Disease Pattern of Out-Patient Department Visits in The Department of Obstetrics and Gynecology at A Tertiary Care Hospital

Abstract

Background: Department of obstetrics and gynecology is one of the busiest departments amongst hospital visits. The aim of this study was to determine the disease pattern prevailing in out-patients of department of obstetrics and gynecology and their segregation with respect to infectious and non-infectious etiology. Methods: This hospital based cross-sectional study was conducted in outpatients attending obstetrics and gynecology department of Kathmandu National Medical College, Kathmandu, Nepal from 17th August 2017 to 16th August 2018. A sum of 1504 patients attending the department was enrolled in the study which included cross referrals for out-patient consultations as well. Diagnosis was based on history, examination and/or investigations (urine, cervical discharge, blood and/or ultrasonography- abdomen and pelvis). Results: More than half (n=803, 53.4%) out-patient department consultation was observed in age group of 20-30years with mean age of 24years. Noninfectious etiology accounted for most out-patient visits (n=1016, 67.6%). The top five out-patient department visits noted were vaginal discharge syndrome (n=325, 21.6%) followed by abnormal uterine bleeding (n=202, 13.4%), ante-natal visits (n=147, 9.8%), non-specific pain lower abdomen/backache (n=108, 7.2%) and urinary tract infection (n=98, 6.5%). Among the total 82 cross-referrals, the order for referral was Medicine (n=34, 41.5%), Dermatology (n=22, 26.8%), Pediatrics (n=12 14.6%), Surgery (n=8, 9.8%) followed by Dental (n=6, 7.3%). Conclusions: The patterns of gynecological problems observed were vaginal discharge followed by abnormal uterine bleeding, non-specific pain lower abdomen/backache and urinary tract infection in descending order. The most common infectious problem being vaginal discharge and non-infectious being abnormal uterine bleeding. The result of this study will be helpful for health planners and policy makers for launching programs to reduce gynecological morbidity and improve overall women’s health.