Browsing by Author "Dangal, Ganesh"
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Publication Fetomaternal Outcome in Antepartum Hemorrhage After 34 Weeks of Gestation(Nepal Health Research Council, 2024) Ranabhat, Bijay Kumar; Dangal, Ganesh; Poudel, Sandesh; Adhikari, Shreeprasad; Khadka, ChiranjiviBackground: Antepartum hemorrhage is defined as any bleeding from or into the genital tract during pregnancy, after the period of viability until delivery of the fetus. APH complicates 2-5% of pregnancies and is a primary cause of perinatal and maternal mortality globally. Aim of this study is to evaluate maternal and perinatal outcome in patients with APH at a tertiary care hospital. Methods: The present study was a cross sectional study conducted in Obstetrics and Gynaecology department of Paropakar Maternity and Women’s Hospital, during a period of 5 months from December 2022 to April 2023. 50 cases of APH were enrolled with gestational age ? 34 weeks of gestation. Results: Incidence of APH after 34 weeks of gestation was 0.51%. The most common type of APH was abruption placenta (44%) followed by placenta previa (32%) and undetermined (24%). The age range of 26 to 30 years old accounted for the highest number of APH patients i.e., 21(42%). In placenta previa, 75% and in abruption placenta 63.64% were multigravida. APH was presented mostly between 37-40 weeks. Around 26% of the patients had anemia at the time of admission. Most common mode of delivery was cesarean section (82%). Most common maternal complications were PPH (40%), blood transfusion (28%), DIC (4%), cesarean hysterectomy (4%). Low birth weight and preterm were the most common causes of fetal complications. Maternal mortality was 2% and perinatal mortality was 18% overall. Conclusions: APH is primary cause of maternal and perinatal morbidity and mortality. In our study, an abruption placenta was the most frequent cause of APH. Cesarean section was the most commonly used mode of delivery. PPH with blood transfusion was the most prevalent maternal complication, while fetal complications included low birth weight and preterm.. Keywords: Abruptio placenta; antepartum haemorrhage; placenta previa.Publication Fetomaternal Outcome of Pregnant Women at Term Undergoing Cesarean Section(Nepal Health Research Council, 2024) Bharati, Sonu; Dangal, Ganesh; Tiwari, Kenusha Devi; Maharjan, Sunita; Bhandari, Srijana; Karki, Aruna; Pradhan, Hema Kumari; Shrestha, Ranjana; Bhattachan, KabinBackground: Cesarean section is one of the most common procedures performed in obstetric practice today and is a lifesaving surgery for mother and fetus. Cesarean sections are classified traditionally, as elective cesarean section or emergency cesarean. The purpose of this study is to compare the maternal and neonatal outcomes in elective and emergency cesarean section so that measures can be taken to reduce maternal and neonatal morbidity and mortality. Methods: A descriptive study including 400 pregnant women who underwent caesarean section were included in this study. Patients were subjected to elective or emergency cesarean section as per the indication and protocol of institute. were included in the study. Results: During the study period there were total 1080 deliveries. The average age of the women was 29.21±4.07 years. Of the 400 cesarean section cases, only 2.8% had wound infection, 3.8% had fever, 4.8% urinary tract infection (UTI) whereas no women had observed with post-partum hemorrhages (PPH) and maternal death. Regarding fetal outcome, neonatal intensive care unit (NICU) admission was observed in 16%, birth asphyxia was 2.3% poor Apgar score 2.5% and neonatal death was not observed. Rate of fever, UTI, wound infection, need of resuscitation and poor Apgar score was significantly high in emergency section than elective caesarean section whereas NICU admission was not statistically significant. The most common indication of emergency cesarean section were fetal dress and for previous LSCS. Conclusions: Emergency cesarean was associated with increased maternal and perinatal complications than in elective cesarean section. Keywords: Caesarean section; elective caesarean section; emergency caesarean section; neonatal morbidity and mortality.