Browsing by Author "Kunwar, Shishir"
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Publication Pattern of Childbirth in Tertiary Hospital in Dang; A Retrospective Study(Rapti Academy of Health Sciences (RAHS), 2025) Tiwari, Shikha; Lamichhane, Basant; Kunwar, Shishir; Gurung, Prashansa; R.C, Jharana; Poudel, RakeshAbstract: Background: Childbirth itself is a complicated process. Conduction of delivery is challenging task. Spontaneous vaginal delivery as well as operative delivery, both requires skilled clinician, well-equipped hospital setting with the services of anesthesiology as well as neonatology. In past few decades, there is increasing trend of cesarean section and decreasing trend of instrumental as well as spontaneous vaginal delivery. Methods: This descriptive retrospective study was conducted in the department of Obstetrics and Gynaecology in Rapti Academy of Health Sciences. Hospital based medical records from 2023 May 1st to 204 April 30th were retrieved. Data regarding demography, characteristics of delivery of newborn, maternal and fetal morbidity associated with all the deliveries were collected. Result: The frequency of vaginal delivery was found to be 62.16% whereas cesarean section comprised 37.84%. Out of 62.16% vaginal delivery, 4.11% were the cases of instrumental vaginal delivery. Common age group was 20 to 24 years and 93.1% cases were delivered at term.Most common maternal complication was 2nd degree tear (4.95%) , primary PPH (1.41%), paraurethral tear ,cervical tear, shoulder dystocia.2% of the total cases received blood transfusion. 2 cases underwent peripartum hysterectomy. 2 cases of maternal mortality were recorded. Fetal complications includes perinatal asphyxia(2.13% in single born and 6.12% in twins),early onset neonatal sepsis (1.63% in single born and 12.24% in twins), neonatal jaundice( 1.26%), meconium aspiration syndrome(0.79%),late onset neonatal sepsis(0.2% ),fresh still birth(0.24% ),HIE( 0.2%). Conclusion: This study focuses the existing pattern of childbirth in the tertiary hospital of Dang showing the significant trends of mode of delivery, maternal demographics, maternal comorbidity and associated fetomaternal outcomes. The findings emphasizes the need for necessary interventions to ensure maternal and neonatal care.Publication Prevalence of Anemia among Pregnant Women in Tertiary Care Teaching Hospital in Nepal(Rapti Academy of Health Sciences (RAHS), 2025) Gurung, Prashansa; Gurung, Narayan Singh; Kunwar, Shishir; Tiwari, Shikha; Gurung, Roshni; Sigdel, MadhuAbstract: Background: Anaemia in pregnancy is condition in which the blood doesn't have enough healthy red blood cells to carry oxygen resulting in poor maternal and fetal outcome. The primary objective of this study was to determine the prevalence of anaemia in pregnant women in tertiary care teaching hospital in Nepal. Methods: A retrospective study was conducted among pregnant women who had delivered (vaginal or cesarean) at Rapti Academy of Health Sciences (RAHS) between April 14, 2023 to April 13, 2024. Ethical clearance from the Institutional Review Committee of RAHS was obtained and then data on participant’s age, ethnicity, obstetric history, and hemoglobin level were collected from the hospital records. Results: Hospital records of 2,501 pregnant women were analyzed in this study, and the prevalence of anaemia was found to be 19.75%. Prevalence of anaemia was found to be highest among the pregnant women from Terai Madhesi ethnic background (45%). Among 484 women who had history of abortions, 110 had anaemia i-e. 23%. The more number pregnancies there were in a woman, the higher the prevalence of anaemia, from 19% in the first and second pregnancies to 41% in women with six pregnancies. Prevalence was seen lowest among women from age group of 15-19 years (0.4%) and highest among women aged 35 and above (24.3%). Conclusions: The prevalence of anaemia in pregnant women was low (19.75%) compared to that of national data (46%). However, the prevalence varied across different ethnic groups. Anaemia was more prevalent among older women, those with higher gravidity, and those with a history of abortion, indicating a need for targeted antenatal monitoring in these groups.