scholarly journals An analysis of obstetric practices and outcomes in a deep rural district hospital in South Africa

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262269
Author(s):  
Adam Konrad Asghar ◽  
Thandaza Cyril Nkabinde ◽  
Mergan Naidoo
Keyword(s):  
South Africa ◽  
Caesarean Delivery ◽  
District Hospital ◽  
Post Partum ◽  
Mode Of Delivery ◽  
Rural District ◽  
Cross Sectional ◽  
Rural Primary Care ◽  
Robson Classification ◽  
Obstetric Services

Background Internationally, there has been a focus on ensuring that Caesarean deliveries are performed only when indicated, to ensure the best outcome for mother and baby. In South Africa, despite a variety of health system interventions, maternal and perinatal mortality remain unacceptably high. Objectives To describe and compare the clinical outcomes related to the mode of delivery, for patients managed at rural primary healthcare level. Methods This retrospective cross-sectional observational analytical study was conducted at a deep rural district hospital in northern KwaZulu-Natal, South Africa. Maternity Case Records and Caesarean delivery audit tools from 2018 were reviewed. Results In total, 634 files were retrieved. The Caesarean delivery rate in the sample was 30.8% (193 of 634 deliveries), and according to the Robson classification, groups 5 and 1 were the biggest contributors to Caesarean delivery. All Caesarean deliveries were deemed to have been medically indicated. As compared to those whose delivery was normal vaginal, the odds of having post-partum haemorrhage were 25 times higher, and the odds of having any complication were three times higher, if a mother delivered by Caesarean (p<0.001). In neonates who were delivered by Caesarean, the odds of being admitted to nursery were four times higher than those delivered vaginally (p<0.001). Conclusion Showing a significantly higher risk of maternal and neonatal complications, this study validated Caesarean delivery at rural primary care as a potentially dangerous undertaking, for which adequate precautions should be taken. There is a need for interventions targeting rural healthcare in South Africa, to ensure that obstetric services are offered to patients in as safe a manner as possible in this environment.

scholarly journals Maternal Attitude and Knowledge towards Modes of Delivery

2018 ◽  
Vol 16 (2) ◽  
pp. 209-214
Author(s):  
Anshumala Joshi ◽  
Meeta Thapa ◽  
Om Biju Panta
Keyword(s):  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
College Teaching ◽  
Cross Sectional ◽  
Medical College ◽  
Acceptable Method

Background: Whether a mother should be allowed to choose between the modes of delivery is a matter of concern among practicing obstetricians. This study aims to explore the knowledge of the Nepalese women attending a tertiary care center about the benefits and complications of vaginal and caesarean delivery and their attitude and preference for the method of delivery.Methods: The study was a hospital based cross sectional questionnaire survey conducted in Nepal Medical College teaching Hospital, Jorpati from 1stShrawan 2074 to 31st Ashoj 2074. All pregnant women who were 36 weeks or more in gestation attending the clinic during the study period were included in the study. A questionnaire was made of 10 questions for knowledge assessment regarding mode of delivery consisting of the indications, the possible complications and advantages of vaginal and caesarean delivery. Results: A total of 256 pregnant women participated in the study. The knowledge of the mode of delivery, their benefit and complications was medium to good in approximately 90% of the mothers attending the antenatal OPD. Overall attitude for vaginal delivery was positive in 93% of women and negative or neutral in 6.6%.Overall attitude for caesarean delivery was positive in 24% and negative or neutral in 75.8%.Conclusions: Women in our setup agree that vaginal delivery is a natural and acceptable method of delivery and would prefer to have a vaginal delivery. Keywords: Attitude; knowledge; modes of delivery; women.

scholarly journals Evaluation of Patients Satisfaction following Caesarean Section in a Secondary level District Hospital

2020 ◽  
Vol 33 (2) ◽  
pp. 101-106
Author(s):  
Sankar Kumar Basak ◽  
Zannatul Ferdosh ◽  
Rehena Begum ◽  
Nasim Iftekhar Mahmud
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
District Hospital ◽  
Secondary Level ◽  
Educational Status ◽  
Cross Sectional Study ◽  
Negative Reaction ◽  
Cross Sectional ◽  
Level Of Satisfaction ◽  
The Mean

Objective: To assess the level of satisfaction with caesarean delivery and to see the relationbetween different parameters and satisfaction. Materials & Methods: This cross sectional study was done in the department of Obstetrics& Gynaecology of the District Sadar Hospital, Laxmipur during the period of 1st January to30th June 2017. A total of 423 post-caesarean women were included in the study. Thestructured questionnaires were used for the collection of data from the patients and the datawere processed and analyzed with the help of software SPSS. Results: During the study period, among the 465 caesarean delivery 423 were enrolledfor the study. The mean age of the patients was 23.99±5.29 years and mean parity was1.22±1.27. Initial negative reaction to the decision of caesaren section was expressed by71.9% of the patients, 18.4% remained indifferent and 9.7% showed positive reaction. Themajor reasons of initial negative reaction were fear of death and dislike of caesareansection. The satisfaction following caesarean delivery was significantly associated withage, educational status and initial positive and negative reaction to the decision of caesareansection. Three hundred and fifty five (83.9%) women expressed their overall satisfactionfollowing caesarean section. Conclusion: Most patients expressed their overall satisfaction to caesarean delivery. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 101-106

The effect of attending a prenatal childbirth preparedness course on labor duration and outcomes

2018 ◽  
Vol 46 (1) ◽  
pp. 47-52 ◽  
Author(s):  
David Yohai ◽  
Debi Alharar ◽  
Ruthi Cohen ◽  
Zohar Kaltian ◽  
Barak Aricha-Tamir ◽  
...  
Keyword(s):  
Post Partum ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
P Value ◽  
Study Group ◽  
Cross Sectional ◽  
Positive Effects ◽  
Childbirth Experience ◽  
Labor Duration ◽  
Entire Duration

AbstractObjective:To evaluate the effect of attending a prenatal childbirth preparation course (CPC) on labor duration and outcomes.Methods:A cross sectional study of 53 primiparous women who attended and 54 women who did not attend a CPC was conducted. The state-trait anxiety inventory (STAI) score was used to diagnose anxiety. Clinical and obstetrical data were collected from the perinatal database of our center. Through post-partum interviews, coping strategies were assessed, patients graded their childbirth experience and breastfeeding was evaluated. Data were analyzed using description analyses and a P-value <0.05 was considered statistically significant.Results:The STAI score was significantly lower in the study group compared with controls (P=0.025). The first stage and the entire duration of labor were significantly shorter (P=0.036 and P=0.026, respectively) in women who attended the CPC. No significant differences were found with regard to the mode of delivery, rate of episiotomy, use of analgesics and neonatal outcomes between the groups. Women in the study group rated their labor experience significantly higher (P=0.016) and exhibited significantly higher rates of breastfeeding (P<0.001) than controls.Conclusions:The knowledge acquired in the CPC has positive effects on the course of labor and delivery outcomes as well as higher rates of breastfeeding.

scholarly journals Retrospective analysis of breech deliveries in tertiary care center

2020 ◽  
Vol 9 (11) ◽  
pp. 4549
Author(s):  
Suneela Mullakkal Sankaran ◽  
Jayasree Sukumara Sukumara Pillai
Keyword(s):  
Intrauterine Growth Restriction ◽  
Caesarean Delivery ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Growth Restriction ◽  
Cross Sectional ◽  
Intrauterine Growth ◽  
Uterine Anomalies

Background: Breech presentation is the commonest malpresentation accounting for 3-4% of all deliveries at term. The most common cause for breech presentation is preterm delivery. The safest route of delivery for breech had long been a topic of debate and after the results of term breech trial mode of delivery has become abdominal route even in teaching institutions.Methods: This is a retrospective cross sectional study conducted at department of obstetrics and gynaecology, Government medical college, Kozhikode, for a period of 2 years from 01 January 2016 to 31 December 2017. Mothers with gestational age between 28 weeks to 41 weeks with singleton live fetus with breech presentation who had either vaginal or caesarean delivery were included. The case notes were retrieved from the medical records department.Results: A total of 823 breech deliveries occurred during the study period. Of the total mothers 429 were primies and 394 were multies. Common causes identified were prematurity, intrauterine growth restriction, uterine and fetal anomalies. Mode of delivery was caesarean in more than 80% of cases.Conclusions: Incidence of breech presentation was 3.2% during the study period. Increasing incidence of caesarean delivery is seen in breech presentation. Persistent breech presentation at term is most commonly seen in patients with associated oligamnios, intrauterine growth restriction, and uterine anomalies.

scholarly journals The Prevalence and Risk Factors of Stress Urinary Incontinence in Postpartum

2017 ◽  
pp. 153-157
Author(s):  
Renny Pratiwi ◽  
Eddy Suparman ◽  
Rudy A Lengkong
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Post Partum ◽  
Mode Of Delivery ◽  
Cross Sectional ◽  
Regression Test ◽  
Questionnaire Result ◽  
Analytic Design ◽  
The Relationship ◽  
Logistic Regression Test

Objective: To know the incidence of stress urinary incontinence in postpartum and determine the relationship among age, parity, infant birth weight, mode of delivery, episiotomy and perineum rupture. Method: This study used cross sectional analytic design. Qualified subjects from inclusion criteria were interviewed by researchers using pre-defined MESA questioner. Subjects with stress urinary incontinence were found from the questionnaire result. The acquired data was measured and analyzed using SPSS v. 22.0 software and discussed using available literature. Result: From 162 subjects, 36 cases (22.22%) had stress urinary incontinence, 47.22% aging ? 35 years old, 72.22% had multiple pregnancies, 88.89% had per vaginal delivery. Using multivariate logistic regression test, we found there was a relationship between stress urinary incontinence with age and parity (p 35 years old and multiple parities. Keywords: multiple parities, post-partum, stress urinary incontinence

scholarly journals Cesarean delivery in Nigeria: prevalence and associated factors―a population-based cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027273 ◽  
Author(s):  
Emmanuel O Adewuyi ◽  
Asa Auta ◽  
Vishnu Khanal ◽  
Samson J Tapshak ◽  
Yun Zhao
Keyword(s):  
Logistic Regression ◽  
Rural Areas ◽  
Caesarean Delivery ◽  
Maternal Obesity ◽  
Mode Of Delivery ◽  
Cross Sectional ◽  
Study Objective ◽  
Factors Associated ◽  
North East ◽  
The North

ObjectiveTo investigate the prevalence and factors associated with caesarean delivery in Nigeria.DesignThis is a secondary analysis of the nationally representative 2013 Nigeria Demographic and Health Survey (NDHS) data. We carried out frequency tabulation, χ2test, simple logistic regression and multivariable binary logistic regression analyses to achieve the study objective.SettingNigeria.ParticipantsA total of 31 171 most recent live deliveries for women aged 15–49 years (mother–child pair) in the 5 years preceding the 2013 NDHS was included in this study.Outcome measureCaesarean mode of delivery.ResultsThe prevalence of caesarean section (CS) was 2.1% (95% CI 1.8 to 2.3) in Nigeria. At the region level, the South-West had the highest prevalence of 4.7%. Factors associated with increased odds of CS were urban residence (adjusted OR (AOR): 1.51, 95% CI 1.15 to 1.97), maternal age ≥35 years (AOR: 2.12, 95% CI 1.08 to 4.11), large birth size (AOR: 1.39, 95% CI 1.10 to 1.74) and multiple births (AOR: 4.96, 95% CI 2.84 to 8.62). Greater odds of CS were equally associated with maternal obesity (AOR: 3.16, 95% CI 2.30 to 4.32), Christianity (AOR: 2.06, 95% CI 1.58 to 2.68), birth order of one (AOR: 3.86, 95% CI 2.66 to 5.56), husband’s secondary/higher education level (AOR: 2.07, 95% CI 1.29 to 3.33), health insurance coverage (AOR: 2.01, 95% CI 1.37 to 2.95) and ≥4 antenatal visits (AOR: 2.84, 95% CI 1.56 to 5.17).ConclusionsThe prevalence of CS was low, indicating unmet needs in the use of caesarean delivery in Nigeria. Rural–urban, regional and socioeconomic differences were observed, suggesting inequitable access to the obstetric surgery. Intervention efforts need to prioritise women living in rural areas, the North-East and the North-West regions, as well as women of the Islamic faith.

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