scholarly journals National cross sectional survey to determine whether the decision to delivery interval is critical in emergency caesarean section

BMJ ◽  
2004 ◽  
Vol 328 (7441) ◽  
pp. 665 ◽  
Author(s):  
Jane Thomas ◽  
Shantini Paranjothy ◽  
David James

AbstractObjective To examine the association between decision to delivery interval and maternal and baby outcomes.Design National cross sectional survey.Setting Maternity units in England and Wales.Subjects reviewed 17 780 singleton births (99% of all births) delivered by emergency caesarean section in England and Wales between 1 May 2000 and 31 July 2000.Main outcome measures Association between decision to delivery interval and baby outcomes (Apgar scores of < 7 and < 4 at five minutes and stillbirth) and maternal outcomes (requirement for special care additional to routine care after caesarean section and where care was provided).Results Compared with babies delivered within 15 minutes, there was no difference in maternal or baby outcome for decision to delivery interval between 16 and 75 minutes. After 75 minutes, however, there was a significantly higher odds of a five minute Apgar score of < 7 (odds ratio 1.7, 95% confidence interval 1.2 to 2.4), and 50% increase in odds of special care additional to routine care for mothers.Conclusion A decision to delivery interval of 30 minutes is not an absolute threshold for influencing baby outcome. Decision to delivery intervals of more than 75 minutes are associated with poorer maternal and baby outcomes and should be avoided.

KYAMC Journal ◽  
2018 ◽  
Vol 9 (2) ◽  
pp. 61-64
Author(s):  
Sushmita Paul ◽  
Debashis Paul ◽  
Ashraful Haque ◽  
Bijan Kumar Nath ◽  
Md Rezaur Rahman Miah ◽  
...  

Background: Emergency caesarean section is one of the commonly performed operation in the department of gynae and obstetrics.Objectives: The aim and objective of the study was to evaluate the organisms responsible for post emergency caesarean wound infection and their antibiotics sensitivity.Materials & Methods: The study is a prospective type of cross sectional study where 100 patient of post emergency caesarean wound infection was evaluated during July 2012 to December 2012 (6 Month Duration) at Rajshahi Medical College Hospital (RMCH) Rajshahi. The wound swab was sent for culture and sensitivity test.Results: The peak incidence of wound infection to between 6th - 8th post operative day. In wound discharge shows various organism but 16% showed no growth. The most of the infected wound showed (48%) thick creamy pus and the organisms isolated is Staphylococcus. antibiotics mostly used were Ciprofloxacin, Cephradine and Metronidazole. This study revealed that maximum wound infection is due to S. aureus. Regarding antibiotic sensitivity of the cultured organisms, all of them are sensitive to Imepenem (100%). Staphylococcus aureus mostly sensitive to Flucloxacillin (79.16%). Ciprofloxacin sensitivity is found in 58.33% cases. E coli mostly sensitive to Imepenem (100%) followed by Ceftriaxone (53.84%). Klebsiella pneumonia found mostly sensitive to Imepenem (100%) followed by Ceftriaxone (75%) and Cephradine (50%).Conclusion: Selection of appropriate antibiotic is important to reduce post caesarean wound infection.KYAMC Journal Vol. 9, No.-2, July 2018, Page 61-64


2020 ◽  
Vol 4 (August) ◽  
Author(s):  
Mirjam Lukasse ◽  
Ingrid Hovda ◽  
Sara Thommessen ◽  
Sosan McAuley ◽  
Marian Morrison

2021 ◽  
Vol 2 (1) ◽  
pp. 60-65
Author(s):  
Jamila A Garba ◽  
Abubakar A Panti ◽  
Ahmed Yakubu ◽  
Eze A Ukwu ◽  
Ahmed T Burodo ◽  
...  

Background: Caesarean section is the most significant obstetrics operative intervention globally. Good postoperative experience after caesarean section is important because there is need for the mother to recover from surgery and take care of her baby. The aim of this study was to assess the experience of women that had caesarean section in the first 24 hours postoperatively. Materials/methods: This was a cross-sectional study conducted among women that had elective and emergency caesarean section. They were followed up to 24 hours post-operative. The primary outcome measures were pain score and satisfaction. Secondary outcome measures were time of mobilization, time of commencement of oral feeds and time of initiation of breastfeeding. Data analysis was carried out using Statistical Package for Social Sciences version 22. Results: The median pain scores among those that had emergency and elective caesarean section ranged between 2 and 3 at all points of pain assessment. The satisfaction was good among 66.1% that had emergency caesarean section and 71.2% among those that had elective caesarean section. However, the difference was not statistically significant (χ2 = 0.546, p = 0.761). More than 90% of the participants that had either emergency or elective caesarean section did not ambulate within the first 24 hours after caesarean section and there was no association between the time of ambulation and the type of caesarean section (χ2 = 0.005, p = 0.941). Conclusion: The participants had adequate pain relief and majority were satisfied with the pain relief. However, the optimum satisfaction was not achieved. The participants did not ambulate early and did not initiate breast-feeding early. Recommendation: Further research is recommended to assess other factors that affect patient's satisfaction and ambulation so as to improve on patient's postoperative care.


Author(s):  
Rose Sitonma Iwo-Amah ◽  
Felix Chikaike Clement Wekere ◽  
Simeon Chijioke Amadi ◽  
Joseph Ngozi Kwosah

Background: Caesarean section (CS) is one of the most common surgical procedure in obstetrics. It involves a surgical incision made through the abdominal and uterine walls to deliver the foetus and placenta after the period of foetal viability.Methods: This was a cross-sectional study aimed at reviewing emergency caesarean section in Rivers State University Teaching Hospital (RSUTH) over a 5-year period, to determine the prevalence and sequelae. Data were analysed using IBM Statistical Product and Service Solution (SPSS) version 25.0 (Armonk, NY).Results: During the review period, there were 13516 deliveries and 3699 cases of emergency CS, giving the prevalence of emergency CS as 27.4% or 274 per 1000 deliveries. Majority (90%) of the parturient were unbooked. The most common complication in women that had emergency caesarean section was fever (56.4%), followed by endometritis (14.7%), absconding from hospital (8.8%), urinary tract infection (7.1%) and wound infection (6.1%). There was a statistically significant association between types of CS and their sequelae, χ2=1153.9, p<0.001, (95% CI: 0.000, 0.000). Women that had emergency CS were 101 times more likely to have a complication compared to those that had planned CS.Conclusions: The rate of emergency caesarean section is high in RSUTH and with more complications compared to planned caesarean section. Booking for antenatal care, early presentation for delivery, birth preparedness and complication readiness will enhance improved maternal and perinatal outcome. 


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Napolitani ◽  
C Lorenzini ◽  
L Kundisova ◽  
F Crescenzo ◽  
L Alaimo ◽  
...  

Abstract Introduction Evidence in literature suggests that the outcomes of children born by in-labor non-emergency caesarean section (CS) are better if compared to those born by programmed CS. The aim of this work was to evaluate impact of type of CS on neonatal outcomes and breastfeeding. Materials and methods The cross-sectional study was performed in the Siena province (hospital of Siena and Poggibonsi) during the period January-December 2015. All females that gave birth by CS were included, except those that had emergency CS from severe medical indication (pre-eclampsia/eclampsia, fetal distress, intrauterine growth retardation, etc) or due to multiple pregnancy. The sample was divided in two groups (programmed CS/CS in the presence of labor). The outcome variables were: necessity of hospitalization in neonatal intensive therapy unit (NITU) or resuscitation; weight loss after birth (%), hours passed between birth and first attack to the breast, type of breastfeeding at discharge (exclusive/mixed). The statistical analysis was performed with Stata 12. Results In total 446 females were included (53.6% programmed CS). Any association between the type of CS and admission to NITU or resuscitation was observed. Among the newborns born by CS in the presence of labor, there was a greater proportion of babies who attached to the breast immediately after birth (82% vs. 71%; p &lt; 0.05) and also those exclusively breastfed at the moment of discharge (71% vs. 60%; p &lt; 0.05). The weight loss was lower in babies born by CS in the presence of labor (8%±1.8; 95% CI 7.7%-8.2% vs. 8.53%±1.7%; 95% CI: 8.3%-8.8%; p &lt; 0.05). Conclusions Our study confirmed the negative impact of the CS in the absence of labor on the breastfeeding initiation, probably due to incomplete activation of neuroendocrine mechanisms (release of oxytocin; etc). The CS in the presence of labor is more stressful from the organizational point of view, but it helps promotion of health through the facilitation of breastfeeding. Key messages In-labor non-emergency caesarean section is more physiological and helps to initiate and maintain breastfeeding. The CS in the presence of labor is more stressful from the organizational point of view, but it helps promotion of health through the facilitation of breastfeeding.


Author(s):  
Mapatano Shalamba E. ◽  
Mwambali Nabintu ◽  
Nyakio Ngeleza O. ◽  
Mukanga Omar ◽  
Mulindwa Murhula J. ◽  
...  

Background: The objective of this study was to determine the maternal-fetal prognosis of emergency caesarean sections on the scar uterus to contribute to the reduction of maternal-fetal morbidity and mortality.Methods: An analytical cross-sectional study of pregnant women who were observed from admission to discharge including their newborns at Panzi Reference General Hospital in gynecology and obstetrics department. The sample was comprehensive for convenience consisting of 150 deliveries by caesarean section who had previously delivered at least once by caesarean section. (In 4 months, from 01st December 2018 to 31st March 2019). A pre-established survey sheet allowed us to collect the data. For data analysis, SPSS software and Microsoft excel were used. The chi-square test was used at the 0.05 level.Results: A total 95.2% of newborns were found to be of normal weight, their mothers were emergency cesarized but should be programmed and macrosomia was noted in 4.8%; (p >0.05). In addition, 57.1% of urgent caesarean sections scheduled to be performed were performed in female children (p <0.05). We note the low Apgar in 26.2% of newborns whose mothers were emergency cesarized but should be programmed; (p <0.05). Afterwards, 33.3% of the emergency cesarized gestates, their newborns were transferred to neonatology with transfer reasons asphyxia light in 50%, moderate asphyxia in 28.5% and in 21.5% for the infectious risk. The neonatal prognosis at discharge, we noted two cases of neonatal deaths or 4.7% in pregnant emergency cesarized (p >0.05). On the maternal side, morbidity was dominated by puerperal infections in 16.7% and uterine rupture in 2.4% in the emergency caesarean section, and no maternal deaths occurred in both groups during the study period.Conclusions: Maternal-fetal prognosis was characterized by asphyxia, neonatal infection and two cases of neonatal death. Study did not register a maternal death but we noticed puerperal infections.


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