scholarly journals Maternal and perinatal outcomes in urgent referral and non-referral cases of emergency cesarean section at a district hospital in Zambia: a retrospective observational study

2019 ◽  
Vol 33 ◽  
Author(s):  
Yasuhiro Miyoshi
Keyword(s):  
Observational Study ◽  
Cesarean Section ◽  
District Hospital ◽  
Perinatal Outcomes ◽  
Retrospective Observational Study ◽  
Emergency Cesarean Section ◽  
Urgent Referral ◽  
Emergency Cesarean

scholarly journals Feto-maternal outcome in previous one cesarean section: a retrospective observational study at a district hospital of Jharkhand

2021 ◽  
Vol 10 (10) ◽  
pp. 3834
Author(s):  
Tanu Sharma ◽  
Suchita Singh
Keyword(s):  
Observational Study ◽  
Cesarean Section ◽  
District Hospital ◽  
Maternal Outcome ◽  
Retrospective Observational Study ◽  
Risk Pregnancy ◽  
Emergency Cesarean ◽  
Repeat Cesarean Section ◽  
Population Maximum ◽  
Set Up

Background: Cesarean section is one of the most common surgery done in department of obstetrics and gynecology. It becomes more complicated in cases of high risk pregnancy like PIH, APH etc. Its rate is increasing day by day. Once a CS, always a CS, is questionable but being followed up at various set up due to various reasons. Today, one of the important indications of repeat CS is previous CS which increases the rate of CS in a particular set up and morbidities associated with multiple CS. According to ACOG guidelines, VBAC should be attempted to decrease the incidence of repeat CS and morbidity among them. This study was conducted to analyze the incidence of subsequent CS in previous one CS cases, demographic variables and feto-maternal outcome in previous CS patients.Methods: This was a retrospective observational study on previous CS patients, carried out in District hospital, Dumka, Jharkhand. The rates, demography and feto-maternal outcome among previous one CS patients were studied during 1 year duration and data was obtained from labor room and medical record department.Results: Out of 2947 deliveries, 63 patients had previous one cesarean section, the incidence being 2.13%. 39.7% deliver vaginally while 60.3% needed repeat cesarean section. Majority (95.2%) were in 21-30yrs age group, 76.2% were unbooked and 25.4% were tribal population. Maximum (79.4%) were gravid 2 and 93.7% were term. 93.7% had birth space >18 months. Out of 38 repeat cesarean section, 78.9% underwent emergency cesarean section. The most common indication being scar tenderness (39.5%) followed by CPD (15.8%). Intraoperatively, severe adhesions found in 15.8% cases, bladder adherence in 18.4% cases and 2.6% had adherent placenta. PPH occurred in 4.8% cases and blood transfusion or injectable iron therapy required in 25.4% cases. 4.7% had wound infection, 7.9% had prolong hospital stay and 22.2% cases required prolong foley’s catheterization. There was no maternal mortality. 95% babies born alive, 3.2% was stillbirth, 1.5% was IUD and the neonatal death rate was 3.2%.Conclusions: Previous cesarean section is one of the most important causes of CS in subsequent pregnancies, hence increase in the rates of CS and the morbidities associated with multiple CS among mothers. Thus the decision of CS in primigravida should be taken wisely and practice of CS on demand should be discouraged. 

scholarly journals Decision-to-delivery interval of emergency cesarean section in Uganda: a retrospective cohort study

2019 ◽  
Author(s):  
Noemi Hughes ◽  
Imelda Namagembe ◽  
Annettee Nakimuli ◽  
Musa Sekikubo ◽  
Ashley Moffett ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Proportional Hazards ◽  
Perinatal Death ◽  
Perinatal Outcomes ◽  
Cox Proportional Hazards ◽  
Maternal Risk ◽  
Development Index ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Adverse Perinatal Outcomes

Abstract Background : In many low and medium human development index countries, the rate of maternal and neonatal morbidity and mortality is high. One factor which may influence this is the decision-to-delivery interval of emergency cesarean section. We aimed to investigate the maternal risk factors, indications and decision-to-delivery interval of emergency cesarean section in a large, under-resourced obstetric setting in Uganda. Methods: Records of 344 singleton pregnancies delivered at ≥24 weeks throughout June 2017 at Mulago National Referral Hospital were analysed using Cox proportional hazards models and multivariate logistic regression models. Results : An emergency cesarean section was performed every 104 minutes and the median decision-to-delivery interval was 5.5 hours. Longer interval was associated with preeclampsia and premature rupture of membranes/oligohydramnios. Fetal distress was associated with a shorter interval (p<0.001). There was no association between decision-to-delivery interval and adverse perinatal outcomes (p>0.05). Mothers waited on average 6 hours longer for deliveries between 00:00-08:00 compared to those between 12:00-20:00 (p<0.01). The risk of perinatal death was higher in neonates where the decision to deliver was made between 20:00-02:00 compared to 08:00-12:00 (p<0.01). Conclusion : In this setting, the average decision-to-delivery interval is longer than targets adopted in high development index countries. Decision-to-delivery interval varies diurnally, with decisions and deliveries made at night carrying a higher risk of adverse perinatal outcomes. This suggests a need for targeting the improvement of service provision overnight.

scholarly journals Decision-to-delivery interval of emergency cesarean section in Uganda: a retrospective cohort study

2020 ◽  
Author(s):  
Noemi Hughes ◽  
Imelda Namagembe ◽  
Annettee Nakimuli ◽  
Musa Sekikubo ◽  
Ashley Moffett ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Proportional Hazards ◽  
Perinatal Death ◽  
Perinatal Outcomes ◽  
Cox Proportional Hazards ◽  
Maternal Risk ◽  
Development Index ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Adverse Perinatal Outcomes

Abstract Background : In many low and medium human development index countries, the rate of maternal and neonatal morbidity and mortality is high. One factor which may influence this is the decision-to-delivery interval of emergency cesarean section. We aimed to investigate the maternal risk factors, indications and decision-to-delivery interval of emergency cesarean section in a large, under-resourced obstetric setting in Uganda. Methods: Records of 344 singleton pregnancies delivered at ≥24 weeks throughout June 2017 at Mulago National Referral Hospital were analysed using Cox proportional hazards models and multivariate logistic regression models. Results : An emergency cesarean section was performed every 104 minutes and the median decision-to-delivery interval was 5.5 hours. Longer interval was associated with preeclampsia and premature rupture of membranes/oligohydramnios. Fetal distress was associated with a shorter interval (p<0.001). There was no association between decision-to-delivery interval and adverse perinatal outcomes (p>0.05). Mothers waited on average 6 hours longer for deliveries between 00:00-08:00 compared to those between 12:00-20:00 (p<0.01). The risk of perinatal death was higher in neonates where the decision to deliver was made between 20:00-02:00 compared to 08:00-12:00 (p<0.01). Conclusion : In this setting, the average decision-to-delivery interval is longer than targets adopted in high development index countries. Decision-to-delivery interval varies diurnally, with decisions and deliveries made at night carrying a higher risk of adverse perinatal outcomes. This suggests a need for targeting the improvement of service provision overnight.

scholarly journals Effect of decision to delivery interval on perinatal outcomes during emergency cesarean deliveries in Ethiopia: A prospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0258742
Author(s):  
Tebabere Moltot Kitaw ◽  
Birhan Tsegaw Taye ◽  
Mesfin Tadese ◽  
Temesgen Getaneh
Keyword(s):  
Cohort Study ◽  
Cesarean Section ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Perinatal Outcomes ◽  
Adverse Outcomes ◽  
Public Hospitals ◽  
Systematic Sampling ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean

Background The National guidelines of most developed countries suggest a target of 30 minutes of the decision to delivery interval for emergency cesarean section. Such guidelines may not be feasible in poorly resourced countries and busy obstetric settings. It is generally accepted that the decision to delivery interval should be kept to the minimum time achievable to prevent adverse outcomes. Therefore, this study aimed to determine the average decision to delivery interval and its effect on perinatal outcomes in emergency cesarean section. Methods A prospective cohort study was conducted from May to July 2020 at Bahir Dar City Public Hospitals. A total of 182 participants were enrolled, and data were collected using a structured and pre-tested questionnaire. A systematic sampling technique was applied to select the study subjects. Data were cleaned and entered into Epi-Data version 4.6 and exported to SPSS version 25 software for analysis. Logistic regression analysis was performed to identify predictors of outcome variables, and variables with a p-value of <0.05 were considered statistically significant. Results The average decision to delivery interval was 43.73 ±10.55 minutes. Anesthesia time [AOR = 2.1, 95%CI = (1.3–8.4)], and category of emergency cesarean section [AOR = 3, 95% CI = (2.1–11.5)] were predictors of decision to delivery interval. The prolonged decision to delivery interval had a statistically significant association with composite adverse perinatal outcomes (odds ratio [OR] = 1.8, 95% confidence interval [CI] = (1.2–6.5). Conclusion The average decision to delivery interval was longer than the recommended time. It should always be considered an important factor contributing to perinatal outcomes. Therefore, to prevent neonatal morbidity and mortality, a time-dependent action is needed.

A Case of Emergency Cesarean Section on Client with Pseudopregnancy

2020 ◽  
pp. 1-6
Keyword(s):  
Heart Rate ◽  
Cesarean Section ◽  
Fetal Heart Rate ◽  
Medical Service ◽  
Fetal Heart ◽  
Placenta Previa ◽  
Urban Hospital ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Rural Health Center

Pseudopregnancy detection is significant while as the false pregnancy may show all symptoms. It is important to differentiate it. This is a case report of a pseudopregnancy which led to an emergency cesarean section. A 28-year-old woman who claimed to 7-month pregnancy was brought to the rural health center by husband families complaining of vaginal bleeding. The woman refers to an urban hospital by Emergency Medical Service with the diagnosis of placenta previa. In the hospital, she underwent an emergency cesarean section due to a severe deceleration of fetal heart rate, prior to assessing by sonography. No fetus or signs of uterine or abdominal pregnancy were found. Wrong auscultation of the mother's heart rate instead of fetal heart rate seems to be the main error. It is required to pay more attention to the methods of differentiation of fetal heart rate from the mother's heart rate. This report enlightens false pregnancy and early differentiation.

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