Background: Abnormal Uterine Bleeding is defined as any deviation from a normal menstrual pattern. It is one of the common presentation in extremes of ages. However endometrial hyperplasia and carcinoma are commoner in perimenopausal and postmenopausal women warranting investigations like ultrasonography and endometrial biopsy.Aims and Objective: The aim of the study was to note the endometrial thickness by transabdominal ultrasonography and observe the histopathological pattern in women presenting with abnormal Uterine Bleeding.Material and Methods: Premenopausal women more than 45 years of age and the postmenopausal patients, without any pelvic pathology were included in the study. Endometrial thickness was measured by transabdominal sonography and endometrial biopsy was done. Tissue obtained was sent for histopathological examination.Results: A total of 105 patients were studied. Majority (92%) of patients were premenopausal. Proliferative Endometrium (32%) was the most common finding in premenopausal and atrophic endometrium (37.5%) in postmenopausal group. Malignancy was higher in a postmenopausal group (12.5%) as compared to the premenopausal group (2%). Malignancy was not seen when endometrial thickness was less than 11mm in the premenopausal age group. Endometrial hyperplasia was also more common when the thickness was more than 11mm.In postmenopausal group12.5% of patients, had complex hyperplasia.25% had simple hyperplasia and malignancy was seen in 12.5% of patients. When endometrial thickness was less than 5 mm, hyperplasia and malignancy was not seen.Conclusion: Measurement of Endometrial thickness and histopathological workup in patients above 45 years presenting with abnormal uterine bleeding will be helpful in detecting endometrial hyperplasia and carcinoma.Asian Journal of Medical Sciences Vol.9(2) 2018 31-35

Introduction: Women who conceive at advance age are at risk of pregnancy complications and adverse foetal outcome. This study aims to find out the prevalence of pregnancy at advance age in a teaching hospital. Methods: A descriptive cross-sectional study was conducted between October 2019 to August 2020 at department of obstetrics and gynaecology of a tertiary care centre of Nepal, after obtaining ethical clearance from Institutional Review Committee (dated 03/09/2019 with ref no. 266) and informed consent from patient. Convenience sampling was done. All the patient who were ≥35 years and >28 weeks of gestation without any chronic illness were selected. Data and descriptive analysis were done using Statistical Package for the Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Women aged 35 years and above constituted 104 (5.73%) of the total deliveries of study period. Most were multigravida 72 (69.23%) and 23 (22.12%) had preterm delivery. Rate of caesarean section were higher in advance maternal age 69 (66.35%). Maternal complications such as Hypertensive disorder of pregnancy 9 (8.65%), and mal-presentation 15 (14.42%) were higher among them. Perinatal outcome in form of low birth weight 9 (8.65%) and perinatal death 5 (4.80%) were increased in those women. Conclusions: From this study, it can be concluded that prevalence of advanced age at pregnancy was lower than study done in developed country but it was similar to study in India and is increasing in Nepal.

Introduction: Hypertensive disorder in pregnancy complicates around 5 to 10% of all pregnancies. It is one of the leading causes of maternal and fetal morbidity and mortality. Measurement of protein excretion by 24 -hour urine protein collection is gold standard but as it is time consuming, an alternative method like random urine protein/creatinine ratio is required.Objectives: The aim of this study was to assess the diagnostic accuracy of urine protein/ creatinine ratio compared with 24-hour urine protein as an alternative method for evaluating proteinuria in preeclampsia.Methodology: Patients with preeclampsia after 20 weeks of gestation were included in the study. Random urine protein/ creatinine ratio and 24-hour urine for protein was collected and evaluated for proteinuria. Results were entered and analysis was done.Results: Fisher's exact test depicted a positive association between UPCR with 24-hour urine protein, p value being less than 0.05. The area under curve was calculated as 0.87 95% CI (0.74-1.01), which was statistically significant. At cut off point of 0.3, sensitivity was 100%, specificity 90%, positive and negative predictive value 97.2% and 100% respectively.Conclusion: Random urine protein/ creatinine ratio (>0.3) is a reliable indicator of proteinuria >300mg/day. It can be used as an alternative to 24-hour protein estimation. BJHS 2018;3(1)5 : 350-353

Background: COVID-19 has become a global pandemic. It has affected the psychological condition of pregnant women. Aims and Objective: This study aims to assess prevalence of depression and anxiety in pregnancy during COVID-19 pandemic. Materials and Methods: The current study was an observational, cross sectional study conducted in the Department of Obstetrics and Gynecology, Manipal Teaching Hospital. Patients were assessed using Nepali version of Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) for anxiety and depression respectively. Result: There were total of 115 patients in this study. The prevalence of anxiety according to BAI was 39.1%. The prevalence of depression according to BDI was 19%. There was a statistically significant difference in rate of anxiety according to maternal age (p value 0.028). Anxiety was higher in women less than 20 years of age. Anxiety symptoms were more prevalent i.e., 44.6% in third trimester followed by 31.4% in second trimester and 29.4% in first trimester. Symptoms of depression was higher in women more than 35 years of age (27.2%) and in second trimester of pregnancy (27.2%). Conclusion: Antenatal anxiety and depression are important issues because it impacts both maternal wellbeing and fetal health. Prevalence of anxiety and depression among pregnant women during COVID 19 pandemic was studied. The prevalence of anxiety and depression was 39.1% and 19% respectively.

Introduction: Major concern shifts from mother to newborn in postnatal period. Postpartum complications contribute to a lot of maternal morbidity and mortality. This study aims to determine the prevalence of morbidities in women following delivery at Manipal Teaching Hospital so as to identify and improve maternal quality care. Methods: This is a descriptive cross-sectional study conducted at department of Obstetrics and Gynaecology, Manipal Teaching Hospital from September 2018 to March 2020 after ethical approval from the institutional review committee with reference number 1296. All the women presenting to the department during the study period were included in the study. Women who were admitted to accompany and nurse their babies for neonatal problems were excluded.Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Data were entered in Excel and analysed in SPSS. Results: Among 3510 cases, 104 women were admitted with various postpartum morbidities. The prevalence of postpartum morbidity was found to be 104 (2.96%) at 95% Confidence Interval (2.67-3.25). Puerperal sepsis was diagnosed in 23 (22.11%), preeclampsia in 20(19.23%) eclampsia in 14 (13.46%) and haemorrhage in 14 (13.46%) respectively. Majority of patients, 83.65% belonged to age group of 20-34 years. Nine patients (8.65%) were teenage mothers. Conclusions: Puerperal sepsis, preeclampsia, eclampsia and haemorrhage were the major postpartum complications requiring admissions in hospital.