Urinary Incontinence among Pregnant Women in Third Trimester of Pregnancy in a Tertiary Care Center: A Descriptive Cross-sectional Study.

INTRODUCTION: Urinary incontinence is an involuntary passage of urine. The aim of the study was to find the prevalence of urinary incontinence among pregnant women in the third trimester of pregnancy at a tertiary care center. METHODS: This descriptive cross-sectional study was conducted in a tertiary care center from March 2021 to May 2021. Ethical approval was obtained from the Institutional Review Board (reference number: 854/2077/78). Convenience sampling method was used. A descriptive analysis of socio-demographic profile and urinary incontinence symptoms were recorded on International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form questionnaire and analysis were done using Statistical Package for Social Sciences 27. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Among 277 pregnant women admitted in the antenatal ward, urinary incontinence was present in 26 (9.4%) (95% Confidence Interval= 5.96-12.84). Among them, stress urinary incontinence 16 (61%) was most common followed by mixed incontinence 6 (23%). Majority of them 18 (69.3%) had small leaks with almost all 25 (96.2%) having only a mild to moderate impact on the quality of life. Majority 197 (71.2%) had features of lower urinary tract syndrome. CONCLUSIONS: Our study showed similar prevalence of urinary incontinence compared to other international studies.

Rectal Perforation: A Rare Complication Following Uncomplicated Vaginal Delivery.

Rectal perforation during vaginal delivery is an uncommon event. It can cause complications including pelvic abscess and other life threatening illnesses, if not treated early. We here report a 24 years lady presented with a week long history of abdominal pain and fever associated with rectal discharge three weeks after uncomplicated vaginal delivery. Abdominal computed tomography findings suggestive of rectal perforation and revealed a huge pelvic abscess. A pigtail catheter was inserted into the pelvic abscess under transrectal ultrasound guidance and drained successfully. The patient recovered uneventfully and discharged 5 days after admission. Keywords: Pelvic abscess; rectal perforation; uncomplicated vaginal delivery.

Prevalence of Postpartum Family Planning Service Coverage in Selected Referral Facilities of Nepal.

INTRODUCTION: Nepal Society of Obstetricians and Gynecologists jointly with the Nepalese government and with the support from the International Federation of Obstetrics and Gynecology has implemented an initiative to institutionalize postpartum family planning services in selected major referral facilities of Nepal to address the gap of low uptake of postpartum family planning in Nepal. The aim of the study is to find the prevalence of the service coverage of postpartum contraception in the selected facilities. METHODS: A descriptive cross-sectional study was conducted in seven major referral facilities across Nepal. Data were collected from the hospital records of all women who delivered in these facilities between October 2018 and March 2019. Ethical approval for this study was obtained from Nepal Health Research Council. Data analysis was done with SPSS version 23. RESULTS: Among the 29,072 deliveries from all the facilities, postpartum family planning counseling coverage was 27,301 (93.9%). The prevalence of uptake of Postpartum Intrauterine Device is 1581 (5.4%) and female sterilization is 1830 (6.3%). In total 11387 mothers (52.2%) had the intention to choose a postpartum family planning method. However, 36% of mothers neither used nor had the intention to choose a postpartum family planning method. CONCLUSIONS: The coverage of Postpartum Intrauterine Device counseling service coverage in Nepal is higher in 2018 as compared to 2016-2017 and in other countries implementing Postpartum Intrauterine Device initiatives. However, the prevalence of service coverage of immediate Postpartum Family Planning methods, mainly Postpartum Intrauterine Device in 2018 is lower in Nepal as compared to 2016-2017, and other countries implementing Postpartum Intrauterine Device initiative. More efforts are needed to encourage mothers delivering in the facilities to use the postpartum family planning method.