Background: Globally, Preterm delivery is a major contributory factor for early neonatal death. Till date definite causative factor for preterm labour has not been proven. However, the genital tract infection is considered to be the contributory factors for PPROM. Method: This case control study was conducted at Nepalgunj Medical College Teaching Hospital, Kohalpur. 100 cases enrolled in the study were divided into two groups; group A consisted of 50 cases with PPROM; and in group B 50 cases were included cases without PPROM who came to routine antenatal check-up in ANC (antenatal care) clinic. The high vaginal swab was taken from the upper one-third of the posterior wall of the vagina and sent for culture and sensitivity in all cases. Results: In group A (with PPROM)74% of cases were culture positive and the commonest organism was E. coli which was isolated in 40% (20/50). In group B (without PROM) 28% of cases had culture positive, and again the commonest organism was E. coli isolated in 14 % cases (7/50). This present study showed that E. coli was most sensitive to amoxyclav and staphylococcus epidermis was most sensitive to nitrofurantoin. Ceftriaxone was found to be most effective in mixed infections. Conclusions: The genital tract infections in PPROM group was very high (+ve) culture in 74% in comparison to the non PPROM group where genital tract swab showed growth in only 28% (p-value 0.001). The lower genital tract infection has been considered as one of the potent cause of PPROM, so it is advised that a vaginal swab should be routinely obtained in the ANC clinic for culture and sensitivity. An appropriate antibiotic should be started in culture positive cases.

Plexiform neurofibromas are rare variant (30%) of neurofibromatosis type 1 (NF-1) in which neurofibromas arise as large deforming masses from multiple nerve endings involving also connective tissues and skin folds. We report a case of 24 years old female, second gravida and one parity with diagnosis of plexiform neurofibromatosis made in previous pregnancy with remission of symptoms after pregnancy and accentuation during second pregnancy with positive pregnancy outcome.

Introduction: Pregnancy is one of the important risk factor for occurrence of vaginal candidiasis which may lead to pregnancy complications like abortions, premature birth, low birth weight and other morbidities. It is essential to know pattern of distribution of the species of Candida that are pathogenic. Aim and Objective: To identify prevalence of Candida albicans in the genital tract of pregnant women. Materials and Methods: Total of 100 vaginal swabs were collected from 100 pregnant women attending at antenatal clinic of Gynaecology and Obstetrics department for a period of six months from March 2017 to August 2017. Gram's staining and inoculation onto Sabouraud dextrose agar (SDA) medium were done for general identification of yeast and to isolate the positive cases. The specifications of Candida species was done on the basis of sugar fermentation, carbohydrate assimilation, production of germ tube in fresh human serum, formation of chlamydospore on Cornmeal agar and colour of colony on CHRO Magar. Results: Out of 100 high vaginal swabs 40(40%) samples were positive for Candida. Of these positive samples, Candida albicans was isolated in 52.5% of pregnant women. Candida albicans was most commonly isolated in the age group of 25-29(38.09%), in third trimester of pregnancy and in the multigravidae. Conclusions: High prevalence of Candida albicans species among pregnant women were documented in this study. Our results indicate that gravidity, as the risk factor for occurrence of infection, has the significant role in the occurrence of vaginal candidiasis.

Introduction: Maternal mortality is an indicator of the quality of obstetric care in a community directly reflecting the utilization of health care services available. Maternal mortality has been recognised as a public health problem in the developing countries. Aim and Objective: To analyse the etiology of maternal deaths. Material and Methods: This descriptive study was conducted in the gynaecology and obstetrics department of the Nepalgunj Medical College Teaching Hospital Banke Nepal for a period of two years from august 2016-august 2018. All cases of maternal deaths in line with the definition of World Health Organization have been included. Data were collected and analyzed. Results: Twenty three (23) maternal deaths were identified during the study period. 69.56% of deaths occurred due to direct obstetric causes. Uncontrollable postpartum haemorrhage with 37.5 % was the leading cause of maternal death followed by eclampsia (18.75%) and sepsis (18.75%). Indirect causes were dominated by heart disease. Maximum 56.5% of deaths had occurred after 48 hours of admission. Conclusions: Haemorrhage, eclampsia and infections are the main causes of maternal deaths in our study. access to emergency medication, transfusion and anaesthetic and surgical teams in hospitals but also through the involvement of religious leaders, traditional and any community to better understand the population obstacles to reducing maternal mortality.