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.

Introduction: Birth defect is one of the least studied areas in most developing countries like Nepal where low birth weight, prematurity, sepsis, and perinatal asphyxia are still the leading causes of neonatal and infant mortality. However, studies have shown that the incidence of birth defects is increasing trend and has significant impacts on individuals, families, healthcare, and society. Awareness of birth defects is essential in both prevention as well as early intervention. The objective of this study was to find out the pattern and prevalence of birth defects presenting in newborns in KIST Medical College Teaching Hospital, Lalitpur, Nepal.Materials and Methods: This is a hospital-based cross-sectional, descriptive study conducted in the NICU, Nursery, and postnatal wards of KIST Medical College Teaching Hospital, Lalitpur, Nepal from August 2018 to August 2020. The study population included all inborn newborns with birth defects, stillbirths, and IUFD of more than 22 weeks gestation with birth defects. Outborn babies admitted in Nursery/NICU and abortions of less than 22 weeks gestation were excluded from the study. The data was collected using WHO based surveillance system with a clinicalreview. Data were analyzed using SPSS version 23. Prevalence and pattern of birth defects were expressed in frequency and percentages. Results: In a total delivery of 3360, the incidence of the birth defect was 3.75% (n=126). Of the total birth defects, 28.9% (n=112) were born alive and 11.1% (n=14) were stillborn. Among the live births, 2.4% (n=3) died during their hospital stay. The commonly occurring birth defects were cardiovascular (35.7%, n=45) followed by oro-facial defects (23%, n=29), genitourinary (15.9%, n=20), musculoskeletal (15%, n=19), central nervous system (15%, n=19), various syndromes (7.1%, n=9), gastrointestinal (4.7%, n=6) and respiratory (0.8%, n=1).Conclusions: The true magnitude of birth defects in Nepal is unknown due to the lack of national birth defect surveillance. The lack of proper data regarding birth defects is undermining its impact on perinatal health. Awareness about the birth defect and their prevalence can significantly affect the prevention strategy and the management plan in decreasing perinatal mortality and subsequent neonatal and infant mortality as well.

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.

Introduction: Cervical cancer is the leading cause of cancer deaths for women worldwide. Early diagnosis of cervical cancer may be done by a simple and cost effective technique of Pap smear. The morbidity and mortality could be significantly reduced with an active cervical cancer screening programme.Methods: A cross sectional interview based study was done among 200 patients attending Obstetrics and Gynaecology OPD of one of the tertiary care hospital at Lalitpur, to assess the knowledge and awareness of patient regarding screening methods of cervical cancer and its prevention and early detection. Results: Among all the participants, 76.5% (n-153) were literate and 23.5% (n-47) were illiterate. Only 41% had heard about the Pap test and only 1% had heard about other methods of screening test like VIA(Visual Inspection with Acetic acid). Only 16% think that infection of the genital tract and 12.5% think that multiple partners is the leading cause of cervical cancer. Among them 51% (n-102) think that regular screening will prevent cervical cancer. But only 22.5% (45) had done Pap smear once and 67% did not know the risk factor of cervical cancer.  Only 7% had heard of HPV vaccination but did not know  details about it.Conclusions: There is very low level of knowledge about cervical cancer, Pap smear and HPV among the participants attending Obstetrics and Gynaecology OPD. For using Pap smear as a preventive method for cervical cancer, it is necessary to inform women about cervical cancer and the Pap smear test. An aggressive campaign with in depth teaching about cervical cancer by media and health care providers is mandatory.