Introduction: Cesarean section is a surgical procedure performed to deliver fetus through abdominal route. Increasing rate of cesarean section worldwide is an alarming concern for public health and obstetricians due to increase in financial burden and risk to health of the mother in comparison to vaginal delivery. The aim of the study was to find the prevalence of cesarean section and its most common indication in a tertiary care hospital. Methods: This descriptive cross-sectional study was done in a tertiary care hospital, from July 2016 to June 2018 after taking ethical clearance from institutional review board. Convenience sampling was done to reach the sample size. Data was collected and entry was done in microsoft excel, point estimate at 95% CI was calculated along with frequency and proportion for binary data and analysis was done. Results: Out of total deliveries conducted, 862 (36.8%) were CS deliveries, 1477 (63.1%) were vaginal deliveries, and 12 (0.51%) were instrumental deliveries. Prevalence of CS is 862 (36.8%) at 95% CI (34.82%-38.78%). Mean age±S.D of delivering mother was found to be 26.1±0.25 years. Primi cesarean section was more than repeat cesarean section. Most common indication of cesarean section was fetal distress 243 (28%) followed by previous cesarean section 165 (18%), non-progress of labour 106 (12%), oligohydramnios 59 (7%), malpresentation 59 (7%), cephalo pelvic disorders 52 (6.5%), and hypertensive disorder in pregnancy 33 (4%). Conclusions: Prevalence of cesarean section in a tertiary care hospital is high compared to WHO data. The most common indication of cesarean section are fetal distress and previous cesarean section.

Introduction: Abnormal uterine bleeding is a common gynecological presentation, accounting forat least 20% of all new outpatient visits. It has been recognized that thyroid dysfunction may haveprofound effects on the female reproductive system. Both hypothyroidism and hyperthyroidism areassociated with a variety of changes, including delayed onset of puberty, anovulatory cycles, andabnormally high fetal wastage. Hence, this study was conducted to know the thyroid status of thepatient with abnormal uterine bleeding. Methods: A descriptive cross-sectional study was conducted in all the patients with abnormaluterine bleeding in a tertiary care hospital from 2 August 2019 to 2 February 2020. Ethical clearancewas received from the institutional review committee of KIST Medical College. Convenient samplingwas done. Data was collected using a questionnaire which includes patients profile, the pattern ofabnormal uterine bleeding, and thyroid profile. Statistical analysis was done using Statistical Packagefor the Social Sciences version 23. Results: Out of 79 patients, it was found that 67 (84.8%) were euthyroid, 11 (13.9%) were hypothyroid,and 1 (1.2%) was hyperthyroidism. The most common type of abnormal uterine bleeding wasmenorrhagia 34 (43%), followed by polymenorrhoea 23 (29%), oligomenorrhoea 13 (16.5%),menometrorrhagia 6 (7.6%), metrorrhagia 2 (2.5%), and hypomenorrhea 1 (1.3%). The maximumnumber of patients was between 20-25 years with the mean age of 31 years. Among hypothyroid, 7(8.8%) had subclinical hypothyroidism and 4 (5%) had frank hypothyroidism. Conclusions: Most females with abnormal uterine bleeding were euthyroid. Menorrhagia was themost common pattern of abnormal uterine bleeding.

Introduction: Sustainable development goal 3 targets at ensuring healthy lives and promoting well-being for all at all ages. One of the component for achievement of this goal is improvement of maternal and child health; the indicators of which is perinatal mortality rate. The aim of this study was to evaluate the cause of perinatal death in a tertiary care medical centre, which may help to reduce the incidence of perinatal death and improve the quality of care. Methods: A prospective study was done over a period of one year from April 2016 to March 2017. Causes of perinatal deaths based on PSANZ classification were recorded along with patients demographics and also avoidable factors were evaluated. Results: Out of total 1275 deliveries, there were 21 perinatal deaths including three intrauterine foetal deaths, one still birth and seven early neonatal deaths. The perinatal mortality rate was 16.27 per 1000 birth. Majority of perinatal deaths (19%) occurred due to congenital anomalies followed by (14%) hypertensive disorder in pregnancy, intrapartum hypoxia (14%), unexplained causes (14%), 9.5% cord prolapse, antepartum haemorrhage (9.5%), 5% due to intrauterine growth restriction, gestational diabetes mellitus or preterm labour. Most of the mothers whose baby had perinatal deaths had ANC outside. Most of the deaths occurred in between gestational age of 37 to 41 weeks. Perinatal mortality was more in multigravida. Delay to seek health care and inadequate antenatal checkups were the most common avoidable factors. Conclusions: Congenital anomalies and hypertensive disorders during pregnancy were the most common causes of perinatal death. Delay in health seeking behaviour was the most common avoidable factors for perinatal death. We recommend early identification of high risk pregnancy through proper antenatal screening, educating pregnant women to identify danger signs of pregnancy, creating public awareness about importance of antenatal checkups, vigilant labour monitoring for foetal distress, to reduce some categories of deaths.

Background: Reproductive health of women has been the central agenda of Cairo conference since its inception in 1999. As a signatory country for Cairo Conference, Nepal government is also committed for reproductive rights for Nepalese women. Despite this, reproductive health challenges do exist in Nepal. This prompted us to determine the reproductive health status of married women attending in cervical cancer screening in Kath­mandu. Methods: Cross sectional study was designed to include retrospective data of married women, obtained during cervical cancer screening camp conducted by KIST Medical College at Laga Khala Clinic, Lagan, Kathmandu on 12-02- 2017. Among married women (131) attended cervical 100 wom­en’s records with complete set of data for reproductive health variables required for the study were included in this study. Statistical analysis was done descriptively. Results: Participant’s age is between 21 years to 61 years, 83% are liter­ate and 46% are employed. Adolescence marriage and pregnancy were two main problems noted. Cervical examination in relation showed 3% (3) VIA positive, 33% (33) Cervicitis, 10% (10) cervical polyp, 7% (7) atrophic vaginitis, 4% (4) cervical erosion and 43% (43) healthy cervix. Regarding Knowledge about risk factor majority 92% (92) had either no knowledge or only some extent of knowledge. Conclusions: Married women who lives in Kathmandu has significant re­productive health problem. Urban health program should address these issues.

Introduction: Access to safe abortion services has been the need of the current era. Medical abortion (MA) is a simple, safe and effective method of induced abortion. MA drugs have been approved by Government of Nepal for termination of pregnancy up to 63 days of gestation in safe abortion service sites. But registered as well as unregistered MA drugs have been widely and easily available without prescription even in rural settings. This has led to a tremendous increase in self-induced medical abortions and its adverse consequences. Aim of our study was to find out incidence of abortion related admissions and description of self- induced MA presented to our institution. Methods: Descriptive study was conducted in Department of Obstetrics and Gynecology of KIST Medical College Teaching Hospital (KISTMCTH) from January 2015 to December 2016. Cases of complications of self-induced medical abortions were studied in detail which included age, parity, gestational age, address, type of complications and management. Results: Total number of Gynecology related admission over the period was 308. Among these, abortion related admission were 95 (30.84%). 44(46.3%) were spontaneous abortion and 51(53.7%) were induced abortion. 22(43.1%) were admitted due to complications of self- induced MA like incomplete abortion, bleeding, shock, sepsis and renal failure. Most of the patients were of age group 20-25 years and were multigravida and had done MA in first or second trimester. Conclusion: Self-induced medical abortion is still practiced even in urban area, landing to tertiary care hospital with complications. Thus MA should be provided by registered medical practitioner.