Some fetal and pregnancy parameters in Nepal.

In Patan Hospital, Kathmandu, 4600 single live births were analysed concerning birth weight in relation to gestational age. At term, the median birth weight of females was 2900 g and of males 3010 g. Compared with Norwegian newborns, the birthweights of Nepali babies were lower for all corresponding gestational lengths. The differences increased with gestational age. Fundal height was lower in Nepali than in Norwegian pregnant women for all periods of pregnancy. An increase in the differences between Norwegian and Nepali women was also noted. Hematocrit values of Nepali women who did not take supplementary iron, correspond well to findings in Norwegian women without iron supplementation. Only a slight degree of hemoconcentration was noted towards term. For Norwegian women with iron supplementation the hematocrit values were much higher, with a tendency towards hemoconcentration near term. In Nepal the average woman probably has small iron stores, and without iron supplementation the hematocrit values will remain low throughout the pregnancy. The high altitude does not seem to cause hemoconcentration in pregnancy to a greater extent than at lower altitude. Hemoconcentration is therefore not a major causative factor of the lower birth weights.

PIP: The association between birthweight and gestational age was examined in 4600 singleton live births occurring at Patan Hospital (Kathmandu, Nepal) in 1983-86. Other parameters evaluated included fundal height in relationship to duration of pregnancy and hematocrit levels during pregnancy. The study results were then compared to similar data from Norway. At term, the median birth weight in Nepal in this series was 3010 grams for males and 2900 grams for females. Although the birthweights of Norwegian infants are consistently higher than those of Nepalese infants, this difference is most pronounced after the 36th week of pregnancy. Fundal height shows a steady, almost linear increase in Nepalese infants until the 37th week of pregnancy, at which point it slows down. In general, fundal height is lower in Nepalese than Norwegian women and this gap widens after 36 weeks of pregnancy. Finally, hematocrit values are generally lower in Nepalese women than Norwegian women, regardless of whether iron supplements are provided. Nepalese women further demonstrated a lack of hemoconcentration during the last 8 weeks of pregnancy, indicating that maternal iron stores had been depleted. The findings of this study are useful for establishing standards for weight for gestational age, fundal height, and hematocrit values in relation to stage of pregnancy in hospital deliveries in Nepal. They suggest, moreover, that Nepalese women suffer from nutritional deficiencies that require further research.

Prolapse of an ovarian tumor during labor.

A case of prolapsed tumor after home delivery is reported. At first a puerperal inversion of the uterus was suspected. At operation a dermoid ovarian tumor was found to be prolapsed through the vaginal fornix.