scholarly journals Changing trends in indication of cesarean section in a tertiary care centre of Central India

2017 ◽  
Vol 6 (7) ◽  
pp. 2829 ◽  
Author(s):  
Pooja Patil ◽  
Malini Bhardwaj ◽  
Priyanka Sharma ◽  
Garima Chandrakar
Keyword(s):  
Cesarean Section ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
Central India ◽  
Fetal Distress ◽  
Tertiary Care Centre ◽  
Main Indication ◽  
Drastic Increase ◽  
Fetal Scalp ◽  
Failed Induction

Background: This study was carried out to find the rate of Cesarean section (CS) in our institute from 2012 to 2016 and also to find any change in the indications of CS over these five years.Methods: A retrospective analysis of data was done from the records of the patients who underwent CS and the rate of Cesarean section and the indications were noticed.Results: The rate of Cesarean section has increased from 43.85% in 2012 to 48.18% in 2016. There is increase in the number of Primary Cesarean cases from 61.8% in 2012 to 68.4% in 2016.The percentage of Elective CS has increased in last five years from 10.2% in 2012 to 23.6% in 2016 which is due to the drastic increase in Elective Repeat CS from 13.3% in 2012 to 43.4% in 2016. The first and second major indication of Primary CS over the years remained the same i.e. fetal distress and CPD. Other major contributing indications were Non-progress of labour, failed induction and Malpresentation. Oligohydraminos and IUGR, Multiple pregnancy and precious pregnancy have emerged as the major indication in last three years. Previous CS and Previous 2 CS contributed as the main indication for Elective CS.Conclusions: The rate of Cesarean section need to be reduced. The overall main indication for CS was Previous CS and thus Primary CS rate should be reduced. Fetal distress being the main indication for Primary CS should be further confirmed by fetal scalp pH findings and Repeat CS cases should be given more trial of labour.

scholarly journals Analytical study on indications of primary cesarean section in tertiary care hospital

2019 ◽  
Vol 8 (8) ◽  
pp. 3179
Author(s):  
Arpitha S. Ballu ◽  
Asha M. B.
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Tertiary Care ◽  
Previous History ◽  
Fetal Distress ◽  
Tertiary Hospital ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Failed Induction

Background: Cesarean delivery is a commonest obstetric surgical procedure performed. WHO stated that regional cesarean section rate should not exceed 10 to 15%. However in many countries cesarean delivery has increased steadily over years. Hence present study is conducted to analyze various indications of primary cesarean section in a tertiary hospital, with an aim to reduce cesarean section rate.Methods: This is a retrospective study conducted in Cheluvamba hospital, Mysore Medical College Research Institute, Mysore, which is a tertiary care centre. For a period of 6months from 1st June 2018 to 31st November 2018Inclusion criteria: All primary cesarean section done at Cheluvamba hospital during study period were included.Exclusion criteria: Previous cesarean section, patients with previous history of laparotomy done for any obstetric or gynecological cause were excluded.Results: During the study period there was 3799 number of cesarean section. Amongst these 983 cases were primary cesarean section done for varying indications. Hence the rate of cesarean section in our hospital is 25.87%. There were 40.3% cases of fetal distress, failed induction (13.6%), breech (10%), CPD (8%), IUGR with poor BPP (1.8%) Ante partum haemorrhage (3%), DTA (3.5%).Conclusions: From our study, we would conclude that rising trend in cesarean section is an alarming issue. Measures need to be taken to reduce cesarean delivery like Regular use of partograph, Judicious use of amniotomy, oxytocin with inducing agents, Expertization of skills to conduct instrumental vaginal delivery, which is a lost art in modern obstetrics.

scholarly journals THE RATE AND INDICATION OF CAESAREAN SECTION IN A TERTIARY CARE CENTRE

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Urvashi Kumawat ◽  
Neeta Natu
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Tertiary Care ◽  
Fetal Distress ◽  
The Elderly ◽  
Elderly Age ◽  
Tertiary Care Centre ◽  
Live Births ◽  
Cesarean Births ◽  
History Of

Method: The rate of caesarean section was only slightly higher than recommended by the WHO. Most of caesarean sections were emergency caesarean sections. Data on all live births were collected, including type of delivery, and indication was recorded if cesarean section was done. Total, primary, & repeat cesarean section rates were calculated for each year. The cesarean rate was calculated as the number of cesarean births divided by total live births. The rate for each indication was calculated annually as the number of cesarean births performed for each indication per 1,000 live births.   Result: These two groups constituted nearly 87.7% of total C-Sections. Only 3.4% of the cases belonged to the elderly age group of above 35 years. Maximum no. of caesarean sections was in multiparous females (54.3%).  Out of 550 caesarean deliveries 76.7% were from urban area. Also, result showed that only 68.7% were booked for antenatal care. Conclusion: The rate of cesarean section has increased with time with primary and repeat cesareans both showing an increase. In the primary CS rate, indications like labor arrest disorders & fetal distress show an increase more than the objective indications like malpresentation. In repeat CS, history of 02 or more previous sections & scar tenderness contributed more than the fetal distress. Keywords: Indication, Caesarean

scholarly journals Cesarean Section Among all Deliveries in a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (241) ◽  
pp. 839-843
Author(s):  
Renuka Tamrakar ◽  
Sachin Sapkota ◽  
Deekshanta Sitaula ◽  
Rohit Thapa ◽  
Bandana Pokharel ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Care Centre ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Cesarean Deliveries

Introduction: Worldwide there is a tremendous increase in cesarean section rate over the last decades which has been a global public health issue. This study aimed to find out the prevalence of cesarean delivery in a tertiary care center of Nepal. Methods: A descriptive cross-sectional study was conducted among pregnant women at tertiary care centre from 15th September 2019 to 15th October 2020. Ethical clearance was taken from the Institutional Review Committee (Ref: CMC-IRC/077/078-200). Convenience sampling was done to reach the sample size. Basic demographic data, clinical indications and neonatal outcomes were noted. Data entry was done using Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 3193 total deliveries, cesarean deliveries were 1412 (44.22%) at 95% Confidence Interval (42.49-45.94). Among caesarean deliveries 1086 (76.9%) were emergency cesarean sections. Most common indication for cesarean section was fetal distress (24.9%). Among 1437 newborns, 1428 (99.4%) were live births, 1387 (98.2%) were singleton and 801 (55.7%) were male. Nearly one third 418 (29.1%) neonates required neonatal intensive care unit admission and transient tachypnoea of newborns (44.28% in emergency and 60.46% in elective cesarean delivery) was the most common indication for admission. Conclusions: The prevalence of cesarean delivery was found to be higher than that recommended by the World Health Organisation. Fetal distress was the leading indication for cesarean deliveries.

scholarly journals A cross sectional observational study to evaluate the maternal and fetal outcome in postdated pregnancies

2020 ◽  
Vol 10 (1) ◽  
pp. 159
Author(s):  
Ritika Narayan ◽  
Sheela S. R.
Keyword(s):  
Observational Study ◽  
Cesarean Section ◽  
Tertiary Care ◽  
Significant Risk ◽  
Fetal Distress ◽  
Perinatal Complications ◽  
Tertiary Care Centre ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Increased Risk

Background: Post-dated pregnancy is when the gestation is more than 40 weeks or 280 days. They last longer than the estimated date of delivery. Postdated pregnancies are associated with increased perinatal and maternal complications. These risks are greater than it was originally thought. Risks have been underestimated in the past leading to increasing number of complicated postdated pregnancies which appears to be otherwise low risk. The maternal risks are very often underappreciated resulting in increased maternal morbidity.Methods: This cross sectional observational study was done to evaluate maternal and fetal complications associated with Postdated pregnancies was carried out in the department of obstetrics and gynecology in a tertiary care centre, Sir Devraj Urs Medical College and RL Jalappa Hospital, Kolar between July 2018 and July 2019, fulfilling all the inclusion and exclusion criteria.Results: 50 out of 100 patients had full term normal deliveries where as 45% patients required cesarean section. Most common indication for cesarean section was meconium stained liquor with fetal distress (25%). 42% of the babies born needed NICU admission. Most common maternal complication seen was Postpartum Hemorrhage.Conclusions: The present study we conclude that postdated pregnancy was associated with significant risk of perinatal complications such as fetal distress, meconium aspiration syndrome and IUGR. There was increased risk of obstetric complications as well like atonic PPH, oligohydramnios, obstructed labor.

scholarly journals Incidence and perinatal outcome of multiple pregnancy in a tertiary care centre in Central India

2018 ◽  
Vol 7 (5) ◽  
pp. 1912
Author(s):  
Nutan Yadav ◽  
Madhuri Alwani ◽  
Ankita Singh
Keyword(s):  
Pregnant Women ◽  
Perinatal Outcome ◽  
Post Partum ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
Central India ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Common Indication

Background: The incidence of multiple pregnancy is increasing all over the world because of assisted reproductive technology or spontaneously as a result of numerous risk factors. The objective of this study was to study the perinatal outcome of multiple pregnancy in a tertiary care centre in central IndiaMethods: It is a prospective study total 2289 pregnant woman were enrolled. Out of which 72 pregnant women were either a twin or triplet. 2217 pregnant women were singleton and had acted as controls. Perinatal outcomes including perinatal morbidity and mortality in relation to history regarding any complication in the present pregnancy were noted and analyzed.Results: In case of multiple pregnancy 90.2% were conceived between 20-30 years of age and 9.8% more than 30 years.13.9% cases of multiple pregnancy were less than 34 weeks at the time of delivery. The IUGR in multifetal pregnant patient was significantly higher. Oligohydromnios was seen in 3 out of 72 multifetal gestation which accounted for 4.1%. The proportion of singleton and multiple pregnant females who had anemia during pregnancy was 92.33% and 91.67%. Most common indication of LSCS in multifetal gestation is abnormal presentation during labour accounting for 41.7% of LSCS. The most common indication for NICU admission in case of multifetal pregnancy was 80.8%.Conclusions: Majority of the twin pregnancy is high risk one, and as such all twin preganancies should have mandatory hospital delivery. Early diagnosis, antenatal, intra-natal and post-partum cares are necessary to improve the outcome.

scholarly journals Emergency obstetric hysterectomy: experience at a tertiary care centre in Central India

2019 ◽  
Vol 8 (8) ◽  
pp. 3280
Author(s):  
Jayashree Mulik ◽  
Tanvi Vibhute
Keyword(s):  
Cesarean Section ◽  
Uterine Rupture ◽  
Placenta Previa ◽  
Post Partum ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Central India ◽  
Tertiary Care Centre ◽  
Study Centre ◽  
Labour Room

Background: Obstetric hysterectomy is an important procedure in modern obstetrics and its proper indications, risks and complications need to be studied for judicious usage and improvement in outcome.Methods: A retrospective, record-based study was carried out over one and a half years at a tertiary care government hospital. All the patients who underwent emergency obstetric hysterectomy at the study centre during study period were studied. Labour room register, operation room register for emergency and elective cases, case records, referral slips and mortality register data were reviewed for the same and outcomes analysed.Results: Total 33 patients underwent emergency obstetric hysterectomy, with the incidence observed at 0.21%. The most common indications were atonic post-partum hemorrhage (42.4%), uterine rupture (33.3%) and morbidly adherent placenta (18.1%). Prior cesarean section (36.4%) and placenta previa (15.1%) were the commonest predisposing factors associated with PPH and uterine rupture. Subtotal hysterectomy (66.7%) was observed to be the preferred type of surgery. Out of total 7 maternal deaths that occurred, 4 (57%) were because of disseminated intravascular coagulation.Conclusions: There is increasing trend in the rate of obstetric hysterectomy along with rise in rate of previous LSCS, emphasizing the importance of the mode of delivery. Measures to reduce the rate of primary cesarean section are advisable.

scholarly journals Prelabour Rupture of Membranes: Mode of Delivery and Outcome

2015 ◽  
Vol 3 (2) ◽  
pp. 237-240 ◽  
Author(s):  
Vlora Ademi Ibishi ◽  
Rozalinda Dusan Isjanovska
Keyword(s):  
Cesarean Section ◽  
Mode Of Delivery ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Maternal Complications ◽  
Cephalopelvic Disproportion ◽  
Cesarean Section Delivery ◽  
Clinical Center ◽  
Failed Induction ◽  
The University

BACKGROUND: Pre-labour Rupture of Membranes (PROM) is an important cause of maternal and fetal morbidity and increased rate of cesarean section delivery. AIM: The aim of this study is to investigate the clinical characteristics, PROM-delivery interval, mode of delivery, and early maternal neonatal outcome among pregnant patients presenting with pre-labour rupture of membranes.MATERIAL AND METHODS: This prospective case control study is implemented at the Obstetric and Gynecology Clinic of the University Clinical Center of Kosovo. The study included 100 pregnant patients presenting with prelabour rupture of membranes of which 63 were primigravida and 37 patients were multigravida.RESULTS: The incidence of cesarean section in this study is 28 % and the most common indications for cesarean delivery were fetal distress, malpresentation, cephalopelvic disproportion, and failed induction. The most common maternal complications in this study are chorioamnionitis, retained placenta and postpartum hemorrhage. Neonatal infectious morbidity was present in 16 % of cases.CONCLUSION: PROM is a significant issue for obstetricians and an important cause of maternal and neonatal morbidity and increased rate of cesarean section delivery.

scholarly journals To study pattern of obstetric cases referred at tertiary care centre in Central India

2017 ◽  
Vol 6 (6) ◽  
pp. 2370
Author(s):  
Prakriti Goswami ◽  
Jyoti Bindal ◽  
Niketa Chug
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Central India ◽  
Maternal Outcome ◽  
Child Health Services ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Common Diagnosis ◽  
Mode Of Transport

Background: Maternal morbidity and mortality remains a major challenge to health systems worldwide. Referral services for identification and referral of high risk pregnancies are an integral part of maternal and child health services. Timeliness and appropriateness of referral are challenge to obstetricians, since delay in referral affects maternal outcome adversely, hence the identification of at risk patients and obstetric emergencies and their timely referral is of immense importance. The aim of this study was to review the pattern of obstetric cases referred to tertiary care centre, to identify their clinical course, mode of delivery and maternal outcomes.Methods: It was prospective observational study carried out from January 2015 to July 2016. Study population was all Obstetrics patients referred to Department of Obstetrics and Gynecology of Kamla Raja Hospital, G.R. Medical College, Gwalior, Madhya Pradesh, a tertiary care centre during the study period.Results: The total number of referred cases in above study period was 4085.The proportion of referred cases in the tertiary care hospital was 20.86%. Mode of transport used by the referred patients were hospital ambulances (38%) and private vehicles (62%). Most common diagnosis at the time of referral was anaemia (27.8%). Out of the total referred cases, 48% had vaginal delivery (either spontaneous or induced), 28% had caesarean section and 24% were managed conservatively. Hypertensive disorders (25.4%) constitutes the leading cause of maternal deaths amongst the referred cases.Conclusions: Peripheral health care system needs to be strengthened and practice of early referral needs to be implemented for better maternal outcome.

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