DOI: http://dx.doi.org/10.3126/njog.v5i2.5072  NJOG 2010 Nov-Dec; 5(2): 17-22

Aim: To determine the incidence and indication of caesarean section. Method: It is a retrospective cross sectional study conducted at Paropakar Maternity and Women’s Hospital for three months. The data was retrieved from the medical record of operation theatre. Results: During the study period, 31.1% (1,592 out of 5,120) of women underwent caesarean section. Eighty eight percent (n-1,402) of them were emergency caesarean section while 12 % were elective (n-190). Majority of the women (70.3%) belonged to 20-29 years and half of them were primigravida. Around 89.2% caesarean sections were performed at 37-42 weeks of gestation. The four leading indications were fetal distress (31.5%), previous caesarean section (19.7%), cephalo -pelvic disproportion (13.4%) and abnormal presentation (7.9%). Conclusions: In this study, incidence of caesarean section is more than WHO recommendation. It may be mainly due to the referral of complicated cases from the periphery of the country. Key words: caesarean section, indication

INTRODUCTION: Complete Hydatidiform mole is one of the most frequent abnormal pregnancies. This review studies the trend of complete mole in Paropakar Maternity and Women's hospital and clinical ability to detect it. METHODS: This is a retrospective study of 504 cases of complete hydatidiform mole recorded at Paropakar maternity and women's hospital, Kathmandu, during 2058-2065 B.S. Medical records were reviewed and incidence, clinical presentation and method of diagnosis were studied. RESULTS: During the study period, there were 13,9117 births and 504 complete moles, 12 partial moles, 48 persistent gestational tumours, six choriocarcinoma and four invasive moles recorded in the hospital. The incidence of complete mole was one per 276 births. It was prevalent among women younger than 29 years (80%) and among the primigravidae (36.7%). More than 90% women presented in the first half of their pregnancy and vaginal bleeding was the main complaint (68.3%). Suction evacuation, dilation and evacuation followed by sharp curettage and abdominal hysterectomy were performed in 80.6%, 17.6% and 1.2% of the women respectively. Persistent mole and choriocarcinoma developed in 9.5% and 0.4% respectively. CONCLUSIONS: Complete mole has the highest incidence. It affects mostly younger women and presents with vaginal bleeding most of the time, usually in the first half of their pregnancy. Keywords: complete hydatidiform mole, gestational trophoblastic disease, persistent gestational tumours.

Background: Cervical cancer ranks the most common cancer among Nepalese women. Cervical and vaginal infections constitute the most common gynecological problems. Through Pap smear screening, early diagnosis, follow up and treatment, morbidity and mortality can be reduced by 70% and 80% respectively.  Methods: This retrospective study was conducted to know the incidence of abnormal cervical epithelial lesions and cervico-vaginal infections. It was carried out in the Outpatient Department of Gynecology at Chitwan Medical College from April 2018 to March 2019. The data were collected and standard statistical analysis done using Microsoft Excel 2007.  Results: The most prevalent cervical epithelial cell abnormality was atypical squamous cells of undetermined significance (3.43%) whereas the least common was low grade squamous intraepithelial lesion (0.21%). The most prevalent cervical vaginal infection was Bacterial vaginosis (12.30%) whereas the least prevalent was Trichomoniasis (0.29%). The majority of the women with epithelial cell abnormality were in the age group of 31-40 years whereas the lowest number in the age group less than 20 years. The highest prevalence of cervical vaginal infection was in the reproductive age group (31-50 years) and the lowest in the age above 51 years. Most of the patients had multiple symptoms like vaginal discharge, genital itching, whereas only (20.17%) visited for routine screening.  Conclusion: Atypical squamous cells of undetermined significance and Bacterial vaginosis were the most common finding in Pap smear test representing abnormal cytology of cervix and cervicovaginal infection respectively.