scholarly journals TO STUDY THE RECENT TRENDS AND DETERMINANTS OF CAESAREAN SECTION RATE AT INDIRA GANDHI MEDICAL COLLEGE & HOSPITAL , SHIMLA

2014 ◽  
Vol 3 (66) ◽  
pp. 14336-14341
Author(s):  
Keshav Ram Benipal ◽  
Santosh Minhas ◽  
Sharma B R
2016 ◽  
Vol 28 (2) ◽  
pp. 82-87
Author(s):  
Shahela Nazneen ◽  
Farhana Begum ◽  
Shakila Nargis

Objective: To find out the sociodemographic characteristics, complications of pregnant woman with premature rupture of membrane (PROM) and asses the outcome of it.Materials and Methods: This prospective study was carried out at the department of Obstetrics & gynaecology of Comilla Medical College Hospital (CoMCH) from January 2009 to December 2009. All pregnant women admitted with PROM during this period were taken as study population. After taking proper history they were categorized as term or preterm PROM on the basis of duration of gestation estimated from 1st day of last menstrual period (LMP), previous antenatal records, clinical examination & also previous ultrasonography (USG) reports. Out of sociodemographic characteristics age distribution and gravidity were noted. Diagnosis was done on the basis of examination and investigations. All the women with PROM were then followed up, management was given according to protocol and caesarean section was performed according to indication. Birth weight and Apgar score of newborns were noted after delivery.Results: There were 198 cases of PROM recorded among 3142 admitted obstetrical patients over one year period. The hospital incidence of PROM was found to be 6.3%. Among them, 57.6% patients were admitted at term and 42.4% patients came before 37 completed weeks of gestation. Most of the pregnant women were between 20-24 years of age (54%), 41% were primigravida (59%) were multigravida. About 48.5% women presented with different complications associated with PROM. Among which 15.7% patients had oligohydramnios, 8.5% patients presented with chorioamnionitis suggested by culture report of high vaginal swab. Urine for culture and sensitivity was also done. About five (5.2%) developed premature labour before 37th week of gestation. About 10% women developed obstetric complications (failed trial) associated with medical diseases. Seventy seven patients were delivered by caesarean section, 16.2% vaginally, 4.04% patients responded to conservative management and 2.5% patients were referred to tertiary centre for extreme prematurity with associated complicating factors. Most of the babies (38.4%) were born with birth weight between 2.1- 2.5kg and 10.3% babies were less than 1.5kg.Conclusion: Term PROM was more in comparison to PPROM and most of them were multigravida. Caesarean section rate was high. Most common complication of was subclinical urogenital infection (53%) next oligohydramnios (25%) & (13.5%) women presented with chorioamnionitis.Bangladesh J Obstet Gynaecol, 2013; Vol. 28(2) : 82-87


Author(s):  
Shanmugapriya Kumaresan ◽  
Malarvizhi Loganathan

Background: There is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. With this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlights includes the rate of caesarean deliveries in the second stage of labour, the indications for delivery and the associated maternal morbidity in this cohort of women.  Methods: This was a prospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between July, 2016 and December 31, 2017 at government medical college hospital Dharmapuri. The main outcome measures were second stage caesarean section, indications and its maternal morbidity.Results: 250 women underwent caesarean delivery in the advanced labor. Among the 250 patient’s majority of them were in the age group of 21-30 yrs. about 76% of the patients were primigravidae and only the remaining 24% were multigravida. The commonest indications for doing caesarean section in the second stage of labor was cephalo pelvic disproportion and non-reassuring fetal heart rate patterns. The difficult task was delivery of the deeply engaged head, the increased likelihood of intraoperative and post-operative complications.Conclusions: Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and morbidity.


Author(s):  
M. Sujatha Alagesan ◽  
M. Meena

Background: The incidences and indications of caesarean sections between the primary caesarean multies and caesarean primies were comparable in respect of their demographical and clinical variables of mothers and their foetal outcomes. Aim and objective of the study was to analyze the incidences and indications of primary caesarean multies and caesarean primies. To compare the incidences and indications of mothers between the primary caesarean multies and caesarean primies. To compare the demographic and clinical profiles of the mothers and babies.Methods: During January to June 2016 total of 3583 deliveries were conducted in Tiruneleli Medical College Hospital, Tamil Nadu, India. Among them 89 and 1168 were primary caesarean multies and caesarean primies respectively. They had been compared according to the objectives.Results: The caesarean incidences were 62.5% among the primies and 4.8% among the multies as Primary. The primary caesarean incidences among the multies were statistically significantly lesser in the 15-24 ages than the primi (P<0.05). 25-29 age bracket the incidences were not differed significantly (P>0.05). After 30 years of age, the incidences were statistically significantly increased among the multies (P<0.05). The birth weight of babies did not show any statistically significant indications between the two groups (P>0.05). The indications of Foetal distress, Severe Oligo hydration and others did not show any statistically significantly difference between the groups (P>0.05). Mal presentation and Ante Partum hemorrhage were significantly more among the multies than primies (p<0.05) and Failed indication and CPD were the significantly lesser indication than the primies (P<0.05).Conclusions: Without reducing the caesarean section rate in primi we cannot bring down the overall caesarean rate of delivery.


2018 ◽  
Vol 27 (1) ◽  
pp. 68-71
Author(s):  
Tahamina Akhter ◽  
Tabassum Ghani ◽  
Subinoy Krishna Paul ◽  
Noorjahan ◽  
Afrina Begum ◽  
...  

Introduction : when a healthy pregnant woman with no obstetric or medical risk factors goes into spontaneous labour, she should anticipate a normal delivery. But still 580, 000 women in the world die from pregnancy and childbirth each year.1 Lack of attention to postpartum care in developing countries is neglected tragedy and requires immediate attention. This study evaluates the incidence of complications of early puerperium and also focuses the specific types of complications and to detect the risk factors associated with these complications. Aims and objectives : Main aim of the study is to evaluate the common complications in early puerperium with special attention to identify the risk factors. Materials and method : This study was carried out in Dhaka Medical College Hospital and Sir Sallimullah Medical College Hospital within the period of March ’2004 to August’ 2004. Two hundred patients were selected for this study who were delivered by caesarean section in these two institutions and complications occurring within 7 days excluding first 24 hours. Patients delivered outside the hospital and with known medical diseases were excluded from this study. Detailed history taking and appropriate clinical examination and specific investigations were done for diagnosis of complications. All relevant informations was noted in prescribed data sheet and results were tabulated and statistical analysis was done. Results : Among 200 cases only 44(22%) cases had early puerperal morbidity.Most of the patients who suffered complications underwent caesarean section for obstructed labour and fetal distress who had trial at home. Many of the patients suffered from wound infection and endometritis (40.9%). Among patients, age group -<20 years suffered from wound infection(53.8%) and endometritis(45.8%) were common in age group 21-30 years. VVF was common in patients in age <20 years.Endometritis (42.2%) was maximum in women with parity 1-3 and wound infection (50%) in women with parity 4-6. Some of the patients had more than one early puerperal morbidity. Maximum number of poor class suffered from wound infection (42.4%).Early puerperal morbidity was more prevalent in women with duration of labour <18 hours and Premature rupture of membrane had relationship with endometritis (15.9%), wound infection (13.6%) and UTI (11.4%). Conclusion : Incidence of early puerperal morbidities is still quite high (22%) and many patients experiences more than one problem at a time.Long term sequelae of early puerperal infectious morbidity should not be neglected as this may interfere quality of life of a woman. J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 68-71


2017 ◽  
Vol 28 (2) ◽  
pp. 66-68
Author(s):  
Rowshan Ara Begum ◽  
Naireen Sultana ◽  
Nahid Sultana ◽  
Amena Begum ◽  
Mohammad Emran Hossain ◽  
...  

To find out the common indications of caesarean section and complications of this operation, both for mother and baby. This observational study was carried out on 100 cases of caesarean sections, who were operated in the Department of Obstetrics & Gynaecology, Tairunnessa Memorial Medical College & Hospital. Previous caesarean section and oligohydroamnios with fetal distress contribute the major causes of caesarean section. Contribute the major causes of caesarean section. Common complications are UTI, wound infection. Indications of caesarean section should be properly identified to decrease the unnecessary operation, which ultimately decrease indication of previous caesarean section. Maintenance of proper asepsis would avoid the complications of this operation.Medicine Today 2016 Vol.28(2): 66-68


1970 ◽  
Vol 18 (1) ◽  
pp. 20-24
Author(s):  
SR Das ◽  
N Sultana ◽  
S Akhter ◽  
F Khan ◽  
F Wazed

Retained placenta is a condition in which the placenta is retained for more than half-an hour after the birth of a child. It accounts for 5-10% of all postpartum haemorrhage (PPH). The present study was conducted to find out the incidence, causes and management of retained placenta of admitted cases in In-Patient Department (IPD) of Obstetrics & Gynaecology of Dhaka Medical College Hospital, Dhaka during the period from June 01 to December 31, 2003. 163 patients were included in the study who presented with retained placenta and developed retained placenta in IPD who had undergone vaginal delivery, with pregnancy equal to or more than 28 weeks both stillbirths and live-births, both singleton and multiple pregnancy. The incidence of retained placenta was found 3.54% of total admissions. Retained placenta developed in 1.53% cases among 1,506 vaginal deliveries in this hospital during this period. The mean age of the respondents was 27.19±1.54 and most of the patients were aged between 21 to 30 years, multipara, illiterate and from low income group and poor socio-economic status. Among them 81.60% had home delivery, 64.42% delivered between 37 to 40 weeks of pregnancy. Majority of the patients i.e. 61.96% reached the hospital within 2 to 6 hours of development of retained placenta and 49.07% had shock with PPH. About 23.92% respondents had predisposing factors like D & C, manual removal of RP and caesarean section. A considerable percentage (19.63%) had history of MR. About 96.93% respondents required manual removal of retained placenta. 124 (76.07%) received blood transfusion ranging from 1 to 13 units of blood. The causes of retained placenta were uterine inertia (38.65%), morbid adhesion (52.76%) and less expulsive efforts of the patients (7.98%). Placenta accreta was the major (96.51%) cause of morbid adhesion. The range of hospital stay was between 6 to 15 days. Of the total retained placenta cases, 98.77% patients improved and 1.23% patients died of irreversible shock due to PPH. Key words: Retained Placenta; Caesarean Section. DOI: 10.3329/jdmc.v18i1.6300 J Dhaka Med Coll. 2009; 18(1) : 20-24


2018 ◽  
Vol 5 (2) ◽  
pp. 290
Author(s):  
Vidya Singaravelu

Background: Identification of the abnormal colonization of the genital tract by a culture based approach has been recommended by the CDC 2000. This will definitely aid in the early recognition of mothers who need to be effectively treated which in turn will prevent newborn infections. Objectives were to study the pattern of maternal vaginal flora in labor and to study the outcome in the neonate.Methods: This study was conducted on 250 mothers in labor and their babies followed up till discharge in the departments of OBG and neonatology in a tertiary care medical college hospital, Deliveries by caesarean section were excluded.Results: Of the 250 babies, 70 were small for gestational age (SGA) and of these 60 (85.71%) were born to colonized mothers; whereas among the appropriate for gestation (AGA) babies, 110 (61.11%) were those born to non-colonised mothers. A statistically significant association was found between SGA babies and maternal colonization. Whereas relation between maternal colonization and gestational age did not show a statistically significant difference.Conclusions: This study shows us that maternal vaginal colonisation in labor significantly impacted the baby's weight with increase in small for gestational age babies being more among the colonised mothers. Hence, finding the organism in the maternal vaginal flora and treating it as per sensitivity might result in lesser incidence of SGA babies.


2019 ◽  
Vol 31 (2) ◽  
pp. 54-58
Author(s):  
Mosammat Nargis Shamima ◽  
Mst Rawson Ara Khatun ◽  
Rubayet Zereen ◽  
Nurjahan Akter ◽  
Nargis Zahan ◽  
...  

Background: Bangladesh recently became a middle income country and despite of its relatively low skilled birth attendance (26.5%) nevertheless experience a rise in caesarean section (CS) rate. But now the rate of CS increased almost seven fold from 3.5% in 2004 to 23% in 2016. Objective: To find out the cause and incidence of caesarean section among the primigravid mother in Rajshahi medical college hospital performed in between January 2017 to December 2017. Methods: This prospective type of observational study was performed in Rajshahi Medical College Hospital (RMCH) over a period of one year from January 2017 to December 2017. All primigravida who underwent caesarean section in RMCH were included. Result: During the study period there were 11018 deliveries. Overall CS rate was 40.98%. The rate in primi was 30.70% and last year it was 25.58%. Conclusion: The vast majority of CS was not medically indicated. A number of policies and program had been launched to counteract this increasing rate of CS but virtually there was no impact. TAJ 2018; 31(2): 54-58


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