women
Authors: Shrivastava Veena 
Published: November 2008

Unsafe abortion is a major health issue. Therefore safe abortion services which is effective. acceptable and techniquely easy to perform should be available. Aim- To confirm effectiveness, side effects, safety and patient satisfaction with medical termination of early pregnancy. 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. 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- combination of mifepristone and misoprostol is a safe and effective of early pregnancy Keywords- medical termination, pregnancy, mifepristone, misoprostol. doi:10.3126/njog.v2i2.1456 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 54 - 58
Caesarean myomectomy - a safe procedure: A retrospective case controlled study
Authors: Owolabi Alexander T , Kuti Oluwafemi , Loto Olabisi M , Makinde Oluwafemiwa N , Adeyemi Adebanjo B 
Published: November 2008

Objective(s): The aim of the study is to determine whether myomectomy at the time of caesarean section leads to increase incidence of intrapartum and postpartum complications. Methods: Fourteen women, with uterine fibroids in pregnancy who were treated by caesarean myomectomy between January 2001 and June 2007, were compared retrospectively with fourteen women, without uterine fibroids who had routine caesarean section during the same period. Myomectomy for all types of myoma was performed at caesarean section after the delivery of the baby. Haemorrhage was controlled with the use of Foleys catheter tourniquet and high dose oxytocin infusion. The cases and control were analysed for age of the patient, parity, pre and post-operative haematocrit levels, duration of operation, blood loss, blood transfusions, and incidence of postpartum fever. Results: Caesarean myomectomy resulted in the mean blood loss of 589 ml (range 300-1300 ml) compared with 518 ml (range 350-850 ml) in the control group (p=0.376). The mean duration of operation was longer in the cases of caesarean myomectomy (66.8 mins) than those of the controls (56.4 mins). There were no significant differences between the two groups in the incidence of intraoperative haemorrhage, the need for blood transfusion, post partum fever, and length of hospital stay. Conclusions: This study shows that myomectomy during caesarean section is a safe procedure in experienced hands and is not as dangerous as generations of obstetricians have been trained to believe. Further research is necessary to establish the cost effectiveness of the procedure. Key words: myomectomy, cesarean section, hemorrhage doi:10.3126/njog.v2i2.1457 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 59 - 62
Prenatal ultrasonographic diagnosis of limb body wall complex
Authors: Thapa Narayan B , Dangal Ganesh , Karki Aruna 
Published: November 2008

In this report, a case of limb body wall complex (LBWC) diagnosed by ultrasonography is presented. Limbbody wall complex refers to a rare combination of disruptive and lethal abnormalities which start early in the gestational process. Abnormalities commonly associated with this disorder include cranio-facial abnormalities, scoliosis, ventral body wall defect (thoraco-abdominoschisis), limb deformations, short umbilical cord, and others. Other terms used to describe similar findings include short umbilical cord syndrome, body-stalk anomaly, and amniotic band syndrome. This complex should be distinguished from other body-wall defects including omphalocele and gastroschisis since the prognosis for limb-body wall complex is uniformly poor. The diagnosis of limb-body wall complex can be made by prenatal sonography. Key words: limb body wall complex, abdominal wall defects, amniotic bands, amniotic band syndrome, ultrasonography. doi:10.3126/njog.v2i2.1460 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 72 - 74
Rupture of rudimentory horn pregnancy with catastrophic haemorrhage
Authors: Joshi Lalita 
Published: November 2008

A 20 yrs primigravida who had attended antenatal clinic 2 weeks back, presented with shock acute abdomen and jaundice at 18 weeks of gestation. Clinically their was evidence of free fluid in the abdominal cavity. Ultrasonography showed dead fetus with haemoperitoneum which was massive at laparotomy. There was rupture of the rudimentary horn on the left side. This was attached to the normal uterus with the broad band. The placenta and fetus in a sac was lying in the peritoneal cavity. The tubes and ovaries on both sides were found normal. Key Words: Rudimentary horn, hemoperitoneum, acute abdomen in second trimester. doi:10.3126/njog.v2i2.1461 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 75 - 77
Experience with surgical options for managing atonic post-partum haemorrhage
Authors: Saha Rachana , Karki Chanda , Padhye Saraswati M 
Published: November 2008

Aim: To analyse the measures taken for controlling primary Post-partum haemorrhage (PPH). Methods: A hospital based descriptive and retrospective study was carried out from 1st January 2005 to 31st December 2006 in the department of Obstetrics & Gynaecology at KMCTH. All patients of having primary Post-partum haemorrhage were analysed for the treatment they received. Results: There were 15 cases of primary Post-Partum Haemorrhage (PPH) from a total delivery of 700 in the year 2005. 9 cases were solely of atonic post-partum haemorrhage. 2 cases were genital tract injuries, 1 case of retained placenta, 1 case of vulval haematoma and 2 cases were of combined cervical tear and atonic primary post-partum haemorrhage. Atonic post-partum haemorrhage remained most important cause. The most common treatment was use of oxytocic. Surgical procedure bilateral uterine artery ligation was frequently performed in 6 cases but it was not effective as a single procedure. B-Lynch brace suture was applied in 5 cases and was successful without further intervention. There were 2 maternal deaths from post-partum haemorrhage. In the year 2006 total number of deliveries was 835 and there were total 11 cases of post partum haemorrhage. The trend changed to from atonic PPH to traumatic PPH. There were 8 cases of traumatic PPH and there were 2 cases of placenta accrete. There was one case of atonic PPH. The overall incidence in two years was 1.6%. Conclusion: Among the various surgical methods adopted B-Lynch brace suture was found to be simple, effective and minimally invasive. Keywords: Atonic post-partum haemorrhage (PPH), surgical management of PPH. doi:10.3126/njog.v3i1.1432 NJOG 2008 May-June; 3(1): 10 - 13
A study of reproductive morbidity of women in the Eastern Terai Region of Nepal
Authors: Dangal Ganesh 
Published: November 2008

Aim: This study aims to fill the gap of information of reproductive health (RH) of women living in rural eastern Terai by providing baseline data on reproductive morbidity (RM) leading to pelvic organ prolapse (POP), reproductive tract infections (RTIs), menstrual problems and subfertility. Methods: This is a descriptive analysis of women who attended mobile RH camps in eastern Terai of Nepal organized at different villages falling in three districts namely Rautahat, Mahottari and Saptari during December 2005 and 2006. The diagnoses were made mostly on clinical evaluation and treatment provided. The leading reproductive morbidity of POP was dealt in detail and surgeries were performed in the district headquarters. The data were recorded and analysed manually. Analysis was done by standard statistical methods and a two tailed P value less than 0.05 was considered to indicate a significant difference. Results: Total number of women treated in the camps was 7750. Majority of the women in this study were found to be suffering from STI (30.1%), followed by POP (20.1%), menstrual disorders (16.7%) and subfertility (9.3%). Among POP patients majority received ring pessary insertion (43.8%) followed by counselling plus pelvic floor exercise (32.9%) and surgical correction (23.3%). Third-degree POP (38.6%) was commonest among all POP cases. Majority (60%) developed POP after first and second child birth. Conclusion: The major reproductive morbidity in this study was STI, POP (most of the women having thirddegree uterovaginal prolapse), menstrual disorders and sub-fertility. Surgical treatment at the camps could only be provided to small number, suggesting expansion of health services in rural Nepal by reproductive health barriers like poverty, education. Key words: menstrual disorders, pelvic organ prolapse, reproductive morbidity, reproductive tract infections, sub-fertility. doi:10.3126/njog.v3i1.1436 NJOG 2008 May-June; 3(1): 29 - 34
Bacteriuria following Foley catheterization after gynecological and obstetrical surgery
Authors: Ojha Neebha 
Published: November 2008

Objective: To find out the frequency of bacteriuria associated with Foley catheterization after gynecological and Obstetric (cesarean section) surgery and to analyze the factors associated with bacteriuria. Methods: This is a retrospective study conducted in the Department of Obstetrics and Gynecology of TUTH. Hospital chart records of one of the four functional units for a period of one year (1st January 2007 to 31st December 2007) were collected in all postoperative women who had undergone major gynecological surgery (like abdominal hysterectomy, laparatomy, vaginal hysterectomy etc) and cesarean sections in obstetrics. Charts were reviewed and relevant clinical findings and bacteriological studies of catheter tip culture and sensitivity were noted. Results: There were total 390 major operations (both Gyne & Obs) during the study period. In obstetrics there were a total of 211 cesarean section. Files obtained were 186. Urine and catheter tip culture were obtained in 165 out of 186 cases. Positive culture was found in 76 out of 165 (46%). In gynecology, there were 179 major operations, out of which 130 files were obtained. Urine and catheter tip culture reports were available in 121 cases and 56 (46%) were found to be positive. In cesarean section, duration of catheterization was not associated with increased bacteriuria (p=0.926), while in gynecological surgery there was significant impact of catheterization duration on bacteriuria (p=0.042). In gynecological surgery, increasing patients' age had important impact on bacteriuria (p=0.0004). Overall 46% had positive catheter tip culture. The most common organisms isolated were E coli, Enterococcus fecalis and Staph aureus. Conclusion: This study establishes that Foley catheter was associated with increased risk of bacteriuria in postoperative women following obstetrical and gynecological surgery. Key words: Bacteriuria, Foley catheterization, Catheter tip culture and sensitivity doi:10.3126/njog.v3i1.1437 NJOG 2008 May-June; 3(1): 35 - 38
Ovarian tumors in childhood and adolescents - Our eight years experiences
Authors: Amatya Archana , Rana Ashma , Gurung Geeta 
Published: November 2008

Aims: To study the distribution of different types of ovarian tumors seen in adolescents and children and evaluate the commonest tumor during this period. Methods: A prospective study conducted at Dept of Ob/Gyn, Tribhuvan University Teaching Hospital form January 1999 - January 2008. Results: There were a total of 80 cases of ovarian tumors in childhood and adolescents. Most of the cases had presented to the outpatient department of Ob/Gyn (54%), Medicine (10%), Surgery (21%) and Emergency Unit (15%). Majority of the cases were between the ages of 15 to 19 and tumors in childhood age up to 14 represented 21% of the total ( < 10year being 4). The most frequently occurring tumor was Germ cell tumors accounting for 59 (73.7%) of the total. Out of which dermoid was the most frequently occurring in 45(76.2%). Nineteen (23.71 %) of the total tumor were malignant. All of them underwent laparatomy followed by enucleation (14); Unilateral ophoorectomy (28), unilateral salphingooophorectomy (36) and TAHBSO (2). Conclusion: This study shows the preponderance of germ cell tumor and high percentages of malignancies within germ cell tumor in young children and adolescents. Keywords: childhood, adolescent, ovarian tumors, malignancy doi:10.3126/njog.v3i1.1438 NJOG 2008 May-June; 3(1): 39 - 42
Outcome of fallopian tube recanalization
Authors: Gautam Jageshwor 
Published: November 2008

Objective: To find out the fertility outcome of tubal surgery. Method: This was a hospital based descriptive study conducted at Om Hospital, Bharatpur. Forty-one women who were operated in this hospital during the period of 6 years. (Jan 2002- December 2007). Results: Of 41 patients who underwent tuboplasty, 34 (82.9%) cases were available for follow-up. Out of these 34 cases, 14 (41.2%) became pregnant. Among them 9 (64.3%) had viable births, 3 (21.4%) ectopic pregnancies and 2 (14.3%) spontaneous miscarriages. Conclusion: Fallopian tube recanalization has been established as an effective, useful and novel treatment of infertility due to tubal occlusion. Key words: Infertility, fallopian tube, tuboplasty, pregnancy. doi:10.3126/njog.v3i1.1439 NJOG 2008 May-June; 3(1): 43 - 45
Classical caesarean section- A time honoured surgery
Authors: Rawal Suniti , Gurung Geeta , Bista Kesang D 
Published: November 2008

Classical caesarean section seldom performed worldwide and even at our hospital was carried out in a 37 years old G3 P0+2 at 36+4 weeks with the indications of transverse lie, cervical fibroid, low lying placenta, oligohydramnios with severe IUGR and PIH, complicated with intraoperative post partum hemorrhage (PPH). Though the classical caesarean section (CCS) is almost a forgotten surgery, its importance may be reminded in situations like this when such an intervention becomes imperative and lower segment caesarean section (LSCS) being lesser advantageous. Key words: classical caesarean section, transverse lie, cervical fibroid, low lying placenta doi:10.3126/njog.v3i1.1442 NJOG 2008 May-June; 3(1): 51 - 54