Browsing by Author "Thapa, Sumana"
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Publication Acceptance of Vaginal Birth After Caesarean Section Trial in Shree Birendra Hospital, Kathmandu, Nepal: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Khatri, Ratna; Chand, Arju; Thapa, Manish; Thapa, Sumana; Khadka, ShailajaAbstract: Introduction: The rate of primary cesarean section is on the rising trend. Vaginal birth after cesarean section can be an alternative to reduce cesarean section worldwide. Antenatal examination and intrapartum monitoring are the most important factors for a vaginal birth after a cesarean section. This study aims to determine the acceptance of vaginal birth after cesarean section trial in a tertiary care hospital in Nepal. Methods: This is a descriptive cross-sectional study carried out in Shree Birendra Hospital, Kathmandu, Nepal, from March 2019 to March 2020. All pregnant women with a previous history of cesarean section meeting Royal College of Obstetrics and Gynecology criteria were included. A trial of labor was conducted on the patients who accepted vaginal birth after cesarean section. Results: A total of 85 cases with previous lower section cesarean section were included in the study. Out of which, 75 (88.2%) refused vaginal birth after cesarean section, and only 10 cases (11.8%) accepted to undergo a trial of labor. Five women (50%) had a successful vaginal birth. Complications were less among the vaginal birth after cesarean section group than the repeat cesarean section group. There was no maternal and neonatal mortality. Conclusions: The acceptance of vaginal birth after cesarean section is very low in this study. No complications were observed among vaginal birth after cesarean section in our study.Publication Surgical Emergencies among Gynecological Surgeries in a Tertiary Care Center: A Descriptive Cross-sectional Study(Nepal Medical Association, 2020) Acharya, Indira; Thapa, SumanaAbstract: Introduction: The management of gynecological emergencies is essential for the preservation of the life of affected woman, her sexual functions and fertility particularly in disease conditions that threaten her life. The main objective of the study is to determine the proportion of the surgical emergencies among gynecological surgeries in a tertiary care center. Methods: This is a descriptive cross-sectional study conducted in the department of gynecology and obstetrics in Shree Birendra Hospital, Kathmandu, Nepal from April 2013 till March 2017. Ethical approval was taken from the Institutional Review Committee (IRC) in November 2019. This study was conducted among 515 gynecological surgeries by using convenience sampling methods. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Data were analyzed using Excel software. Results: In our study, the proportion of surgical emergencies among total gynecological surgeries performed in the department of gynecology and obstetrics in Shree Birendra Hospital was 120 (23.30%). The highest number of surgical emergencies was observed in the age group of 20-29 years old, followed by less than 19 years of old age group. Ectopic pregnancy accounting for 85 (70.83%) is found to be the most common surgical emergencies in our study. Out of all surgical emergency cases, most of them underwent salpingectomy 65 (54.16%) followed by salpingectomy with tubal ligation 20 (16.16%). Conclusions: Surgical emergencies among gynecological surgeries are found to be in greater proportion in the department of gynecology and obstetrics in Shree Birendra Hospital. Ectopic pregnancy accounted for more than half of the diagnoses in this studyPublication Ureteric Injuries after Hysterectomy in a Tertiary Care Center of Nepal: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Khatri, Ratna Adhikari; Chand, Arju; Thapa, Sumana; Khadka, Shailaja; Thapa, ManishAbstract: Introduction: Pelvic surgery is the most common cause of iatrogenic ureteral injury. The incidence of ureteric injuries varies between skilled and inexperienced surgeons. The study aims to determine the prevalence of ureteric injuries sustained during hysterectomy in a tertiary care center of Nepal. Methods: A descriptive cross-sectional study involving the women attending the gynecological outpatient department of a tertiary care center of Nepal, for various benign and malignant conditions and later on underwent hysterectomy from June 2019 to June 2020 was done after obtaining ethical clearence from the Institutional Review Committee (Reference No. 245). Convenient sampling method was used. The data were entered in Excel and analyzed using Statistical Package for Social Sciences version 17. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Altogether, 1 (0.63%) (0.55-0.71 at 95% Confidence Interval) out of 159 patients sustained the ureteric injury during hysterectomy in a tertiary care center of Nepal. The injury was seen during the exploratory laparotomy for adnexal mass. The injury was recognized intraoperatively and was repaired with double J stenting. A total of 159 patients were enrolled in the study that had undergone hysterectomy over one year for various benign and malignant conditions. Out of which 21 (13.2%) had undergone surgeries for malignant conditions and 138 (86.79%) for benign conditions. Conclusions: Iatrogenic ureteric is still a major cause of harm and concern in hysterectomy. Patients with ureteric injury should be evaluated and intervened at the earliest.