Browsing by Author "Shrestha, Pravin"
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Publication Advance Age Pregnancy in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Mahato, Vibha; Shrestha, Pravin; Shrestha, SmitaAbstract: Introduction: Women who conceive at advance age are at risk of pregnancy complications and adverse foetal outcome. This study aims to find out the prevalence of pregnancy at advance age in a teaching hospital. Methods: A descriptive cross-sectional study was conducted between October 2019 to August 2020 at department of obstetrics and gynaecology of a tertiary care centre of Nepal, after obtaining ethical clearance from Institutional Review Committee (dated 03/09/2019 with ref no. 266) and informed consent from patient. Convenience sampling was done. All the patient who were ≥35 years and >28 weeks of gestation without any chronic illness were selected. Data and descriptive analysis were done using Statistical Package for the Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Women aged 35 years and above constituted 104 (5.73%) of the total deliveries of study period. Most were multigravida 72 (69.23%) and 23 (22.12%) had preterm delivery. Rate of caesarean section were higher in advance maternal age 69 (66.35%). Maternal complications such as Hypertensive disorder of pregnancy 9 (8.65%), and mal-presentation 15 (14.42%) were higher among them. Perinatal outcome in form of low birth weight 9 (8.65%) and perinatal death 5 (4.80%) were increased in those women. Conclusions: From this study, it can be concluded that prevalence of advanced age at pregnancy was lower than study done in developed country but it was similar to study in India and is increasing in Nepal.Publication Postdural Puncture Headache after Spinal Anaesthesia in Parturients Undergoing Cesarean Section in the Department of Anesthesia in a Tertiary Care Center: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Lakhe, Gajal; Shrestha, Pravin; Duwadi, VijayaAbstract Introduction: The post-dural puncture headache is one of the common complications of spinal anaesthesia. It is one of the most frequent claims for malpractice involving obstetrics anaesthesia. Though self-limiting it is troublesome to the patient. The aim of this study was to find out the prevalence of post-dural puncture headache after spinal anaesthesia in parturients undergoing cesarean section in the Department of Anesthesia in a tertiary care centre. Methods: A descriptive cross-sectional study was done among parturients who underwent cesarean section under spinal anaesthesia from 27 June 2022 to 19 January 2023 after receiving ethical approval from the Institutional Review Committee (Reference number: MEMG/480/IRC). The pregnant patients aged 18-45 years of the American Society of Anesthesiologists Physical Status II/IIE who underwent elective or emergency cesarean section under spinal anaesthesia were included. A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 385 parturients, the prevalence of post-dural puncture headache was 27 (7.01%) (4.53-9.67, 95% Confidence Interval). A total of 12 (44.44%) cases experienced post-dural puncture headache in the first 24 hours followed by 9 (33.33%) and 6 (22.22%) cases in 48 and 72 hours respectively. Moderate pain was complained of by 3 (11.11%) and 2 (7.41%) cases at 48 and 72 hours post-cesarean section respectively. Conclusions: The prevalence of post-dural puncture headache after spinal anaesthesia in parturients undergoing cesarean section was similar to studies done in similar settings.Publication Postpartum Maternal Morbidity Requiring Hospital Admission in A Teaching Hospital: A Descriptive Cross-sectional Study(Nepal Medical Association, 2020) Shrestha, Pravin; Mahato, Vibha; Karmacharya, Smita ShresthaAbstract: Introduction: Major concern shifts from mother to newborn in postnatal period. Postpartum complications contribute to a lot of maternal morbidity and mortality. This study aims to determine the prevalence of morbidities in women following delivery at Manipal Teaching Hospital so as to identify and improve maternal quality care. Methods: This is a descriptive cross-sectional study conducted at department of Obstetrics and Gynaecology, Manipal Teaching Hospital from September 2018 to March 2020 after ethical approval from the institutional review committee with reference number 1296. All the women presenting to the department during the study period were included in the study. Women who were admitted to accompany and nurse their babies for neonatal problems were excluded.Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Data were entered in Excel and analysed in SPSS. Results: Among 3510 cases, 104 women were admitted with various postpartum morbidities. The prevalence of postpartum morbidity was found to be 104 (2.96%) at 95% Confidence Interval (2.67-3.25). Puerperal sepsis was diagnosed in 23 (22.11%), preeclampsia in 20(19.23%) eclampsia in 14 (13.46%) and haemorrhage in 14 (13.46%) respectively. Majority of patients, 83.65% belonged to age group of 20-34 years. Nine patients (8.65%) were teenage mothers. Conclusions: Puerperal sepsis, preeclampsia, eclampsia and haemorrhage were the major postpartum complications requiring admissions in hospital.