Browsing by Author "Poudel, Sandesh"
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Publication Fetomaternal Outcome in Antepartum Hemorrhage After 34 Weeks of Gestation(Nepal Health Research Council, 2024) Ranabhat, Bijay Kumar; Dangal, Ganesh; Poudel, Sandesh; Adhikari, Shreeprasad; Khadka, ChiranjiviBackground: Antepartum hemorrhage is defined as any bleeding from or into the genital tract during pregnancy, after the period of viability until delivery of the fetus. APH complicates 2-5% of pregnancies and is a primary cause of perinatal and maternal mortality globally. Aim of this study is to evaluate maternal and perinatal outcome in patients with APH at a tertiary care hospital. Methods: The present study was a cross sectional study conducted in Obstetrics and Gynaecology department of Paropakar Maternity and Women’s Hospital, during a period of 5 months from December 2022 to April 2023. 50 cases of APH were enrolled with gestational age ? 34 weeks of gestation. Results: Incidence of APH after 34 weeks of gestation was 0.51%. The most common type of APH was abruption placenta (44%) followed by placenta previa (32%) and undetermined (24%). The age range of 26 to 30 years old accounted for the highest number of APH patients i.e., 21(42%). In placenta previa, 75% and in abruption placenta 63.64% were multigravida. APH was presented mostly between 37-40 weeks. Around 26% of the patients had anemia at the time of admission. Most common mode of delivery was cesarean section (82%). Most common maternal complications were PPH (40%), blood transfusion (28%), DIC (4%), cesarean hysterectomy (4%). Low birth weight and preterm were the most common causes of fetal complications. Maternal mortality was 2% and perinatal mortality was 18% overall. Conclusions: APH is primary cause of maternal and perinatal morbidity and mortality. In our study, an abruption placenta was the most frequent cause of APH. Cesarean section was the most commonly used mode of delivery. PPH with blood transfusion was the most prevalent maternal complication, while fetal complications included low birth weight and preterm.. Keywords: Abruptio placenta; antepartum haemorrhage; placenta previa.Publication Knowledge and Attitude Towards Human Papilloma Virus and Human Papilloma Virus Vaccine(Nepal Health Research Council, 2024) Poudel, Sandesh; Rai, Snigdha; Adhikari, Shree Prasad; Dhakal, Sheela; Rai, Nisha; Upadhyaya, Preetam Chandra; Shah, PushkalBackground: Human papilloma virus is the leading cause of cervical cancer with Human papilloma virus 16 and 18 being the commonest variants. The primary prevention by vaccination against HPV is finally gaining its momentum. This study aimed to evaluate the knowledge and attitude towards Human papilloma virus and Human papilloma virus vaccine and highlighted on the setback of their inadequate knowledge. Methods: This was a community based cross sectional study done among 120 women who attended cervical cancer screening camp at satellite clinic of Paropakar Maternity and Women`s Hospital at Bhaisepati of Kathmandu district. The interview was done one on one with a preformed questionnaire. Data was primarily entered in an individual form and analysis was done using SPSS version 23 program and was depicted in tables, diagrams and chart. Results: The mean age of the women was 41.8±9.9 with majority belonging to age group 41-50 years (47.16%), 88 (74%) women were multiparous,59 (49%) were uneducated and 50 (33%) were previously screened for cervical cancer. Among 27 (22%) of the women who had heard about HPV and knew that it causes cervical cancer, most of them have heard from social media while 110(91.6%) did not know about its vaccine and its availability while 100% of the participants had positive attitude towards receiving the information and keen on vaccinating their daughters. Conclusions: Knowledge and awareness of Human Papilloma Virus and its vaccine still remains low among the women in our society. However, there was high acceptance of HPV vaccine, indicating potentially high uptake rates in these communities. Keywords: Attitude; human papilloma virus; knowledge; vaccine.Publication Obstetric Characteristics and Functional Outcomes in Women with Obstetric Anal Sphincter Injury(Nepal Health Research Council, 2024) Adhikari, Shree Prasad; Poudel, Sandesh; Baidhya, Sapana Amatya; Yadav, ManishaBackground: Obstetric anal sphincter injury is a complication of vaginal delivery, if left untreated, causes significant maternal morbidities; urinary problems and fecal/ flatus incontinence. The aim of this study was to determine the incidence and describe the obstetric characteristics and functional outcomes of women who had vaginal delivery at Paropakar Maternity and Women’s Hospital Nepal and sustained Obstetric anal sphincter injury. Methods: This retrospective descriptive study included women who had vaginal delivery, irrespective of parity, in the labor room or birthing unit of Paropakar Maternity and Women’s Hospital from April 2018 to September 2020, and sustained Grade III or IV Obstetric anal sphincter injury after 28 weeks period of gestation. Maternal characteristics, obstetric details and perineal status after vaginal delivery were noted after review of hospital records. The patients were further inquired via telephone for their current status of fecal and/or urinary incontinence. Results: The incidence of OASI was 106 (0.33%) among 31, 786 Nepalese women with vaginal birth over a 2-year period. The mean age women with Obstetric anal sphincter injury was 24.6 ± 4.3 years and 45(52.9%) cases belonged to Janajati ethnicity. Fifty two (61.2 %) were primipara and 77 (90.6%) had spontaneous vaginal deliveries. Episiotomy was not performed on most of the patients (63, 74.1%). Problems with flatus holding, stool holding and urine holding was reported by 28.3%, 13.2% and 22.6% women respectively. Conclusions: The incidence of Obstetric anal sphincter injury among Nepalese women with vaginal birth over a 2-year period was 0.33%, which was lower than other South Asian studies. Grade III Obstetric anal sphincter injury was the frequent most type. The injuries were more common in women with Janajati ethnicity, primipara and women who did not have episiotomy. Problems with flatus holding and urine holding were present in almost one-fourth of the women with Obstetric anal sphincter injury at follow up. Keywords: Augmentation; episiotomy; induction; obstetric anal sphincter injury.Publication Prevalence and Risk factors of Lower Urinary Tract Symptoms in Menopausal Women(Rapti Academy of Health Sciences (RAHS), 2024) Jha, Anamika; Dangal, Ganesh; Poudel, SandeshAbstract: Introduction: Lower urinary tract symptoms is existing everywhere in the world and depending on the age, geographical location, and culture it is having great impact. They encompass different disease features which include-storage, voiding and post micturition. Numerous risk factors have been identified, and there are few published articles concerning the frequency of LUTS in menopausal women as well as their associated risk factors. Thus, this study was formulated with the intention of ascertaining the incidence and the risk indicators of LUTS in menopausal women. Methods: This was a cross-sectional study of the observational type which was carried out in the Paropakar Maternity & Women’s Hospital Thapathali, Kathmandu. Approval to carry out the study was sought and granted from the IRC. It was a hospital-based descriptive cross-sectional study conducted in gynecological outdoor patient department involving all menopausal women who presented themselves to the clinic between February 1st to April 30th 2024 using convenience sampling technique. Among the study population having LUTS, their details and possible risk factors were incorporated in this study. Results: Three hundred menopausal women were recruited in the study during the considered period of time. Mean age of menopause was 48. 3 years. Concerning LUTS, the current study established a prevalence rate of 71.7% among the respondents. The most frequently reported complaint was urgency reported by 39 % of the patients ,seconded by incontinence reported by 35. 7% of the patients and thirdly nocturia was reported by 23% of patients. In menopausal women, the factors that may increase the risk to develop LUTS were BMI, having a history of childbirth and recurrent UTI. Conclusion: LUTS was significantly high among menopausal women in Paropakar Maternity and Women’s Hospital, the most dominating symptom was urgency and the second one was incontinence. Several factors were established to be predictive of LUTS namely; BMI, giving birth and a history of recurrent UTI but there was no statistical evidence related to the type of delivery. Keywords: Lower urinary tract symptoms, menopause, women