Utilization of Antenatal Services among Postnatal Mothers.

BACKGROUND: Antenatal care is medical supervision and care given to pregnant women to ensure, support and maintain maternal and fetal well-being throughout the pregnancy. Therefore, this study was done to find out the utilization of antenatal services among postnatal mothers. METHODS: The descriptive cross sectional study design was used to identify the utilization of antenatal services among postnatal mothers who came in Maternal and Child Health Clinic for the immunization of baby. Total 367 postnatal mothers within one year of childbirth were recruited by simple random sampling technique, and data was collected with face-to-face interview by using semi structured interview schedule. Analysis was done by using descriptive and inferential statistics. RESULTS: All postnatal mothers consumed iron and folic acid during pregnancy, 96.2% consumed until the childbirth, 94.0% got freely, 97.0% taken anti helminths drug, 98.1% did urine test, 98.1% did blood test, 97.8% got ultrasound service, and 96.5% received Td vaccine. Likewise, higher proportion had checked weight 98.6% and lower proportion had checked height 86.9%. Similarly, majority 90.2% received counselling on danger signs and only 26.2% received the counselling on preparation of items safe delivery and care of newborns. There is significant association of antenatal care service utilization with postnatal mothers' educational level and her husband's occupation (P<0.05 level). CONCLUSIONS: Although most of the postnatal mothers utilized antenatal care services, some aspect of antenatal education and counselling need to be improved such as preparation of item for delivery and new born care, finance, and blood donors.

Pattern of Deaths among Women of Reproductive Age in Major Autopsy Centres of Capital Cities of the Seven Provinces of Nepal.

BACKGROUND: The females in the reproductive age group are vulnerable to injuries and diseases. There is no reliable evidence of the pattern of deaths in reproductive age group females from Nepal. This study was conducted to explore the patterns of deaths of females of the reproductive age group in Nepal. METHODS: A multicentric quantitative cross-sectional study was conducted among the 611 deceased females of age 15 to 49 years who had undergone medico-legal autopsy in major autopsy centers of the capital cities of seven provinces of Nepal in a duration of one year. The demographic, clinical, and causes of death data were retrieved from the records and analyzed. The intentional and unintentional causes were compared with the marital status, age groups, ethnicity, and deceased of rural and urban communities. RESULTS: Female reproductive age group deaths constituted 611 (20·64%) of the total autopsies. Suicide was the most common manner of death (413, 67·59%) followed by accident (121, 19·80%). The most common cause of suicide was hanging (258, 62·47%) followed by poisoning (149, 36·08%) whereas road traffic accident (72, 59·5%) was the commonest cause of accidental death. Intentional deaths were associated with higher risk to the females of younger age groups (p<0·001), ethnicity of the hilly region (p<0·001), and unmarried women (p=0·001). CONCLUSIONS: Suicide was the commonest manner of death among the autopsies of females of the reproductive age group in Nepal. Appropriate preventive strategies need to be developed to uplift the overall health, socioeconomic status, and general wellbeing of the females.

Perinatal Mortality among All Deliveries in a Tertiary Care Center: A Descriptive Cross-sectional Study.

INTRODUCTION: Perinatal mortality comprises the number of stillbirths and death of newborns within seven days of life which is the main contributor to infant and maternal mortality. The aim of this study was to find out the prevalence of perinatal mortality among all the deliveries in a tertiary care center of a remote part of Nepal. METHODS: This was a descriptive cross-sectional study conducted in a tertiary care center located in Jumla among 3798 deliveries (childbirth) from August 2014 to April 2020. Ethical approval was taken from the institutional review committee (2076/2077/05) of the same institution. A convenience sampling technique was used and the data were collected from the medical record section and then entered and analyzed in Statistical Package for Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequencies and percentages for binary data. RESULTS: The prevalence of perinatal mortality was 187 (4.92%) (4.23-4.60% at 95% Confidence Interval) among 3798 deliveries. Regarding the primary causes; the highest proportion was intrapartum hypoxia 62 (33.3%), spontaneous preterm labor 40 (21.5%), and congenital anomalies 38 (20.4%). Similarly, about the final cause; the highest proportion was birth asphyxia 64 (34.2%), intrauterine fetal death 51 (27.3%), congenital anomalies 35 (18.7%), and complication of prematurity 32 (17.1%). CONCLUSIONS: The perinatal mortality was quite high in this study with respect to similar studies done in other countries. The finding of this study showed that quality antenatal care with rural ultrasound service is essential to reduce the causes of perinatal mortality.