Browsing by Author "Ghimire, Asmita"
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Publication Maternal and Perinatal Outcome in Women with Congenital Heart Disease: A DescriptiveCross-sectional Study(Nepal Medical Association, 2025) Paudyal, Pooja; Ghimire, Asmita; Parajuli, Bashu Dev; Khakural, PrabhatAbstract Introduction: Untreated and residual congenital heart disease in a pregnant woman is concerning for both the mother and the baby. Early diagnosis and management are imperative to ensure survival of both mother and the baby. The aim was to study the maternal and perinatal outcomes in women with congenital heart disease. Methods: An observational study was conducted in a tertiary care hospital over a three-year period from April 2020 to March 2023. The data was collected retrospectively after ethical approval from the Institutional Review Committee [Reference number: 373/ (6-11) E2/076/077]. Total sampling was done where all women with congenital heart disease who delivered in the hospital after twenty- eight weeks of gestation during the study period were enrolled. Data were collected from the record book of labour room, patient files, and labour room, along with mortality audits of the department. Maternal and fetal outcomes were recorded, and descriptive analyses were done. Results: Seventy-three women with congenital heart disease delivered in our center during the study period. The average age of the women was 26.51± 5.50 years. Among them, 39 (53.4%) of the patients had uncorrected heart conditions. Atrial septal defect was present in 20 (27.39%) pregnant patients. There were 69 (94.52%) live births and four (5.47%) intrauterine foetal deaths. One (1.36%) newborn was diagnosed to have an ostium secundum atrial septal defect, and two (2.73%) newborns were diagnosed to have patent foramen ovale. Conclusions: The maternal and perinatal outcomes in women with treated congenital heart disease are favourable, whereas the maternal mortality remains high in women with Eisenmenger Syndrome.Publication Spectrum of Obstetrics Case Referrals(Nepal Health Research Council, 2025) Ghimire, Asmita; Shrestha, Reshika; Yadav, Jeshika; Thapaliya, Ishwor; Sapkota, Sangrila; Khatiwoda, Susmita; Ojha, NeebhaBackground: Maternal health is an important focus for ensuring the well-being of both mothers and their babies. Maternal and fetal mortality which is a burning issue especially in third world countries can be reduced significantly with right obstetric referral. This study reviewed the primary reasons, time, distance, and pattern of obstetric cases referred to a tertiary center. Methods: This descriptive study was conducted after taking ethical approval {Approval number 136 (6-11) E2} from the review board of Maharajgunj Medical Campus, Nepal, and data of three years from 1st August 2020- 31st September 2023 were analyzed from medical records. The study included all referral cases aged 18-45 years who were past 28 weeks of gestation till 42 days post-delivery. Women who had incomplete medical records were excluded from the study. A continuous convenience sampling method was used. The point estimate was calculated at a 95% confidence interval. Results: Among 174 referred cases, 84 (48.28%) were from the government district-level hospitals with the predominant reason being medical disorders complicating pregnancy 136 (78.17%). The majority of cases 94 (54.02%) were referred during the intrapartum period. Conclusions: Medical disorders complicating pregnancy were the primary cause for the referral in obstetrics cases, notably from district-level hospitals having less manpower to deal with those cases. Keywords: Hospital; maternal mortality; obstetric; pregnancy; referrals.