Browsing by Author "Rajbhandari, Subrina"
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Publication Effect of Advanced Maternal Age on Pregnancy Outcomes(Public Health Concern Trust-Nepal (phect-NEPAL), 2024) Sah, Ranjana; Pradhan, Peru; Dangal, Ganesh; Shrestha, Sona; Rajbhandari, SubrinaAbstract: Introduction: Advanced maternal age generally denotes age after 35years during the time of delivery. Despite the fact that being pregnant at any reproductive age is not risk free, older gravidity usually culminates with adverse outcomes both to mother and fetus or neonates. The objectives of this study is to investigate the impact of advanced maternal age on perinatal and neonatal outcomes of primiparous singleton pregnancies. Methods: This was a prospective cohort study conducted in Kathmandu Model Hospital/Kirtipur Hospital including 60 elderly pregnant Women from exposed groups (35-40 years) and 60 pregnant women from unexposed groups (30-34 years) and analyzed for maternal and fetal outcomes. Data was collected in the proforma and statistical analysis was done using IBM SPSS v 26. Results: A total no. of 120 pregnant patients were selected for the study. The average age of the patients was 36.561.61years and 31.53±1.27years in exposed and unexposed groups. The risk of pregnancy induced Hypertension (55%), preterm labour (30%) and low birth weight (28.3%) were significantly higher in exposed group as compared to non-exposed group. There was little evidence of increased risk of oligohydramnios (13.3%) and cesarean delivery rates (63.4%) in exposed group. Rate of neonatal intensive care unit admission was high in exposed group (46.7%) than unexposed group (30%). Conclusions: This present study showed that pregnancy at advanced maternal age associated with increased risk of certain maternal and fetal complication and these finding emphasize the importance of age-appropriate prenatal care and early intervention to improve outcomes of elderly pregnant women.Publication Post-partum Symphysis Pubis diastasis(Nepal Health Research Council, 2024) Rai, Sangam; Pradhan, Peru; Dangal, Ganesh; Shrestha, Sona; Rajbhandari, Subrina; Yadav, Ranjana; Shah, Ranjana; Sherpa, Sona; Ansari, RawabPubic symphysis is a non-synovial joint, made up of a fibrous cartilage disc connecting the two sides of pubic rami in the midline. During pregnancy under the influence of hormones particularly relaxin, the gap increases by 2 to3mm. When the diameter is more than 10 mm, it is considered as pubic symphysis diastasis. Pregnancy and childbirth are the most common causes of pubic symphysis diastasis followed by traumatic causes. Women with post-partum symphysis diastasis present during puerperium with inability to bear weight owing to severe supra-pubic and groin pain. They have complaint of severe excruciating pain while standing up or to perform any movement involving hip abduction. For the diagnosis, proper history regarding delivery should be sought followed by physical examination and radiological imaging. Most cases can be treated with conservative management which includes- use of analgesia and anti-inflammatory medicines for the pain management and stabilization of pelvis using brace/pelvic belt. Some may benefit from physiotherapy. In extreme cases, operative fixation may be required with the involvement of orthopedic surgeon. Keywords: post-partum symphysis diastasis; pubic symphysis; rare presentation.Publication Single Dose Versus Multiple Dose Prophylactic Antibiotics in Cesarean Section in a Tertiary Care Hospital(Institute of Medicine, 2021) Rajbhandari, Subrina; Acharya, Sarita; Subedi, Nilam; Gurung, Gahana; Das, Ruby; Bajracharya, SunitaABSTRACT Introduction: Choice of antibiotics as prophylaxis has become crucial factor for morbidity of women after delivery and neonatal complication associated thereafter. The purpose of this study was to compare the efficacy of single dose versus multiple dose of ceftriaxone in cesarean section (CS). Methods: A prospective experimental study was carried out in Universal College of Medical Sciences and Teaching Hospital, Tribhuvan University, Bhairahawa, from May 2015 to October 2016. One hundred patients who had undergone cesarean section were divided in two groups with fifty in each. Patients in group I were treated with single dose of ceftriaxone, whereas patients in group II were treated with multiple dose of ceftriaxone. The data were analyzed using independent "t" test, chi-square test as appropriate. A p-value of <0.05 was considered significant. Results: The distribution of Emergency CS and Elective CS were 72% and 28% in prophylactic single dose group and 88% and 12% in postoperative multiple dose regime and was statistically non-significant difference between single and multiple dose ceftriaxone. One wound infection was observed in multiple dose ceftriaxone treated women as compared to single dose ceftriaxone treated women. Febrile morbidity (8%) and urinary tract infections (2%) were observed in postoperative multiple dose regimen as compared to prophylactic single dose regimen. Conclusion: Prophylactic single dose of ceftriaxone was effective in reducing infective morbidity in patients with cost benefit, and also reduces chances of drug resistant in future. Keywords: Ceftriaxone, cesarean section, morbidity, multiple, prophylaxis, single dose