scholarly journals A clinical study on indications for caesarean section among primigravida in a tertiary care centre

2019 ◽  
Vol 5 (2) ◽  
pp. 119-124
Author(s):  
Dr. Rema V. Nair ◽  
◽  
Dr. Sowbharnika C.P. ◽  
Dr. Seetha P.M. ◽  
◽  
...  
Author(s):  
Shanthi C. ◽  
Mahalakshmi N. K.

Background: Caesarean section rates are on the rise all over the world. Primary caesarean section usually determines the future obstetric course of any woman and therefore should be avoided whenever possible. WHO recommended that caesarean rates should not be more than 15 %. In this view we started our study on how to reduce the rate of Primary caesarean section in Tertiary Care Centre, Madurai, India. The objective of the present study was to evaluate how the implementation of universally acceptable standards affects rates of primary caesarean section rates without compromising maternal and foetal safetyMethods: This a comparative study on the effect of standard labour protocols and guidelines devised after audit of cases from January 2017 to June 2017, on the rate of primary caesarean section rates, induction of labour, failed induction, maternal and fetal outcomes before and after the implementation of the guidelines.Results: Primary caesarean section rates from 52.85% to 45.02% noted in the induced cases. There were no significant adverse maternal and perinatal outcomes.Conclusions: Implementation of standard labour protocols can reduce primary caesarean section rate without compromising maternal or foetal safety.


Author(s):  
Lekshminath Gopinath ◽  
Rajani Vaidya

Background: Over the last few decades, there has been an alarming increase in the rate of deliveries by caesarean section (CS) in most of the countries, though the drivers of this trend are not completely understood. In 1985, WHO had proposed that ideal rate for regional CS rates should not exceed 10-15%. The Robson’s classification system is simple, robust and flexible. The study was done as it was important to have a tool to monitor, compare the CS rates in a same setting and between different settings over a period of time and to optimise the CS rates.Methods: It was a retrospective study conducted in the department of obstetrics and gynaecology in a tertiary care centre. The hospital delivery records were reviewed for a period of 15 months from April 2020 to June 2021.Results: The total number of deliveries during the study period was 1016. The total number of CSs was 441 and the total number of vaginal deliveries was 575.The CS rate was 43.4%. The relative contribution from groups 1, 2 and 5 in our study accounted for 76.36% and group 5 accounted for 44.4% of the total CSs. These 3 groups should be the focus of attention to reduce the overall CS rates.Conclusions: It is advisable that all institutions can use the Robson’s report table to analyse the population catered by them and to make institutional specific policies. This will allow comparing the data amongst the different institutions and countries which can help in policy making.


2017 ◽  
Vol 39 (5) ◽  
pp. 391
Author(s):  
Meryl Hodge ◽  
Minxue Shen ◽  
Sunny Xie ◽  
Michelle Wise ◽  
Shi-Wu Wen ◽  
...  

Author(s):  
Kusum Dogra ◽  
Neetu Arora ◽  
Bhawna Sharma ◽  
Meenakshi Tanwar

Background: High caesarean section rate worldwide including India is matter of concern. The aim of this study is to analyse caesarean section rate at tertiary care centre according to Modified Robson’s classification.Methods: This retrospective study was conducted at Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIMHS) and Shri Mahant Indiresh Hospital at Dehradun from April 2018 to September 2018. All women delivered during this period were classified according to modified Robson’s classification using their maternal characteristics and obstetric history. For each group, authors calculated the caesarean section rate within the group and its contribution to overall caesarean section rate.Results: Out of total 1302 women delivered, 395 underwent CS (30.3%).The major contribution to overall caesarean section rate was 33.4% by group 5 (Previous CS, singleton, cephalic, >37weeks) followed by 16.7% by group 1 (nullipara, singleton, cephalic, >37 weeks, spontaneous labour), 12.4% by group 3 ( multipara, singleton, cephalic, >37 weeks, spontaneous labour ).CS rates among various group ranges from 100% among women with abnormal lie (group 9) to 77.5% in nulliparous breech (group 6), 73.7% in previous CS (group 5) and least 11.2%  in multipara induced or pre labour CS (group 4).Conclusions: Modified Robson classification is simple, systematic, reproducible and can be effectively utilized in analyzing delivering women. Major contribution to overall caesarean section is made by previous CS.


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