Aims: To evaluate and detect the thyroid dysfunction in patients with abnormal uterine bleeding (AUB) from puberty to menopause.Methods: This is an observational descriptive study of 90 patients of abnormal uterine bleeding at Paropakar Maternity and Women’s Hospital, Kathmandu from 17th January 2016 to 16th January 2017. Besides thyroid function test Pap smear, endometrial biopsy and histo-pathological examination of uterus following hysterectomy was done in selected cases.Results: The incidence of AUB was 6.2 % with mean age of 37 years. The most common presenting complaint was menorrhagia (36.7%) followed by metrorrhagia (23.3%). Thyroid dysfunction accounted for 20% of AUB with major share occupied by subclinical hypothyroidism (11%) and least by hyperthyroidism (1%). The most common association of thyroid dysfunction with AUB was overt hypothyroidism (27.3%) with menorrhagia. Non-structural cases of AUB accounted for 30.4% of thyroid dysfunction.Conclusions: This study shows that thyroid dysfunction plays significant role for AUB so it is wise enough to perform TFT on routine basis in order to avoid unnecessary hormonal treatment with Estrogen, Progesterone or their combination and even the hysterectomies.

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Background and Objectives: Eclampsia poses a global threat in terms of feto-maternal morbidity and mortality and all medical practitioners fear the ailment. It is one of the major causes behind preventable maternal death. Etio-pathogenesis of the disease condition is ambiguous and is considered to be multi-factorial. This study was done to analyze cases of eclampsia in relation to maternal and fetal outcomes at a tertiary level care hospital. Materials and Methods: A descriptive cross-sectional observational study was carried out in patients developing eclampsia over a period of five years starting from July 2011 to June 2016 at National Medical College and Teaching Hospital, Birgunj. Relevant data were collected from the statistics section of hospital reviewing the case sheets. Results: There were 291 cases of eclampsia out of 16,445 deliveries and prevalence of eclampsia was calculated to be 1.77%. Fourty-five percent of eclamptic women had age less than 20 years and two-third was primigravida. Approximately 84% of women were unbooked. Antepartum eclampsia was observed in 78.8% followed by postpartum eclampsia (14.8%) and intrapartum eclampsia (6.5%).  At the time of admission systolic blood pressure more than 140 mmHg and diastolic blood pressure more than 90 mmHg were noted in 79% and 92.1% cases respectively. Caesarean section was the preferred mode of delivery and was performed in 62.9% cases. ICU admission was required in 35.7% and remaining cases were managed in general/eclampsia ward. Renal failure was the most common cause of maternal mortality seen in 29.4%. Still birth was noted in 13.4%. Conclusion: Institutional obstetric patients are gradually facing eclampsia as prime cause of maternal death and unfortunately most of the cases are primigravid at younger age. All health care professionals should be proficient to manage eclamptic women instantaneously. Key words: Eclampsia; Fetal Mortality; Maternal Mortality; Pre-Eclampsia

Introduction: Caesarean section is a commonly performed major obstetric surgery to deliver baby under certain indications which may be maternal or fetal. If performed timely, it is helpful to save the life of mother and fetus and if not, it increases both maternal and fetal risks. Methods: A hospital based descriptive cross-sectional study was conducted at Dhading district hospital from 17th October 2016 to 17th October 2017. Total of 41 patients undergoing emergency caesarean section meeting the selection criteria were included. Results: The incidence of emergency caesarean section was 41 (5.5%). Most common indication for caesarean delivery was fetal distress in 12 (29.3%) followed by failed induction and cephalopelvic disproportion each accounting 6 (14.6%) cases. The least common causes being chorioamnionitis and cord prolapse in 1 (2.4%). Regarding perinatal outcomes, 33 (80.5%) babies delivered were of normal weight. Low Apgar score (<7) at one minute was noted in 8 (19.5%) cases. Neonatal resuscitation in the form of oxygen supplementation was required in 2 (4.9%) cases whereas bag and mask ventilation was required in 5 (12.2%) cases. Referral for neonatal intensive care unit admission was done in 6 (14.6%) cases. There were three neonatal deaths.Conclusions: Residential posting was fruitful to decrease feto-maternal morbidities and mortalities. Even to minimize the delay of treatment, government should provide adequate equipments and skilled man-power to run neonatal intensive care unit.