Browsing by Author "Kayastha, S"
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Publication A Study on Obstetric Intensive Care in Dhulikhel Hospital, Kathmandu University Hospital(Kathmandu University, 2017) Shrestha, A; Kayastha, B; Kayastha, SABSTRACT Background Maternal mortality ratio in developing countries is high, depending upon the country and region. Many programmes have been launched in different parts of the world like “Safe motherhood Initiatives” under the WHO guidance. An alternative indicator of obstetric health care is obstetric transfer to an intensive care unit. Very few have been reported from developing countries in South East Asia. Objective To determine the intensive care unit (ICU) utilization by critically ill obstetric patients and to see the spectrum and outcome of disease. Method A prospective study performed on obstetric patients admitted to the intensive care unit of Kathmandu university hospital during a five year period (1st January 2010- 31st December 2015). A total of 56 patients were studied. Result The main cause of admission was hypertensive disorder in pregnancy (22 patients), bleeding disorders in pregnancy (18 patients), sepsis (8 patients), heart disease complicating the pregnancy (4 patients) and 4 others with respiratory problems encountered during delivery. These are the important causes of maternal mortality and morbidity. Conclusion In this study obstetric patients form a small percentage of the total patients admitted to ICU and majority of them were with preventable aetiology. In order to decrease the maternal mortality in developing countries better primary health care and efficient referral system is recommended. KEY WORDS Developing countries, Intensive care unit, Maternal morbidity, Maternal mortality, Obstetric patientsPublication Histological Examination of Tissue Obtained in Early Pregnancy Loss(Kathmandu University, 2021) Kayastha, S; Shah, L; Mainali, SABSTRACT Background It is a routine practice to send histological sample after surgical evacuation of early pregnancy loss. Objective This study was carried out to see the justification of regular histological study by carrying out the histological study of early pregnancy loss and to find the prevalence of gestational trophoblastic disease in early pregnancy loss. Method It was a descriptive prospective study, conducted in Nepal medical college teaching hospital from February to October 2020 in Obstetrics and Gynaecology department. Clinical data such as age, parity, gestational age and diagnosis were collected of 130 patient of early pregnancy loss. Then histological study were sent after surgical evacuation. Result Among the age group, 21-30 age group was maximum. (64.61%), more than half of the patient was primigravida (53.07%) and most of the cases were between 6 to 9 weeks of gestation. Incomplete abortions were maximum (43.07%), missed abortions 38.46%, blighted abortions 16.15%, enevitable abortions 1.53% and septic abortion was 0.76%. Among histological finding, 72.30% were product of conception, 15.38% of the cases had no product of conception, decidual tissue only in 6.92%, partial mole in one case (0.76%), complete mole in one case (0.76%) and hydrophic changes in one case (0.76%). The total cases of Gestational trophoblastic diseases (GTD) were 3(2.30%). Conclusion In our study we found 2.3% of cases of GTD, which was quite high in compare to Western word. So it is a good practice to do histological study of all cases of EPL in our country to detect GTD, determining cause for recurrent pregnancy loss and detecting unexpected fetal pathology. KEY WORDS Early pregnancy loss, Histology, Gestational trophoblastic disease