Prevalence of Repeat Cesarean Section in a Tertiary Care Hospital.

INTRODUCTION: Cesarean section is the surgical delivery of a baby through an incision made in the mother's abdomen and uterus. Repeat cesarean section has recently increased, partly because of concern about increased risk of uterine rupture in women attempting vaginal birth after cesarean delivery. Among the women who underwent cesarean section in their first delivery, 80-96% had a second surgical delivery. Therefore, the present study aimed to describe the prevalence of repeat cesarean section among Nepali women presented at Kathmandu Medical College and Teaching Hospital who had a previous cesarean section. METHODS: This was a descriptive cross-sectional study conducted in Kathmandu Medical College and Teaching Hospital from 1st of February to 31st of May 2020. Ethical approval was taken from the Institutional Review Committee of the Kathmandu Medical College. Convenient sampling was done. All pregnant patients between gestational ages of 37-40 weeks with previous cesarean section admitted for safe confinement were included in the study. RESULTS: Among the 104 women, who had prior cesarean section, 99 (95.19%) had second cesarean section and 5 (4.81%) had vaginal birth after cesarean. The most common indication for the first cesarean section was fetal distress 31 (29.81%) while the indication for the second cesarean section among previously cesarean section women was cephalo pelvic disproportion 39 (39.40%). CONCLUSIONS: The proportion of cesarean section in both first and subsequent delivery is quite high. This high rate may compromise the reproductive future of the women who underwent consecutive cesarean section with possible consequent complications.

Pattern of Body Mass Index and Common Health Problems in Women of Reproductive Age Group in a Private Clinic in Kathmandu.

INTRODUCTION: High Body Mass Index is one of the risk factors for many chronic diseases and adverse health outcomes. It is associated with an increased risk of coronary heart disease, ischemic stroke, high blood pressure and type 2 diabetes mellitus. It also have many adverse effect on reproductive health of the women like sub fertility, polycystic ovarian disease, menstrual abnormality etc. The purpose of this study is to find Basal Metabolic Rate and the diseases pattern of reproductive age woman in Nepal. METHODS: This is a descriptive study of women of reproductive age (15 to 49 years) attending a private gynaecology clinic in Kathmandu Valley from October 2016 to June 2017. Six hundred and eight women of current reproductive age group participated in this study. Women's particulars and complaints were noted down. Detailed history was taken. Height, weight and blood pressure were recorded and general examination was done. BMI was calculated as BMI is weight in kilogram divided by height in meter square, and it was interpreted as per WHO guidelines. RESULTS: Out of the total 608 participants, 243 (40%) were overweight, 96 (15.8%) were obese. Regarding the common health problems, 154 (25.3%) have sub fertility and 199 (32%) had genitourinary infection. Similarly, 90 (14.8%) had menstrual problems. CONCLUSIONS: Prevalence of overweight and obesity has risen significantly comparing to the study done decade ago in same setting. Similarly, sub fertility rate has also risen whereas the prevalence of genitourinary infections has decreased.