Background: The risk to the mother and the fetus increase with advancing gestation age. Our study aims to study the maternal and fetal outcome in pregnancy extending beyond the expected date of delivery so that safe timings of induction and appropriate mode of delivery can be determined. Methods: We conducted a retrospective study of 152 patients with pregnancy beyond the expected date who presented to the department of Obstetrics and Gynecology, College of Medical Sciences Teaching Hospital from the time period of October 2019- November 2021.The primary outcome measures were obtained in terms of rate of cesarean section, postpartum hemorrhage, wound infection, admission in neonatal intensive care unit, birth asphyxia and meconium aspiration syndrome. Statistical analysis was performed using Chi-square test with P value <0.05. Results: The majority of 86 (56.58%) patients were between 40-41 weeks of gestation. Maximum number of vaginal deliveries were seen between 40-41weeks (77.90%). Overall cesarean section rate was 40.13% with maximum number between 41-42 weeks (64.28%). Fetal distress with meconium-stained liquor was the most common indication (36.06%). The rate of neonatal intensive care unit admission was 16.44% with birth asphyxia (12.50%) and meconium aspiration syndrome (8.55%) as the primary cause for admission. Maternal complications like oligohydramnios, postpartum hemorrhage, wound infection, cervical tear, shoulder dystocia was seen in 16.45%, 1.97%, 1.97%, 2.63% and 1.31% respectively. Conclusions: The pregnancy beyond the expected date causes definite risk to the mother and the fetus. Therefore, strict fetal surveillance with early induction of labor prior to expected date of delivery is recommended for better fetomaternal outcomes.

Introduction: Breech is the commonest malpresentation. The objective of this study is to find out the prevalence of breech presentation at term. It also aims to present the mode of delivery conducted and to highlight the maternal and fetal complications associated with it. Methods:  This   was   a   descriptive   cross-sectional   study   conducted in Department of Obstetrics and Gynaecology department of College of Medical Sciences done over a period of 2 years. All term pregnant women (≥ 37 weeks) aged 16 years and above, admitted to the maternity and labor ward with the diagnosis of singleton breech presentation during the study period were included in the study. Results: The incidence of breech presentation at term was 5.03%. Out of these, only 7 (18.92%) patients underwent breech vaginal delivery. Mean maternal age was 28.07 (± 11.56) years and  majority were primigravidae. The mean birth weight of newborn was 2.8±0.5 kg. Conclusions: Breech presentation can result in both maternal and fetal complications. Skills related to conducting delivery in  breech presentation must be learned by all those who manage pregnant women.

IntroductionEctopic pregnancy is a life threatening emergency in first trimester of pregnancy. Hemodynamicstability of the patient remains one of the crucial factors that determine the treatment modalities.The main objective of this study was to study the correlation between the vital signs and amountof hemoperitoneum in ruptured ectopic pregnancy so that early and active interventions can bedone. MethodsWe conducted a cross sectional study of all the pregnant women with ruptured ectopic pregnancywith hemoperitoneum who presented to the emergency department of College of MedicalSciences Teaching Hospital from time period of 1st May 2017-31st May 2020.The different vitalsigns present at the time of initial emergency department and preoperative period prior surgerywere reviewed and used for correlation with amount of hemoperitoneum by using Pearsoncorrelation analysis. ResultsA total of 61 patients were studied. Pearson correlation between different vital signs and amountof hemoperitoneum were: heart rate(r=0.48, p<0.001), systolic blood pressure(r= -0.41,p=0.001),diastolic blood pressure (r= -0.34,p=0.06), mean arterial pressure (r= -0.37,p=0.03), respirationrate(r= 0.33, p=0.08) temperature (r=0.09,p=0.94), and shock index (r=0.55,p<0.001). Only 19 of 36patents with hemoperitoneum ≥750 ml had HR≥100 beats/min and 8 patients had SBP≤90mmHg. ConclusionsNone of the vital signs showed strong association with the amount of hemoperitoneum. Ifdecision for surgical interventions were made based on hemodynamic instability, most of thepatients would have been over-diagnosed and treated differently. Proper and timely diagnosiswith immediate management should be done.