scholarly journals Maternal and foetal outcome in elective versus emergency caesarean sections

2017 ◽  
Vol 6 (4) ◽  
pp. 1222
Author(s):  
Amit A. Gurunule ◽  
Himangi S. Warke
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
Breech Presentation ◽  
Emergency Caesarean Section ◽  
Tertiary Care Centre ◽  
Emergency Caesarean ◽  
Significant Difference ◽  
Foetal Outcome ◽  
Tract Infections

Background: Caesarean delivery is defined as the birth of the foetus through an incision in the abdominal wall (i.e. laparotomy) and the uterine wall (hysterotomy). The purpose was to analyze the maternal and foetal outcome in elective versus emergency caesarean sections retrospectively in a tertiary care centre and to analyze the indications of elective versus emergency caesarean sections.Methods: A retrospective observational study of the cases undergoing caesarean sections in KEM hospital, Mumbai, India was carried out during the period of September 2013 to September 2015. Maternal and foetal outcome was studied. The data was collected and analyzed from the maternal medical records. The neonatology records were also examined.Results: Out of the 600 selected patients, 300 patients in each group of elective and emergency caesarean section were studied. The usual indications of emergency caesarean sections were foetal distress, followed by meconium stained amniotic fluid (MSAF) and cephalopelvic disproportion (CPD). The most frequent indicator for elective lower segment caesarean section (LSCS) was patient with previous LSCS not willing for vaginal birth, followed by breech presentation and previous multiple LSCS. There was a significant difference seen in the occurrence of fever, urinary tract infections and wound infections in the two groups. These were more common in the emergency caesarean section group. Significant difference was also seen in the incidence of postpartum haemorrhage in the two groups, which was more in the elective caesarean section group.Conclusions: The maternal morbidity, intra operative and postoperative complications were more in the emergency LSCS group as compared to patients who underwent elective LSCS.

scholarly journals EMERGENCY CAESAREAN SECTION

2008 ◽  
Vol 15 (02) ◽  
pp. 211-215
Author(s):  
SAMIA HASSAN ◽  
MISBAH KAUSAR JAVAID ◽  
SADIA TARIQ
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Emergency Caesarean Section ◽  
Fetal Mortality ◽  
Mortality And Morbidity ◽  
Emergency Caesarean ◽  
Section Design ◽  
Tract Infections ◽  
A Prospective Study ◽  
Antibiotic Cover

Objective: Comparative analysis of problems encountered betweenpatients of elective caesarean section and patients for whom elective caesarean section was planned but ended upin emergency caesarean section. Design: Descriptive prospective analysis. Setting: Gynae Unit-II, Services Hospital,Lahore. Duration: One year, 1 January 2006 to 31 December 2006. Patients & Methods: A prospective study of st st100 patients who presented for antenatal care (ANC) and for whom elective caesarean section (CS) was planned wasdone. Patients evaluation was done on a designed performa that included demographic, social and obstetrical histories.Problems encountered in the preparatory stage, logistic problems, administrative problems, problems encounteredduring surgery, maternal, fetal mortality and morbidity were noted. Results: The patients were divided into twocategories. Categories I: included patients who had elective CS and category II: included patients who ended up inemergency CS. Numerous problems were encountered for category II patients. In the preparatory phase there wasdifficulty in arranging medicines for 32 patients. (59.2%), arranging blood for 28 patients (51.8%), obtaining consentfor 1 patient (1.85%). Logistic problems included non-availability of operation theatre for 15 patients (27.75%), nonavailability of anaesthetist for 9 patients (16.65%), and non-availability of paediatrician for 38 babies (17.3%). Noneof the emergency CS were done with in the recommended 30 minutes interval. Despite this, there was no significantcoloration between the decision delivery interval (DDI) and perinatal outcome. In our study like threatening cases wereoperative within 60 minutes. Intra operative problems in the category II patients included adhesions in 40 patients (74%)vs 10 patients (21.7%) of category I, partial dehiscence in 16 patients (29.6%) of category II vs 4 patients (8.68%) ofcategory I. Excessive hemorrhage in 8 patients (14.8%) of category II vs 2 patients (4.34%) of category I. Among thepost operative complications anemia was present in 20 patients (43.4%) of category I vs 45 patients (83.25%) ofcategory II patients. Blood transfusion was required for 16 patients (29.6%) of category II vs 4 patients (8.68%) ofcategory I and all patients were given iron supplement. Major wound infection were seen in 9 patients (16.65%) ofcategory II vs 2 patients (4.34%) of category I. Resuturing was done after appropriate antibiotic cover and dailyantiseptic dressing. Minor wound infections were seen in 22 patients (40.7%) of category II vs 12 patients (26.04%)of category I. Urinary Tract Infections (UTI) was seen in 6 patients (11.1%) of category II vs 1 patient (2.17%) ofcategory I. Respiratory Tract Infection (RTI) was seen in 5 patients (9.25%) of category II vs 2 patients (4.34%) ofcategory I. All these were treated by appropriate antibiotic cover. Regarding the neonatal outcome 16 babies (29.6%)of category II were kept under observation in neonatal nursery (NNU) as compared to 6 (13.02%) babies of categoryI. Admission for 2-10 days in NNU were 8 babies (14.96%) of category II vs 2 babies (4.34%) of category I. 2 babies(3.74%) of category II expired later while none of category I. Conclusion: Patients for whom elective CS was plannedbut who ended up in emergency CS, the DDI was prolonged and there was increase risk of maternal morbidity, fetalmorbidity and mortality as compared to those patients who had elective CS.

scholarly journals Determinants and outcomes of caesarean delivery: elective versus emergency in a tertiary care teaching institute in Kerala, India

2019 ◽  
Vol 8 (10) ◽  
pp. 4000
Author(s):  
Heera Shenoy T. ◽  
Remash K. ◽  
Sheela Shenoy T.
Keyword(s):  
Caesarean Section ◽  
Hospital Stay ◽  
Gestational Age ◽  
Caesarean Delivery ◽  
Tertiary Care ◽  
Breech Presentation ◽  
Lower Segment Caesarean Section ◽  
Emergency Caesarean ◽  
Risk Pregnancy ◽  
Tract Infections

Background: Globally, the caesarean delivery rate is rising continuously, making caesarean one of the most common surgical procedures. The purpose was to analyse the determinants and maternofoetal outcomes in elective versus emergency caesarean sections in a tertiary care centre.Methods: All women, who gave birth by Caesarean deliveries done over a period of 1 year (January 2018-December 2018), were studied in Travancore Medical College in Kerala, India. Indications of caesarean, whether emergency or elective, medical morbidities, Gestational age at decision, birthweights and extended hospital stay and new-borns needed to resuscitate were looked into. The data was collected and analysed from the hospital registry.Results: Out of the 378 selected patients, 95 patients in group of elective and 283 emergency caesarean section were studied. The indications of emergency caesarean sections were failed induction, non-progression of labour, CPD, Previous caesarean in labour, foetal distress. The most frequent indicator for elective lower segment caesarean section (LSCS) was patient with previous LSCS not willing for vaginal birth, followed by breech presentation and high risk pregnancy ( BOH and ART). Younger mothers, gestational age remote from term, low-birth weight, and extended hospital stay were statistically significant in mothers undergoing emergency caesarean delivery. Fever, urinary tract infections, need for maternal and neonatal ventilation, blood transfusion, scar dehiscence were more common in the emergency caesarean group.Conclusions: The antenatal morbidity, low birth weights, decision taken preterm for salvaging the baby, postoperative complications and extended stay were more in the emergency caesarean when compared to elective caesarean.

scholarly journals MODE OF DELIVERY AND ITS IMPACT ON NEONATAL OUTCOMES IN PRETERM INFANTS

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e27-e27
Author(s):  
Sarah McKnight ◽  
Bishal Gautam ◽  
Michael Miller ◽  
Bryan S Richardson ◽  
Orlando da Silva
Keyword(s):  
Caesarean Section ◽  
Preterm Infants ◽  
Periventricular Leukomalacia ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Neonatal Outcomes ◽  
Care Hospital ◽  
Significant Difference

Abstract BACKGROUND The optimal mode of delivery for preterm infants remains controversial, and routine Caesarean sections (C/S) are not recommended, except for maternal indications. Nonetheless, many preterm infants are delivered by C/S, particularly those in breech presentation, and recent retrospective data have suggested that these infants may have improved outcomes. OBJECTIVES To examine whether C/S as the mode of preterm delivery is associated with decreased mortality and improved short term outcomes. DESIGN/METHODS This retrospective, population-based cohort study examined infants with a gestational age between 23 0/7 weeks and 32 6/7 weeks, born between January 1, 2007 and December 31, 2016, and admitted to the Neonatal Intensive Care Unit at a single Canadian Tertiary Care hospital. Infants with major congenital anomalies were excluded. Data were abstracted from the local Neonatal-Perinatal database for all infants. Two groups, those delivered vaginally and those delivered by C/S, were compared for major neonatal outcomes including the primary outcomes of death and severe intraventricular hemorrhage (IVH), defined as grade 3 or higher. RESULTS A total of 1442 infants met inclusion criteria (784 born by C/S and 658 vaginally). There was no significant difference in neonatal mortality (7.0% vs 7.1%, p=0.925) or severe IVH (6.1% vs 7.4%, p=0.317). There was, however, a significant difference in the incidence of IVH, any grade (19.9% vs 27.5%, p=0.001), which remained after controlling for other significant predictors. There were no other significant differences in the secondary outcomes examined including need for extensive resuscitation, respiratory distress syndrome, bronchopulmonary dysplasia, patent ductus arteriosus, necrotizing enterocolitis, periventricular leukomalacia, or retinopathy of prematurity. CONCLUSION Caesarean section was not associated with decreased mortality in preterm infants, relative to vaginal births. Caesarean section was associated with a reduced rate of IVH (any grade) and there was a trend towards decreased severe IVH which may warrant further study.

scholarly journals Profile of Caesarean Section at Kathmandu Medical College

2017 ◽  
Vol 15 (2) ◽  
pp. 110-113
Author(s):  
Apurwa Prasad ◽  
Garima Bhandari ◽  
Rachana Saha
Keyword(s):  
Caesarean Section ◽  
Demographic Data ◽  
Elective Caesarean Section ◽  
Emergency Caesarean Section ◽  
Medical College ◽  
Emergency Caesarean ◽  
Clinical Indications ◽  
Depth Study ◽  
Elective Procedure ◽  
Failed Induction

Background: There is a world-wide rise in caesarean section rateduring the last three decades and has been a cause of alarm and needs an in-depth study. The objective of this study was to determine the rate and clinical indications of Caesarean Section.Methods: A hospital based study was carried out from 15th June 2015 to 15th January 2016 in Department of Obstetrics and Gynecology at Kathmandu Medical College, Sinamangal, Nepal. Patients who delivered by caesarean section were included in the study. Basic demographic data and clinical indications were noted.

Results: A total of 1172 deliveries were carried out during the study period. Total number of caesarean section was 537 accounting to 45.81%. Most of the patients were of the age group of 25-29 years (42.8%). Most of the patients were primigravida (n=274; 51%). Emergency caesarean section was 411 (76.5%) and elective caesarean section was 126 (23.4%). Multigravida (71%) underwent more elective procedure than primigravida (25. 39%).The most frequent indication was fetal distress19.55% (n=105), failed induction 19.73%(n=106), and previous caesarean section 21.3% (n=115).Conclusions: The rate of cesarean section is quite high than that recommended by WHO which is (10-15%). Most of the caesarean sections were emergency caesarean section with previous caesarean being the leading cause.

scholarly journals Vaginal Delivery versus Elective Caesarean Section for Breech Presentation - Experience in Institute of Child and Mother Health (ICMH)

2019 ◽  
Vol 31 (1) ◽  
pp. 23-26
Author(s):  
Mahe Jabeen ◽  
Sabiha Shimul ◽  
Ummay Salma ◽  
Jebunnesa
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Maternal Morbidity ◽  
Neonatal Outcome ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Cost Of Care ◽  
Increased Risk

Introduction: Compared with a fetus with cephalic presentation, a breech fetus faces increased risk during labour and delivery of asphyxia from cord compression and of traumatic injury during delivery of the shoulders and head. Caesarean section avoids most of this risk. The purpose of this study was to evaluate the feasibility of vaginal delivery of uncomplicated singleton breech presentation by evaluating early neonatal morbidity and mortality as well as maternal morbidity following vaginal and caesarean delivery for breech presentation. Materials and Methods: This is a cross sectional comparative study.104 women with singleton breech presentation at term in labour were included consequetively in labour ward of Institute of Child and Mother Health (ICMH). Informed consent was taken from them. Neonatal and maternal outcome were recorded and statistical analysis was done using SPSS version 22. Results: APGAR at 5 min and Neonatal Intensive Care Unite (NICU) admission were not affected by mode of delivery. Long term neonatal outcome is similar in either mode of delivery. Maternal morbidity and duration of hospital stay is increased in caesarean births. Conclusion: Neonatal outcome did not depend on mode of delivery though maternal morbidity and cost of care is increased following Caesarean Section. Proper selection of cases and by improving skill & confidence in new generation obstetrician, vaginal delivery of singleton fetuses in breech presentation at term remains a safe option that can be offered to a woman in a tertiary care centre. Medicine Today 2019 Vol.31(1): 23-26

scholarly journals Elective versus emergency caesarean section: differences in maternal outcome

2019 ◽  
Vol 8 (8) ◽  
pp. 3207
Author(s):  
Anshu Sharma ◽  
Rajiv Acharya ◽  
Yashika Pehal ◽  
Bhawna Sharma
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Fetal Distress ◽  
Emergency Caesarean Section ◽  
Maternal Outcome ◽  
Common Indication ◽  
Emergency Caesarean ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Caesarean section is a life-saving surgical procedure when certain complications arise during pregnancy or labour. The use of CS worldwide has increased worldwide unprecedented levels although the gap between higher- and lower-resource settings remains. The present study evaluates the difference in maternal outcome in elective versus emergency caesarean sections in our institute.Methods: The study included first 65 cases of emergency caesarean section (group A) and during the study period, first 65 elective caesarean section (group B) if they fulfilled the inclusion criteria. Various intra operative and postoperative events were recorded which included intra operative complications, postpartum haemorrhage and transfusion indices.Results: The most common indication of caesarean section in group A was fetal distress (27.7%). In group B most caesarean sections were classified under 5 followed by class 6, the most common indication being previous caesarean section (27.6%). It was observed that pre-operative mean haemoglobin in group A was 10.6 g/dl and in group B was 11.2g/dl. A drop of 1.36 g/dl in group A and 1.10 g/dl in group B was observed in the post-op period. Cross match / transfusion ratio 1.5 in group A and  2 in group B, transfusion probability ratio was 60 % in group A and  66.7%  in group B and transfusion index was 1 in group A and  group B. There was significantly higher contraception acceptance in group B compared to group A.Conclusions: Elective caesarean section has more favourable maternal outcome as compared to emergency caesarean section as the former is done under controlled and planned circumstances.  However, there should be stringent audit to scrutinise indication of caesarean section, outcome of caesarean and blood transfusion practices.

scholarly journals Post-operative Experience following Caesarean Section in a Nigerian Obstetric Population

2021 ◽  
Vol 2 (1) ◽  
pp. 60-65
Author(s):  
Jamila A Garba ◽  
Abubakar A Panti ◽  
Ahmed Yakubu ◽  
Eze A Ukwu ◽  
Ahmed T Burodo ◽  
...  
Keyword(s):  
Pain Relief ◽  
Caesarean Section ◽  
Outcome Measures ◽  
Elective Caesarean Section ◽  
Cross Sectional Study ◽  
Emergency Caesarean Section ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Patient’S Satisfaction ◽  
Emergency Caesarean

Background: Caesarean section is the most significant obstetrics operative intervention globally. Good postoperative experience after caesarean section is important because there is need for the mother to recover from surgery and take care of her baby. The aim of this study was to assess the experience of women that had caesarean section in the first 24 hours postoperatively. Materials/methods: This was a cross-sectional study conducted among women that had elective and emergency caesarean section. They were followed up to 24 hours post-operative. The primary outcome measures were pain score and satisfaction. Secondary outcome measures were time of mobilization, time of commencement of oral feeds and time of initiation of breastfeeding. Data analysis was carried out using Statistical Package for Social Sciences version 22. Results: The median pain scores among those that had emergency and elective caesarean section ranged between 2 and 3 at all points of pain assessment. The satisfaction was good among 66.1% that had emergency caesarean section and 71.2% among those that had elective caesarean section. However, the difference was not statistically significant (χ2 = 0.546, p = 0.761). More than 90% of the participants that had either emergency or elective caesarean section did not ambulate within the first 24 hours after caesarean section and there was no association between the time of ambulation and the type of caesarean section (χ2 = 0.005, p = 0.941). Conclusion: The participants had adequate pain relief and majority were satisfied with the pain relief. However, the optimum satisfaction was not achieved. The participants did not ambulate early and did not initiate breast-feeding early. Recommendation: Further research is recommended to assess other factors that affect patient's satisfaction and ambulation so as to improve on patient's postoperative care.

scholarly journals Socio-demographic Factors Associated with Emergency Caesarean Section Cases admitted at Tertiary Care Hospital in Dhaka City

2018 ◽  
Vol 4 (1) ◽  
pp. 23-26
Author(s):  
Rifat Sultana ◽  
Dewan Shahida Banu ◽  
Mahmuda Khatun ◽  
Fatima Dolon ◽  
Mahmuda Nahar ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Intraoperative Complications ◽  
Tertiary Care ◽  
Demographic Factors ◽  
Emergency Caesarean Section ◽  
Care Hospital ◽  
College Hospital ◽  
Medical College ◽  
Emergency Caesarean ◽  
Socio Demographic Factors

Background: Socio-demographic factors are related with the need of emergency obstetric care.Objectives:  The purpose of the present study was to see the socio-demographic characteristics of emergency caesarean section.Methodology: This cross-sectional of study was conducted in the Department of Obstetrics and Gynaecology at Dhaka Medical College, Dhaka from the duration July 2006 to December 2006 for a period of six (6) months. The pregnant women underwent emergency caesarean section admitted at Dhaka Medical College Hospital during the mentioned period of the study were my study population. The cases were selected from the patients who got admitted at obstetrics ward of DMCH with an indication of emergency caesarean section with stable general condition at that moment. Every 10th patient was selected for the study. Data has been collected after taking written consent from the patients as per consent form. Then a thorough history, clinical examination was done and information were collected. Intraoperative complications such as haemorrhage, cardiac arrest were noted.Result: The study was performed on 100 cases of which 35(35.0%) emergency caesarean section cases belonged to the age group of 20 to 24 years and 56.0% were from lower socio economic class. Among them 42.0% of the cases of emergency caesarean section had education SSC and above level; furthermore 12.0% were illiterate. In addition 92.0% cases were house wife.Conclusion: In conclusion young house wives from lower socio economic status are mostly underwent emergency caesarean section.Journal of Current and Advance Medical Research 2017;4(1):23-26

In pregnant bitches, is elective caesarean section more effective than vaginal delivery at improving puppy survival?

2020 ◽  
Vol 5 (3) ◽  
Author(s):  
Mullika Borisoot
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Research Question ◽  
Elective Caesarean Section ◽  
Emergency Caesarean Section ◽  
Clinical Expertise ◽  
Bottom Line ◽  
Safe Delivery ◽  
Definitive Answer ◽  
Emergency Caesarean

PICO question In pregnant bitches due to whelp, is elective caesarean section more effective than vaginal delivery to improve puppy survival?   Clinical bottom line Category of research question The category of the research question is regarding the incidence of puppy mortalities as a result of vaginal delivery, emergency caesarean section and elective caesarean section. The number and type of study designs reviewed Two retrospective articles were reviewed and critically appraised; one retrospective study with high single canine breed bias and one study on different canine breeds but limited support in directly answering the PICO question. Strength of evidence The studies selected both had strong uses of experimental designs but together provided weak evidence to determine a definitive answer to the PICO question. Outcomes reported The outcomes from both retrospective studies suggests that the mortality rates of newborn puppies can be reduced if pregnant bitches are scheduled ahead for elective caesareans, in comparison to undergoing an emergency caesarean section when complications develop, particularly in breeds with higher risks of dystocia. Therefore, there is some evidence to support that it may be advantageous to consider the breed, age and overall health of the bitch during pregnancy to determine whether elective caesarean sections, for the safe delivery of puppies, should be considered. Conclusion There are currently insufficient studies, literatures and evidence in veterinary medicine for caesarean sections to become a routine procedure in first opinion practices. Future prospective studies should be conducted and include the optimum anaesthetic protocols with the lowest associated risks for the pregnant bitch and puppies.   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

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