scholarly journals Incidence and determinants of neonatal morbidity after elective caesarean section at the national referral hospital in Kampala, Uganda

2015 ◽  
Vol 8 (1) ◽  
Author(s):  
Annettee Nakimuli ◽  
Sarah Nakubulwa ◽  
Othman Kakaire ◽  
Michael O. Osinde ◽  
Scovia N. Mbalinda ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Neonatal Morbidity ◽  
Referral Hospital ◽  
National Referral Hospital

scholarly journals Rates and indications of caesarean section deliveries in Bhutan 2015–2019: a national review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Thinley Dorji ◽  
Phurb Dorji ◽  
Sonam Gyamtsho ◽  
Saran Tenzin Tamang ◽  
Tshering Wangden ◽  
...  
Keyword(s):  
Caesarean Section ◽  
General Hospital ◽  
Referral Hospital ◽  
Hospital Records ◽  
Regional Referral Hospital ◽  
Emergency Caesarean ◽  
Institutional Deliveries ◽  
National Rate ◽  
National Referral Hospital ◽  
Eastern Regional

Abstract Background Bhutan has made much efforts to provide timely access to health services during pregnancy and increase institutional deliveries. However, as specialist obstetric services became available in seven hospitals in the country, there has been a steady increase in the rates of caesarean deliveries. This article describes the national rates and indications of caesarean section deliveries in Bhutan. Methods This is a review of hospital records and a qualitative analysis of peer-reviewed articles on caesarean deliveries in Bhutan. Data on the volume of all deliveries that happened in the country from 2015 to 2019 were retrieved from the Annual Health Bulletins published by the Ministry of Health. The volume of deliveries and caesarean deliveries were extracted from the Annual Report of the National Referral Hospital 2015–2019 and the data were collected from hospital records of six other obstetric centres. A national rate of caesarean section was calculated as a proportion out of the total institutional deliveries at all hospitals combined. At the hospital level, the proportion of caesarean deliveries are presented as a proportion out of total institutional deliveries conducted in that hospital. Results For the period 2015–2019, the average national rate of caesarean section was 20.1% with a statistically significant increase from 18.1 to 21.5%. The average rate at the six obstetric centres was 29.9% with Phuentsholing Hospital (37.2%), Eastern Regional Referral Hospital (34.2%) and Samtse General Hospital (32.0%) reporting rates higher than that of the National Referral Hospital (28.1%). Except for the Eastern Regional Referral and Trashigang Hospitals, the other three centres showed significant increase in the proportion of caesarean deliveries during the study period. The proportion of emergency caesarean section at National Referral Hospital, Central Regional Referral Hospital and the Phuentsholing General Hospital was 58.8%. The National Referral Hospital (71.6%) and Phuentsholing General Hospital reported higher proportions of emergency caesarean sections (64.4%) while the Central Regional Referral Hospital reported higher proportions of elective sections (59.5%). The common indications were ‘past caesarean section’ (27.5%), foetal distress and non-reassuring cardiotocograph (14.3%), failed progress of labour (13.2%), cephalo-pelvic disproportion or shoulder dystocia (12.0%), and malpresentation including breech (8.8%). Conclusion Bhutan’s caesarean section rates are high and on the rise despite a shortage of obstetricians. This trend may be counterproductive to Bhutan’s efforts towards 2030 Sustainable Development Goal agendas and calls for a review of obstetric standards and practices to reduce primary caesarean sections.

scholarly journals Incidence of Post Dural Puncture Headache and Associated Factors Following Spinal Anaesthesia for Caesarean Delivery in Mulago National Referral Hospital

2019 ◽  
Author(s):  
Philo Nambooze ◽  
Kizito Samuel ◽  
John Baptist Kiggundu ◽  
Andrew Kintu ◽  
Mary T. Nabukenya
Keyword(s):  
Caesarean Section ◽  
Spinal Anesthesia ◽  
Spinal Anaesthesia ◽  
Associated Factors ◽  
Dural Puncture ◽  
Cost Effective ◽  
Referral Hospital ◽  
P Value ◽  
Mulago National Referral Hospital ◽  
National Referral Hospital

Abstract Background Spinal anaesthesia is a cost effective anaesthesia technique commonly used for abdominal procedures like caesarean sections. The incidence of post dural puncture headaches (PDPH) which is one of the most reported complications) remains unknown in Uganda. We set out to study the incidence of PDPH and associated factors following spinal anaesthesia in mothers delivering by caesarean section in Mulago National Referral Hospital. Methods Prospective cohort study among 1294 women that received spinal anaesthesia for emergency caesarean section delivery from July 2015 to February 2016. Consecutive sampling was applied to recruit participants. Pre-tested interviewer administered questionnaires were used to collect information on demographics and associated factors. Both bivariate and multivariate logistic regressions were used with a P value of 0.05 and confidence interval of 95% being considered statistically significant. Results The incidence of PDPH was found to be 48.8% (n=239/1294) (95%CI: 46.0-51.6). Significant factors associated with PDPH were history of spinal anaesthesia OR 1.3 95% CI (1.0-1.6) p=0.04 and loss more than 500mls of blood during surgery OR 2.2, 95% CI (1.1-4.2) P=0.02. Conclusion Results from our study indicate high incidence of PDPH women undergoing spinal anesthesia for Caesarean section. Prior exposure to spinal anesthesia and blood loss of more than 500mls are the major associated factors. There is need to objectively screen women at risk for PDPH prior to caesarean section and institute appropriate interventions.

scholarly journals Incidence Of Post Dural Puncture Headache And Associated Factors Following Spinal Anaesthesia For Caesarean Delivery In Mulago National Referral Hospital

2019 ◽  
Author(s):  
Philo Nambooze ◽  
Kizito Samuel ◽  
John Baptist Kiggundu ◽  
Andrew Kintu ◽  
Mary T. Nabukenya
Keyword(s):  
Caesarean Section ◽  
Spinal Anesthesia ◽  
Spinal Anaesthesia ◽  
Associated Factors ◽  
Dural Puncture ◽  
Cost Effective ◽  
Referral Hospital ◽  
P Value ◽  
Mulago National Referral Hospital ◽  
National Referral Hospital

Abstract Background Spinal anaesthesia is a cost effective anaesthesia technique commonly used for abdominal procedures like caesarean sections. The incidence of post dural puncture headaches (PDPH) which is one of the most reported complications) remains unknown in Uganda. We set out to study the incidence of PDPH and associated factors following spinal anaesthesia in mothers delivering by caesarean section in Mulago National Referral Hospital. Methods Prospective cohort study among 1294 women that received spinal anaesthesia for emergency caesarean section delivery from July 2015 to February 2016. Consecutive sampling was applied to recruit participants. Pre-tested interviewer administered questionnaires were used to collect information on demographics and associated factors. Both bivariate and multivariate logistic regressions were used with a P value of 0.05 and confidence interval of 95% being considered statistically significant. Results The incidence of PDPH was found to be 48.8% (n=239/1294) (95%CI: 46.0-51.6). Significant factors associated with PDPH were history of spinal anaesthesia OR 1.3 95% CI (1.0-1.6) p=0.04 and loss more than 500mls of blood during surgery OR 2.2, 95% CI (1.1-4.2) P=0.02. Conclusion Results from our study indicate high incidence of PDPH women undergoing spinal anesthesia for Caesarean section. Prior exposure to spinal anesthesia and blood loss of more than 500mls are the major associated factors. There is need to objectively screen women at risk for PDPH prior to caesarean section and institute appropriate interventions.

scholarly journals Postpartum femoral neuropathy: managing the next pregnancy

2019 ◽  
Vol 12 (12) ◽  
pp. e232967 ◽  
Author(s):  
Cathy Rowland ◽  
Daniel Kane ◽  
Maeve Eogan
Keyword(s):  
Caesarean Section ◽  
Motor Function ◽  
Lower Limb ◽  
Elective Caesarean Section ◽  
Mode Of Delivery ◽  
Primiparous Woman ◽  
Limb Weakness ◽  
Femoral Neuropathy ◽  
Lower Limb Weakness ◽  
Spontaneous Labour

A 34-year-old primiparous woman presented in spontaneous labour and had an unassisted vaginal birth of a 3.5 kg infant. Postnatally, the patient experienced lower limb weakness and was unable to mobilise unassisted. A diagnosis of postpartum femoral neuropathy was made. Full recovery of normal motor function was not achieved until 5 months postpartum. She returned in her next pregnancy, seeking advice on how to avoid this complication from reoccurring. It was decided that an elective caesarean section was an appropriate mode of delivery, which she underwent at 39 weeks without complication and without recurrence of the femoral neuropathy.

scholarly journals Maternal and neonatal risk factors for neonatal respiratory distress syndrome in term neonates in Cyprus: a prospective case–control study

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Paraskevi Stylianou-Riga ◽  
Theodora Boutsikou ◽  
Panayiotis Kouis ◽  
Paraskevi Kinni ◽  
Marina Krokou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Caesarean Section ◽  
Distress Syndrome ◽  
Elective Caesarean Section ◽  
Case Control ◽  
Male Gender ◽  
Term Neonates ◽  
Systemic Hypotension ◽  
Neonatal Respiratory Distress

Abstract Background Neonatal respiratory distress syndrome (NRDS) is strongly associated with premature birth, but it can also affect term neonates. Unlike the extent of research in preterm neonates, risk factors associated with incidence and severity of NRDS in term neonates are not well studied. In this study, we examined the association of maternal and neonatal risk factors with the incidence and severity of NRDS in term neonates admitted to Neonatal Intensive Care Unit (NICU) in Cyprus. Methods In a prospective, case-control design we recruited term neonates with NRDS and non-NRDS admitted to the NICU of Archbishop Makarios III hospital, the only neonatal tertiary centre in Cyprus, between April 2017–October 2018. Clinical data were obtained from patients’ files. We used univariate and multivariate logistic and linear regression models to analyse binary and continuous outcomes respectively. Results During the 18-month study period, 134 term neonates admitted to NICU were recruited, 55 (41%) with NRDS diagnosis and 79 with non-NRDS as controls. In multivariate adjusted analysis, male gender (OR: 4.35, 95% CI: 1.03–18.39, p = 0.045) and elective caesarean section (OR: 11.92, 95% CI: 1.80–78.95, p = 0.01) were identified as independent predictors of NRDS. Among neonates with NRDS, early-onset infection tended to be associated with increased administration of surfactant (β:0.75, 95% CI: − 0.02-1.52, p = 0.055). Incidence of pulmonary hypertension or systemic hypotension were associated with longer duration of parenteral nutrition (pulmonary hypertension: 11Vs 5 days, p < 0.001, systemic hypotension: 7 Vs 4 days, p = 0.01) and higher rate of blood transfusion (pulmonary hypertension: 100% Vs 67%, p = 0.045, systemic hypotension: 85% Vs 55%, p = 0.013). Conclusions This study highlights the role of elective caesarean section and male gender as independent risk factors for NRDS in term neonates. Certain therapeutic interventions are associated with complications during the course of disease. These findings can inform the development of evidence-based recommendations for improved perinatal care.

Sign in / Sign up

Export Citation Format

Share Document