NepMed Repository :: Browsing by Author "Kunwar, Shishir"

Browsing by Author "Kunwar, Shishir"

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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, Rakesh
Abstract: 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.
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, Madhu
Abstract: 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.
Prevalence of Precancerous Cervical Lesion in Women Attending Cervical Cancer Screening Programme at a Tertiary Level Hospital
(Rapti Academy of Health Sciences (RAHS), 2024) Sharma, Sharmila; Khatri, Binita; Kunwar, Shishir
Abstract: Introduction: Cervical cancer is the second leading cause of cancer deaths in women in developing countries, and their incidence can be reduced by early detection and treatment of related precancerous lesions. Visual inspection with acetic acid (VIA) screening test is common method of finding precancerous cervical lesion. The aim of this study was to determine the prevalence of precancerous cervical lesions in women attending the cervical cancer screening program at a tertiary-level hospital. Methods: This retrospective, cross-sectional study (record review) was conducted among women who attended cervical screening at the Maternal and Child Health (MCH) clinic of Rapti Academy of Health Sciences (RAHS) from Baisakh to Chaitra, 2080. After obtaining ethical clearance from the Institutional Review Committee of RAHS (IRC RAHS), data on the participants’ age, residence, ethnicity, and other reproductive morbidities were retrieved from hospital records. Results: The hospital records of 1,055 women were analyzed in this study. The mean age of the participants was 37.91±10.41 years, with more than one-third (36.5%) in the age group of 31-40 years. Among those who underwent cervical screening, the prevalence of precancerous lesions was 4.4%. No significant associations were found between age (p=0.55), residence (p=0.91), ethnicity (p=0.055), or other reproductive morbidities and the prevalence of precancerous lesions at the 95% confidence level. Conclusion: The prevalence of precancerous cervical lesions was low; however, the findings highlight the need for establishing regular screening programs at the community level.
Trend of Teenage Pregnancy and its Adverse Outcome at Rapti Academy of Health Sciences, Dang District, Lumbini Province
(Rapti Academy of Health Sciences (RAHS), 2024) Lamichhane, Bikash; Lamichhane, Basant; Darlami, Radha; Kunwar, Shishir; Bhattarai, Stuti; Gautam, Ajaya Raj; Pokhrel, Bishal
Abstract: Introduction: Teenage pregnancy is defined as a pregnancy in a girl who is 10-19 years of age. In Nepal, adolescents aged 10 to 19 comprise 6.4 million of the population. The most common maternal complications in teenage pregnancy were hypertensive disorders, preterm birth and low birth weight. Teenage pregnancy has negative effects on the health outcomes of both the mother and the newborn. So, this study was conducted to describing the trend of teenage pregnancy and its outcome at a tertiary care hospital in the Dang district. Methods: A retrospective, cross-sectional study was conducted at Rapti Academy of Health Sciences (RAHS). Ethical approval was taken from the Nepal Health Research Council (NHRC). Data was retrieved from January 2018 to December 2022 from the hospital Central Admission Register and maternity register record. The total 1097 records of teenage deliveries were taken as a whole sampling. Data entry was done in Microsoft Excel and point estimate at 95% CI was calculated along with frequency and percentage. Results: Total 1097 teenage deliveries were conducted in five years where maximum teenage deliveries were of 19 years (41.2%). Among teenage delivery, live birth delivery was 89.9%. Significant tear was found in 264 teenage deliveries (95.0%) as a maternal complication. Conclusion: The trend of teenage pregnancy was in decreasing trend over five years in RAHS, Dang. Preterm delivery, Perineal tear, and Spontaneous abortion were common complications seen in pregnancy. Further awareness and health education programs helps to reduce the teenage pregnancy

Browsing by Author "Kunwar, Shishir"

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