Browsing by Author "Ojha, Neebha"
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Publication Clinical and Endometrial Histopathological Profile of Women with Perimenopausal and Postmenopausal Bleeding(Institute of Medicine, Tribhuvan University, 2025) Bhardwaj, Manisha; Bista, Kesang Diki; Ojha, Neebha; Khaniya, BishalAbstract: Introduction: Abnormal uterine bleeding (AUB) in perimenopausal and postmenopausal women is common and clinically important concern, as it may indicate anything from hormonal imbalance to serious pathologies like endometrial hyperplasia or carcinoma . The objective of this study was to assess clinical and endometrial histopathological characteristics in women with perimenopausal and postmenopausal bleeding in TUTH. Methods: This was a descriptive study carried out in the Department of Obstetrics and Gynecology at Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Kathmandu from April 2018 to April 2019. All women > 40 years with abnormal uterine bleeding attending gynecology OPD were taken. Endometrial biopsy was done and histopathological examination findings were studied. Results: Among 328 women, 218 were with perimenopausal bleeding and those with postmenopausal bleeding were 110. The most frequent bleeding in ladies with perimenopausal bleeding was menorrhagia in 93(42.9%) and spotting accounting 68 (71%) in postmenopausal bleeding. Out of total 328 cases, 317(96.6%) had benign endometrial findings and 11 cases (3.4%) had malignant endometrial findings. The most frequent histopathological finding in women with perimenopausal bleeding was secretary endometrium. Among postmenopausal bleeding 110 (91%) were benign and 9( 8.2%) had malignant histopathology. Conclusion: The most frequent bleeding pattern in perimenopausal bleeding was menorrhagia and spotting in those with postmenopausal bleeding. Malignant histopathological was found more in postmenopausal bleeding than perimenopausal bleeding.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.Publication The Association Between ABO Blood Groups and Adenomyosis(Nepal Health Research Council, 2025) Pun, Sunita; Ojha, Neebha; Koirala, PoonamBackground: Several studies have investigated the relationships between female reproductive diseases and ABO blood groups. However, evidence regarding the potential association between ABO blood groups and adenomyosis remains limited. The aim of the study, thus, was to investigate the association between ABO blood groups and the risk of developing adenomyosis in Nepalese women. Methods: A cross-sectional study was conducted at the department of obstetrics and gynecology, Tribhuvan University Teaching Hospital, Maharajgunj, from 2016 to 2017. Statistical analysis was done using Statistical Package for Social Sciences (SPSS, 29). Odd ratio with their corresponding 95% confidence intervals, and P-value were calculated and analyzed. A P-value equal or < 0.05 was considered statistically significant. Results: A total of 249 with recorded ABO groups were included in this study. Of these, 85 cases (34%) were histologically confirmed to have adenomyosis. The most frequent ABO blood group was B (43%), while the least frequent group was AB (6%). Women with blood group B had a significantly increased risk of developing adenomyosis, with an odds ratio of 2.3 (95% CI: 1.22-4.43, P value = 0.01). Conversely, blood group A was associated with a significantly reduced risk of adenomyosis, with an odds ratio of 0.41 (95% CI: 0.19-0.89, P value= 0.03). Conclusions: This study demonstrated that women with blood group B have a 2.3-fold higher risk of developing adenomyosis, whereas those with blood group A may have a protective effect. Multicenter studies with larger sample sizes and diverse demographics groups are needed to substantiate these findings. Key Words: Adenomyosis; ABO blood group; risk factors.Publication Trends in Cesarean Delivery at a Tertiary Care Hospital(Institute of Medicine, Tribhuvan University, 2025) Ojha, Neebha; Khaniya, Bishal; Pun, Sunita; Bhansakarya, Rakina; Ghimire, Asmita; Sharma, AshishAbstract: Introduction Cesarean delivery is on the rise globally, and many government bodies and clinicians have expressed concern about the rising rate of cesarean delivery. The study aims to assess the trend in cesarean delivery rate and the type of cesarean delivery at five-year intervals during the study period. Methods This descriptive cross-sectional study was conducted at TU Teaching Hospital by a chart review of cesarean delivery (CD) during the years 2014, 2019, and 2024 AD. Basic data including age, parity, ethnicity, gestational age, and multiple pregnancy was obtained. The collected data were entered and analyzed in SPSS 26. Results The annual CD rate was 39.0 %, 52.7%, and 56.0% among the total livebirth delivery during the years 2014, 2019, and 2024, respectively. The proportion of primary CD increased from 2014 to 2019 but remained static in 2024 (31%, 41%, and 39.4%), however for repeat CD it increased steadily. Mothers undergoing CD in the age ≥35 years increased from 106 (6.1%) in 2014 to 241 (13.5%) in 2024 (8%, 11.7%, and 16.5%). The emergency CD were three times more common than elective CD in all the years interval. The most common indications for the primary and repeat CD werea fetal distress and refused trial of labor respectively. Conclusions This study showed increasing trend in the cesarean delivery rate. Primary CD constituted more than the repeat CD, however the rate of increase was more in the repeat than in the primary CD. It is important to reduce primary CD if we want to decrease the overall CD rate.