Nepal Journal of Obstetrics and Gynaecology 

About: Nepal Journal of Obstetrics and Gynaecology is an academic journal published by Nepal Society of Obstetricians and Gynaecologists. The journal publishes majorly in the area(s): Pregnancy & Obstetrics and gynaecology. It has an ISSN identifier of 1999-8546. It is also open access. Over the lifetime, 420 publications have been published receiving 1320 citations. The journal is also known as: NJOG.

Impact of Antenatal Care on Maternal and Perinatal utcome: A Study at Nepal Medical College Teaching Hospital

Abstract: Aims: To identify the determinants of antenatal care (ANC) attendance and its impact on maternal / perinatal outcome. Methods: Prospective descriptive study of women delivered at Nepal Medical College Teaching Hospital (NMCTH), a 700 bedded tertiary care hospital situated at periphery of Kathmandu. Results: Among 322 women delivered during period of four months, majority (87%) reported of attending more than 4 antenatal visits, only 21 (6.5%) women had not attended ANC. The most preferred place of ANC was hospital (71.6%). Women with secondary education and above, business/service holders, 20-29 years age group, primigravida and Brahmin / Chhetri caste were more likely to attend ? 4 visits, while those living further than 6 km. from a health facility were less likely to attend. Financial problem (52.4%) followed by ignorance (28.6%) were the most commonly stated reasons for not attending ANC. Women attending more than 4 antenatal visits have more chance of full immunization with tetanus toxoid and iron supplementation. Most of the women started attending ANC from their second trimester (75.8%), only 21.9% had first ANC visit during first trimester. Overall Cesarean section rate was 17.4% and with increased rates in women who had attended ANC, because of the fact that all elective cesarean section were planned in these women only. Also, all inductions of labor (9.3%) were performed among them. Maternal complications like anemia and pregnancy induced hypertension occurred more commonly in women without ANC. The proportion of low birth weight and preterm babies was higher in women with inadequate or no ANC. Special care baby unit (SCBU) admission was also higher among them due to various reasons like neonatal sepsis, birth asphyxia, jaundice etc. While there were no neonatal deaths during the study period, 3 still births have occurred. Perinatal mortality rate was similar in no ANC and inadequate ANC groups; it was 16 times higher than that in the group with more than 4 visits. Maternal and perinatal outcomes were found to be better in women who attended regular ANC. Conclusions: Although attendance of ANC is quite encouraging, the proportion of women attending ANC from first trimester is low. The quality of antenatal care needs to be strengthened. The health system needs to ensure the availability of ANC in primary care level and to establish mobile clinics for those living far from the health facilities. NJOG 2011 Nov-Dec; 6 (2): 37-43 DOI: http://dx.doi.org/10.3126/njog.v6i2.6755

Pelvic organ prolapse in rural Nepalese women of reproductive age groups: What makes it so common?

Abstract: Aim: To find out the prevalence, aetiopathogenesis and the magnitude of problems of pelvic organ prolapse (POP) among married women of reproductive age (MWEA) in the rural Nepalese community. Methods: A cross-sectional descriptive study conducted in eight selected districts (mountain/ hills to terai region) of Nepal linking community to health services. Proportionate samples of MWRA (15-49 years) in total samples of 2849 were interviewed using questionnaires and clinical examinations were made in health facililities. Results: Among 2849 women who agreed to take part on the study when interviewed (by enumerators with pretested questioners) 2070 (72.6%) came for assessment. POP was diagnosed in 207/2070 giving the incidence as 10% being commoner in the planes (8:1) than mountains. POP formed 2.8% of adolescent due to early marriage d" 15 years in (50%) and unsupported delivery by skilled birth attendant (SBA) out of health facilities (99.2%). Resumption of manual labor after delivery less than a month was (83.8%) and parity was responsible to some extent as P (1-3) occupied by T!. Mean duration of suffering being 7.8 years (e" 10 years in ¼.) having II°/III° or procidentia rectovaginal/ vesicovaginal fistula, urinary incontinence (stress/urge), bleeding, discharge from sore and ulceration, coital problem, urination/ defecation problem walking, sitting, back ache and chronic abdominal pain S!. Conclusion: In this large reproductive morbidity study including women in the rural community of varied ethenic groups from diverse ecology, basic community survey linked to clinical assessment in the health facility found the incidence of POP to be much higher in planes than hills giving unusually lower prevalence rate for POP as 10% than other clinic based studies. Keywords pelvic organ prolapse

Emergency Obstetric Care: Strategy for Reducing Maternal Mortality in Developing Countries

Abstract: Twenty-five years have passed since the global community agreed in Nairobi to address the high maternal mortality by implementing the Safe Motherhood Initiative. However, every year nearly three million women die due to pregnancy related causes. This tragedy is avoidable if women have timely access to required emergency obstetric care. Emergency obstetric care refers to life-saving services for maternal and neonatal complications provided by skilled health workers. Since the beginning of the 1980’s, several efforts have been intensified to improve maternal and child health status and reducing the high morbidity and mortality. There was built on a worldwide consensus to provide improved maternal and child health care for addressing the high morbidity and mortality. All participant countries agreed to integrate emergency obstetric care services in their national health care system. Emergency obstetric care is one of the strategies for reducing the maternal mortality as pregnancy related complications are unpredictable. However, many women in developing countries do not have access to essential health care services including emergency obstetric care. Basic emergency obstetric care by skilled birth attendants or timely referral for further comprehensive emergency obstetric care can reduce maternal deaths and disabilities significantly. This paper is based on the results published in PubMed, Medline, Lancet, WHO and Google Scholar web pages from 1990 to 2013.

Oral Misoprostol for Induction of Labor

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Cervical cytological study in unhealthy and healthy looking cervix

Abstract: Aim: To compare cervical cytology in women with healthy/unhealthy cervix. Methods: A prospective study on Pap smear was performed including 200 women, 100 with healthy and 100 with unhealthy cervix, attending outpatient Gynaecology clinic of the Department of Ob/Gyn TU Teaching Hospital, Kathmandu. The cytology report was compared in the two groups. Results: Cervical dysplasia was seen in 8 women with unhealthy cervix, 7 were mild and one was severe dysplasia. In the women with healthy cervix, 5 had mild and one had moderate dysplasia. Eighty two percent of women with healthy cervix and 83% of women with unhealthy cervix had non-specific inflammation. Women who were married before 20 years (p=0.04) and had higher parity (3.3 Vs 2.8) were more likely to have unhealthy cervix (p=0.03). Excessive vaginal discharge was common in women with unhealthy cervix (p=0.0009). Conclusion: Dysplasia was slightly higher among the women with unhealthy cervix in comparision to healthy cervix but the difference was not statistically significant. Hence this study emphasizes on the importance of universal screening of both the healthy and unhealthy looking cervix. Key Words: carcinoma cervix, visual screening, Pap smear, cervical cytology, cervical dysplasia