VP45.11: Association of cephalopelvic disproportion with ischial spine and ischial tubercle distances in Caesarean section deliveries

Background: The main aim of this study is to determine the maternal and fetal outcome of pregnancy among women with one previous caesarean section at term in relation to vaginal delivery, post partum complication, neonatal complication like low Apgar score, fetal weight and admission in special baby unit. Methods: This is a prospective and descriptive study done in a sample size of 100. Inclusion criteria were term pregnancy, single live fetus with cephalic presentation with one previous caesarean section. During study period total number of obstetric admissions was 3546 and 115 cases were admitted with previous one caesarean section. Result: Out of 100 cases, 31 cases had vaginal delivery and 69 cases had caesarean section. Among 31 vaginal deliveries, 24 cases had spontaneous vaginal delivery and 7 had assisted delivery with vacuum, main indication of vacuum delivery was to cut short the second stage of labor that was in 5(71.43%) cases. Among 69 caesarean section cases, 51 had emergency caesarean section and 18 had elective caesarean section and cephalopelvic disproportion was the main indication in both the groups. Most common complication was scar dehiscence and postpartum hemorrhage. There were two still births in each group and one minute APGAR score was slightly better in caesarean section. Conclusions: Patients with previous caesarean section are at high risk of repeat emergency or elective caesarean section. About one in three patients with previous caesarean section delivered vaginally. In the present study postpartum hemorrhage was the commonest complication, which was found in caesarean section, and only one puerperal pyrexia was seen in case of vaginal delivery. Key words: Cephalopelvic disproportion, Premature rupture of membrane, Septicemia, Vacuum delivery DOI: 10.3126/jnhrc.v7i1.2275 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 25-28

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Risk factors and between-hospital variation of caesarean section in Denmark: a cohort study

BMJ Open ◽

10.1136/bmjopen-2017-019120 ◽

2018 ◽

Vol 8 (2) ◽

pp. e019120 ◽

Cited By ~ 5

Author(s):

Sonja Wehberg ◽

Rikke Guldberg ◽

Kim Oren Gradel ◽

Ulrik Schiøler Kesmodel ◽

Lis Munk ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Caesarean Section ◽

Breech Presentation ◽

Emergency Caesarean Section ◽

Secondary Outcome ◽

Maternity Unit ◽

Cephalopelvic Disproportion ◽

Hospital Units ◽

Hospital Variation

ObjectivesThe aim of this study was to estimate the effects of risk factors on elective and emergency caesarean section (CS) and to estimate the between-hospital variation of risk-adjusted CS proportions.DesignHistorical registry-based cohort study.Settings and participantsThe study was based on all singleton deliveries in hospital units in Denmark from January 2009 to December 2012. A total of 226 612 births by 198 590 mothers in 29 maternity units were included.Primary and secondary outcome measuresWe estimated (1) OR of elective and emergency CS adjusted for several risk factors, for example, body mass index, parity, age and size of maternity unit and (2) risk-adjusted proportions of elective and emergency CS to evaluate between-hospital variation.ResultsThe CS proportion was stable at 20%–21%, but showed wide variation between units, even in adjusted models. Large units performed significantly more elective CSs than smaller units, and the risk of emergency CS was significantly reduced compared with smaller units. Many of the included risk factors were found to influence the risk of CS. The most important risk factors were breech presentation and previous CS. Four units performed more CSs and one unit fewer CSs than expected.ConclusionThe main risk factors for elective CS were breech presentation and previous CS; for emergency CS they were breech presentation and cephalopelvic disproportion. The proportions of CS were stable during the study period. We found variation in risk-adjusted CS between hospitals in Denmark. Although exhaustive models were applied, the results indicated the presence of systematic variation between hospital units, which was unexpected in a small, well-regulated country such as Denmark.

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Towards optimizing caesarean section: a five-year review of caesarean sections at a Southern Nigeria hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20196021 ◽

2019 ◽

Vol 9 (1) ◽

pp. 205

Author(s):

Nkencho Osegi ◽

Olakunle I. Makinde

Keyword(s):

Social Sciences ◽

Caesarean Section ◽

Collaborative Research ◽

Caesarean Section Rate ◽

Breech Presentation ◽

Fetal Distress ◽

Hospital Level ◽

Cephalopelvic Disproportion ◽

Study Centre ◽

Previous Cesarean

Background: Monitoring caesarean sections at hospital level is essential to reduce unnecessary caesarean sections while still ensuring adequate access to caesarean section. This study was conducted to determine the caesarean section rate and indications for caesarean section at the study centre and provide objective data for institutional interventions towards reducing unnecessary caesarean sections in the centre.Methods: A retrospective descriptive study of patients that had caesarean sections between 1st January 2013 and 31st December 2017 at the Federal Medical Centre, Yenagoa, Nigeria. Data were analyzed using Statistical Package for Social Sciences version 22.Results: There were 5,793 deliveries and 1,654 were by caesarean section. The average caesarean section rate was 28.6%. The leading indications for caesarean section were cephalopelvic disproportion (26.6%), previous cesarean section (18.2%), suspected fetal distress (11.2%), severe preeclampsia/eclampsia (7.9%), obstructed labour (6%), and breech presentation (5.9%).Conclusions: The 28.6% caesarean section rate in this study falls within a widely varied rate across Nigeria at hospital level but is comparable to rates within the south-south geopolitical zone of Nigeria. The leading indications for caesarean section are modifiable, thus there is room for institutional intervention to reduce unnecessary caesarean sections. Collaborative research between institutions is required to assess peculiar regional determinants of caesarean section towards developing suitable interventions to reduce unnecessary caesarean sections regionally.

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External Cephalic Version at Term with Tocolysis

Tropical Doctor ◽

10.1177/004947558801800311 ◽

1988 ◽

Vol 18 (3) ◽

pp. 119-124 ◽

Cited By ~ 2

Author(s):

G Justus Hofmeyr

Keyword(s):

Developing Countries ◽

Caesarean Section ◽

Breech Presentation ◽

External Cephalic Version ◽

Cephalopelvic Disproportion ◽

Breech Delivery ◽

Vaginal Breech Delivery ◽

High Prevalence ◽

Large Families ◽

Tocolytic Agents

The problems associated with breech presentation are of particular importance in developing countries. The risk of vaginal breech delivery may be increased because of a high prevalence of cephalopelvic disproportion. Caesarean section presents specific risks to women who may not have medical care in subsequent pregnancies and may desire large families. External cephalic version (ECV) before term has not been proved conclusively to influence the outcome of pregnancy. ECV performed at term (37 or more weeks gestation), using tocolytic agents to relax the uterus, has been shown in a technologically developed setting to reduce the incidence of breech presentation and of Caesarean section. The application of this procedure when technological facilities are limited is discussed and the technique is described.

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A Descriptive Analysis of the Indications for Caesarean Section in Lumbini Zonal Hospital, Butwal

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v5i2.19161 ◽

2018 ◽

Vol 5 (2) ◽

pp. 31-34

Author(s):

Shreedhar Acharya ◽

Bhaktabatsal Raut

Keyword(s):

Caesarean Section ◽

Caesarean Delivery ◽

Caesarean Section Rate ◽

Descriptive Analysis ◽

Fetal Distress ◽

Age Group ◽

Medical Sciences ◽

Cephalopelvic Disproportion ◽

Case Files ◽

One Year

AIM: This study was done to find out the incidence and to analyse the various indications for caesarean sections at Lumbini Zonal Hospital.MATERIALS & METHODS: This was a hospital based retrospective study done at Lumbini Zonal Hospital, Butwal. The case files of all the women who had caesarean delivery over the period of one year from 2071/4/1 to 2072/3/32 were reviewed. Various indications of caesarean sections were analysed for the incidence, age, parity, elective vs emergency caesareans.RESULTS: Out of 7589 deliveries, 1316 (17.34%) had caesarean section. Most common indications were previous caesarean 275 (20.89%), non progress of labour 245 (18.61%), cephalopelvic disproportion 222 (16.86%), fetal distress 215 (16.33%), etc. Majority of caesarean 1226 (93.16%) was done in the age group of 20-30yrs, primipara 702 (53.34%), and elective caesarean sections 766 (58.2%).CONCLUSION: Caesarean section rate at Lumbini Zonal Hospital was optimal. Most common indication was repeat caesarean. The overall reduction in caesarean section rate can be met through reduction of elective caesarean with the promotion of trial of labour.Study also concludes that there is a relation between working duration and health problems, and the problems increase as the duration at work increases.Journal of Universal College of Medical Sciences, Vol. 5, No, 2, 2017, Page: 31-34

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Profile of Cesarean Sections Since the BPJS Era

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v8i1.1028 ◽

2020 ◽

pp. 5-9

Author(s):

Mohd. Andalas ◽

Cut R. Maharani ◽

Raudhatul Jannah ◽

Siti Harisah ◽

Muhammad Haekal ◽

...

Keyword(s):

Caesarean Section ◽

Pregnancy Induced Hypertension ◽

Cesarean Sections ◽

Tertiary Referral ◽

Tertiary Referral Hospital ◽

Cephalopelvic Disproportion ◽

Antepartum Haemorrhage ◽

Vaginal Deliveries ◽

Induced Hypertension ◽

Induction Failure

Objective: to find out the profile of caesarean section in dr. Zainoel Abidin Hospital since the BPJS era. Methods: This study was a descriptive-observational with retrospective design. The data were obtained in March-April 2017. We collected 3656 data from medical record period January 1st, 2014- December 31st, 2016. Results: The finding showed there were 1669 vaginal deliveries (45,65%) and 1987 caesarean sections (54,35%). The most frequent causes to caesarean sections were induction failure (49,77%), cephalopelvic disproportion (14,33%), pregnancy induced hypertension (11,21%), malpresentation (8,91), and antepartum haemorrhage (4,33%). Conclusion: The incidence of caesarean sections in dr. Zainoel Abidin Hospital since the BPJS era was 54,35%, increased by 13,29% than the year of 2011-2013 (41,06%) with the most frequent cause is induction failure (49,77%). Keywords: Antepartum haemorrhage, BPJS, Caesarean section, Induction failure, Pregnancy induced hypertension, Tertiary referral hospital. Abstrak Tujuan: Mengetahui profil persalinan seksio sesarea di RSUD dr. Zainoel Abidin Banda Aceh pada era BPJS. Metode: Penelitian deskriptif-observasional dengan desain studi retrospektif. Pengambilan data dimulai dari bulan Maret-April 2017. Sebanyak 3656 data dikumpulkan dari rekam medik periode 1 Januari 2014- 31 Desember 2016. Hasil: Terdapat 1669 kasus persalinan pervaginam (45,65%) dan 1987 kasus seksio sesarea (54,35%). Indikasi terbanyak yang menyertai seksio sesarea adalah gagal induksi (49,77%), cephalopelvic disproportion (14,33%), hipertensi dalam kehamilan (11,21%), malpresentasi (8,91%), dan perdarahan antepartum (4,33%). Kesimpulan: Angka seksio sesarea di RSUD dr. Zainoel Abidin meningkat 13,29% sejak berlakunya BPJS (1 Januari 2014-31 Desember 2016) mencapai 54,35% dibandingkan tahun 2011-2013 (41,07%) dengan indikasi terbanyak gagal induksi (49,77%). Kata kunci: Perdarahan Antepartum, BPJS, Seksio sesarea, Gagal Induksi, Hipertensi dalam kehamilan, RS Rujukan Tersier.

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Cesárea en el Hospital Verdi Cevallos Balda en el año 2015

QhaliKay Revista de Ciencias de la Salud ISSN 2588-0608 ◽

10.33936/qhalikay.v1i1.127 ◽

2017 ◽

Vol 1 (1) ◽

pp. 41

Author(s):

Juan Carlos Suárez Fernández ◽

Andrea Patricia Chancay Mendoza ◽

Virginia Fernández ◽

Galo Marcelo Proaño Arias ◽

Dadier Marrero González

Keyword(s):

Caesarean Section ◽

Cesarean Section ◽

Pregnant Women ◽

Well Being ◽

Cephalopelvic Disproportion ◽

Mortality And Morbidity ◽

Palabras Clave ◽

Integral Assessment ◽

The City ◽

The Universe

En los últimos años, el parto por cesárea ha aumentado en relación al parto transpelviano a nivel mundial, lo cual constituye una problemática de salud, teniendo en cuenta su asociación con la morbimortalidad de las pacientes y el incremento de los costes que representa. En este trabajo, se realizó un estudio observacional descriptivo en el Hospital Regional Doctor Verdi Cevallos Bal- da de la ciudad de Portoviejo, entre enero y diciembre de 2015, con el objetivo de determinar las indicaciones más frecuentes de la cesárea. El universo estuvo constituido por 3037 gestantes. La muestra fue de 1260 cesareadas que cumplieron con el criterio de inclusión como cesárea primiti- va, y de exclusión para las cesáreas iteradas y los partos transpelvianos. Los resultados mostraron que al 56,1% de las gestantes se les practicó cesárea. Dentro de los diagnósticos de la cesárea se observó predominio de la desproporción cefalopélvica con un 42,5% el compromiso de bienestar fetal con un 26,8% y la corioamnionitis un 0,1%, correspondiendo a las indicaciones maternas, fe- tales y ovulares respectivamente. Se concluyó que la indicación de cesárea, debe ser el resultado de una evaluación integral del estado maternofetal, sobre el que se decide la realización de este procedimiento quirúrgico. Palabras clave: Cesárea, cefalopélvica, bienestar fetal, corioamnionitis Abstract: In recent years, cesarean has risen in relation to the transpelvic delivery worldwide, which is a pro- blem of health, taking into account its association with mortality and morbidity of patients and the increased costs which they represent. In this work, a descriptive observational study was conducted in the Regional Hospital Doctor Verdi Cevallos Balda in the city of Portoviejo, from January to De- cember 2015 with the objective of determining the most frequent indications for cesarean section. The universe consisted of 3037 pregnant women. The sample was cesarean section 1260 that met the inclusion criteria as early cesarean section, and exclusion for iterated transpelvic deliveries and caesarean sections. The results showed that 56.1% of pregnant women underwent caesarean section. Within diagnoses prevalence of caesarean section cephalopelvic disproportion to 42.5% was observed, the commitment of fetal well-being for 26.8% and 0.1% for chorioamnionitis, corres- ponding to maternal, fetal indications and ovular respectively. It was concluded that the indication of cesarean section, must be the result of a integral assessment of the maternal-fetal state, on which the realization of this surgical procedure is decided. Key words: Cesarean, cephalopelvic, fetal well-being, corioamnionitis

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Cephalopelvic disproportion and caesarean section.

BMJ ◽

10.1136/bmj.280.6213.561-b ◽

1980 ◽

Vol 280 (6213) ◽

pp. 561-561

Author(s):

G J Jarvis

Keyword(s):

Caesarean Section ◽

Cephalopelvic Disproportion

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Changing trends of indication of caesarean section

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20202519 ◽

2020 ◽

Vol 9 (7) ◽

pp. 2721

Author(s):

Neelam Goyal ◽

Harshita Pandey

Keyword(s):

Retrospective Study ◽

Caesarean Section ◽

Vicious Cycle ◽

Repeat Surgery ◽

Cephalopelvic Disproportion ◽

Common Indication ◽

Medical College ◽

Changing Trends ◽

High Incidence

Background: Percentage of previous C-section undergoing repeat section is close to 90%-92%, morbidity associated with repeat surgery is bringing an altogether new set of challenges for the upcoming future obstetricians. Object of this study is to highlight high incidence of repeat section required and also growing new indications of C-section due to advanced availability of investigative tools.Methods: Retrospective study of 500 patients who underwent C-section and their indications from April 2019 to July 2019 in Govt Doon Medical college, Dehra Dun.Results: Out of total 500 C-sections carried from April 2019 to July 2019, patients with previous section were found to undergo a repeat C-section in 95% of the cases. Another common indication being oligohydramnios followed by cephalopelvic disproportion and failed induction.Conclusions: After assessing the results it is hereby concluded that the commonest indication of C-section in present time is having a previous C-section, which alarms us to take careful judicious decision in performing primi C-sections in order to prevent patients into entering a vicious cycle of repeat surgeries.

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Pattern of primary caesarean deliveries in a Nigerian tertiary hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20211895 ◽

2021 ◽

Author(s):

Abimbola T. Ottun ◽

Chinonye H. Okoye ◽

Adeniyi A. Adewunmi ◽

Faosat O. Jinadu ◽

Ayokunle M. Olumodeji

Keyword(s):

Caesarean Section ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

University Teaching ◽

State University ◽

Foetal Distress ◽

Hypertensive Disease ◽

Cross Sectional ◽

Cephalopelvic Disproportion ◽

Primiparous Women

Background: Primary caesarean section (CS) has become a major driver of the steadily rising total caesarean rate. This study determined the primary CS rate, pattern and associated factors.Methods: It was a retrospective, hospital-based cross-sectional study of 645 pregnant women who had primary caesarean section over a 3-year period in Lagos state university teaching hospital, Lagos, Nigeria. Data obtained were expressed in frequency and percentages.Results: Primary CS accounted for more than 50% of all the CS done during the study period with a primary CS rate of 16.7% and total CS rate was 30.6%. Primary CS was commonest among women of age group 30-39years (50.1%) and women with no prior parous experience (58.6%). The commonest indication for primary CS was poor progress in labour due to cephalopelvic disproportion, which occurred in 170 women (26.4%), followed by suspected foetal distress in 94 women (14.6%) and hypertensive disease in pregnancy in 91 women (14.1%). Post-operative wound infection and/or dehiscence was the most prevalent post-operative complication occurring in 12.1% of women who had primary CS.Conclusions: Primary CS rate is increasing and relatively more common among primiparous women. Cephalopelvic disproportion, suspected foetal distress and hypertensive disorders of pregnancy are the leading indications for primary CS.

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