Dk Uprety

Germ cell tumors of the ovary : A clinicopathologic study of 121 cases from Nepal

Background:  Although many reports have been published about germ cell tumors of the ovary in developed countries, there has been no such documentation from Nepal. The retrospective study presented here reports the clinicopathologic profile of germ cell tumors of the ovary studied at B. P. Koirala Institute of Health Sciences, Dharan, Nepal.

Progesterone for Prevention of Recurrent Preterm Labor after Arrested Preterm Labor- A Randomized Controlled Trial

Background: Preterm birth is the major cause of neonatal mortality and morbidity. In developing countries, it’s a major health hazard. But there are very few evidence based interventions to prevent it. This study focus on prevention of preterm birth. Methods: A randomized controlled trial was undertaken in BP Koirala Institute of Health Sciences, where 60 patients were randomized into group 1 (n=29, weekly intramuscular Progesterone) and group 2 (n=31,no treatment) after the arrest of preterm labor with tocolysis. Their latency period till delivery and recurrence of preterm labor and neonatal outcomes were compared. Results: There was significant reduction in recurrence of preterm labor and increase in latency period in progesterone group. However neonatal outcomes were similar. Conclusion: Progesterone is useful in reducing the recurrence of preterm labor in a patient who had preterm labor.

Maternal mortality at B P Koirala Institute of Health Sciences, Nepal: review of 6 years

This study aimed to find out the maternal mortality rate (MMR) in mothers dying after admission to the gynaecology and obstetrics ward of BP Koirala Institute of Health Sciences, Nepal, and to analyse the most common causative factor. There was a total of 58 mortality cases in 6 years. The MMR in 1997-1998 was 12/100 000 live births, in 1998-1999 144/100 000, in 1999-2000 294/100 000, in 2000-2001 450/100 000, in 2001-2002 546/100 000 and in 2002-2003 400/100 000. The most common cause of death was septic-induced abortion and its complications, followed by eclampsia and puerperal sepsis.

Complications following arrest of the aftercoming head in breech delivery

Mona Sharma MD Mamta Jha MD Dhruba Uprety MD cavity. The fetal head, the bony spicules and the placenta were removed and subtotal hysterectomy and peritoneal lavage performed. Postoperatively the patient had deep venous thrombosis but ultimately recovered completely. The second case was that ofa woman of25, PH O(three living issue), referred from a district hospital with retention of the aftercoming head of a breech of 6-h duration. She had had a breech delivery at home where the relatives could not deliver the aftercoming head. She was then taken to a district hospital where the head was decapitated and the patient referred to this hospital. On admission her pulse was 11O/min, BP was 90/60mrn of Hg and she was significantly pale. Flank tap showed frank blood. She was taken to theatre for exploratory laparotomy. At operation the placenta and the fetal head were seen lying inside the peritoneal cavity. There was rupture of the right lateral wall of the uterus with extension into the vagina. Total abdominal hysterectomy with repair of the vaginal laceration was performed. The postoperative period was uneventful.