scholarly journals A study of various cesarean section techniques at a government tertiary care centre: Misgav Ladach cesarean section versus Pfannenstiel cesarean section

2017 ◽  
Vol 6 (8) ◽  
pp. 3449
Author(s):  
Medha Kanani
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tertiary Care ◽  
Breech Presentation ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Pfannenstiel Incision ◽  
Emergency Cesarean ◽  
Post Operative Pain ◽  
Duration Of Surgery

Background: It is important to examine every step in any surgery to identify and evaluate its imortance, necessity and purpose with a view to find its better alternatives if they can be found at all. The most appropriate surgical procedure is the one which takes minimum time to be complete, simplest to perform, causing least damage and least complication for the patient. Present study was undertaken to assess the benefits of the Misgav Ladach cesarean section technique in comparison to the conventional Pfannenstiel technique in the tertiary care hospital and evaluate the operative parameters like efficacy, safety, duration of surgery, blood loss, need for suture material, post-operative pain and post-operative stay in hospital.Methods: All the women posted for emergency cesarean section in the Obstetrics OT at Sir T Hospital, Bhavnagar, Gujarat were included in this study. Some of the common indications at our hospital for cesarean section were fetal distress, cephalopelvic disproportion, failure of progress of labour, breech presentation, previous cesarean section and failed induction. Informed consent was taken. All the patients were randomly allocated to two groups with 50 women in each group. Group 1 Pfannenstiel incision and Group 2 Misgav Ladach.Results: The duration of surgery, blood loss and post-operative pain were significantly less in the Misgav Ladach group (P<0.001).Conclusions: Misgav Ladach technique of cesarean section has many advantages and should be used routinely.

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.

Coblation tonsillectomy: our experience as a day care procedure

2021 ◽  
Vol 7 (5) ◽  
pp. 764
Author(s):  
Kripamoy Nath ◽  
Ritu Gupta
Keyword(s):  
Blood Loss ◽  
Prospective Study ◽  
Day Care ◽  
Tertiary Care ◽  
Operating Time ◽  
Tertiary Care Centre ◽  
Post Operative Pain ◽  
Care Surgery ◽  
A Prospective Study ◽  
Care Procedure

<p class="abstract"><strong>Background: </strong>A prospective study to cite our experience in adult and pediatric patients undergoing coblation tonsillectomy. We emphasised on the intra operative and post operative morbidity in coblation tonsillectomy and its feasibility as a day care procedure.</p><p class="abstract"><strong>Methods: </strong>It is a prospective study done on both paediatric and adult cases presenting to our tertiary care centre between January 2018 to February 2020. Study was done to analyse operating time, intraoperative blood loss, post-operative pain, post-operative haemorrhage and post-operative return to home and normal diet.</p><p class="abstract"><strong>Results: </strong>114 cases were selected where bilateral tonsillectomy was performed using Coblation technique. 83 were adult patients and 31 paediatric. 56 were females and 58 males. 1 case presented with secondary haemorrhage, none with primary haemorrhage. No other complications were noted.</p><p class="abstract"><strong>Conclusions: </strong>Coblation tonsillectomy yielded good results in reference to patient morbidity and low complication rate. It turned out to be a success as a day care procedure. Short operating time, minimal blood loss, less post-operative pain specially in the early post-operative period, minimal chance of complication and short stay at hospital as a day care surgery, Coblation tonsillectomy stood out as a hands down winner in our study. In this fast paced life, where consumerism demands everything instant, coblation tonsillectomy as a day care procedure provides good alternative to the patient requiring tonsillectomy. yroidectomies.</p>

scholarly journals Maternal and Perinatal Outcomes of Singleton Term Breech Vaginal Delivery at a Tertiary Care Center in Nepal: A Retrospective Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Tulasa Basnet ◽  
Baburam Dixit Thapa ◽  
Dipti Das ◽  
Ramesh Shrestha ◽  
Sarita Sitaula ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Perinatal Mortality ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Care Hospital ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Emergency Cesarean

Background. Breech presentation is associated with increased rates of maternal and perinatal morbidity regardless of mode of delivery. After the results of Term Breech Trial, most of the countries adopted the protocol of cesarean section for term breech delivery because of which breech vaginal delivery is becoming rare. The aim of this study is to evaluate short-term maternal and perinatal outcomes of breech vaginal delivery at a tertiary care hospital in Nepal. Methods. A retrospective review of case records of all women who had vaginal breech delivery from April 13, 2016, to April 12, 2018, was conducted, over a period of two years. Available demographic variables, obstetric characteristics, details of labor, postpartum complications, and perinatal complications were recorded and analyzed. Results. Out of 21,768 cases of deliveries during the study period, the incidence of term breech deliveries was 528 (2.4%) among which the mode of only 84 (17.8%) deliveries was vaginal. Most of the deliveries were unplanned and were conducted because emergency cesarean section could not be performed. Three (3.6%) women had postpartum hemorrhage, and four (4.8%) had entrapment of aftercoming head, two of them requiring Dührssen incisions. Adverse perinatal outcomes were seen in 23.8% of such deliveries with <7 APGAR score at 5 minutes in 20.2%, neonatal admission in 17.7%, and perinatal mortality in 8.3%. The perinatal mortality was significantly associated with birthweight less than 2500 grams as compared to birthweight ≥2500 grams (21.1% versus 4.6%; P = 0.043 ). Conclusion. The perinatal outcomes for vaginal breech delivery are grave with our existing health facilities, especially when the deliveries are not well planned.

scholarly journals Clinical profile and outcome of COVID positive obstetric patients in a tertiary care hospital: a retrospective study

2021 ◽  
Vol 10 (9) ◽  
pp. 3352
Author(s):  
Asma Hassan Mufti ◽  
Samar Mukhtar ◽  
Mehmood-Ul-Hassan Mufti ◽  
Nasir Jeelani Wani
Keyword(s):  
Pregnant Women ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Clinical Profile ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Total Study Population ◽  
Emergency Cesarean ◽  
Neonatal Icu ◽  
Study Population

Background: To study clinical profile, maternal and fetal outcome in COVID positive pregnancies.Methods: A retrospective observational study was done at Lalla ded hospital, Kashmir, a tertiary care centre. 70 COVID positive pregnant women who were admitted from May 2020 to January 2021 were included in the study.Results: The incidence of COVID positive patients in our study was 11.47%. 60% of patients in our study belonged to 26-30 years age group. 50% patients were primigravida, 20% were second gravid. Among the study population, 31 (44.3%) patients were term while 22 (31.4%) were preterm. Most patients were asymptomatic (61.4%). Among symptomatic patients, maximum had fever (17.1%) followed by cough (10%) and shortness of breath (4.3%). Associated comorbidity was seen in 33 patients (47.1%). Hypertensive disorders of pregnancy were seen in majority i.e. 15.7%, followed by anaemia (11.4%), GDM (8.5%) and hypothyroidism (7.1%). Out of total study population of 70, emergency cesarean delivery (LSCS) was done in 29 patients (41.5%). 21 patients delivered vaginally (30%). Two post-LSCS patients were shifted to designated COVID Intensive care unit (ICU). One patient from the study group died. There were total of 50 deliveries, 10 babies had Neonatal ICU admission (20%), Low birth weight in 9 (18%). Low APGAR score was in 6 (12%). There were 2 stillbirths in the study population.Conclusions: COVID presents as milder disease in pregnancy, but it may be severe in those with associated comorbidities. More studies on susceptibility of pregnant women to infection by COVID-19 are required.

scholarly journals Comparative study of nondescent vaginal hysterectomy and abdominal hysterectomy at tertiary care centre, Maharashtra

2021 ◽  
Vol 10 (9) ◽  
pp. 3397
Author(s):  
Sharayu Prashant Mujumdar ◽  
Priyanka Kunal Purohit ◽  
Shwetambari S. Navale ◽  
Chintan M. Upadhyay
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Study Groups ◽  
Abdominal Hysterectomy ◽  
Economic Benefits ◽  
Tertiary Care Centre ◽  
Abdominal Incision ◽  
Operative Complication ◽  
Duration Of Surgery

Background: Vaginal route of hysterectomy has distinct health and economic benefits in terms of less morbidity, better postoperative quality of life outcomes, reduced hospital stay and better patient satisfaction. Objectives of current study were to evaluate the appropriate route of hysterectomy (abdominal or vaginal) in terms of intra and post-operative complication, morbidity and blood loss. Methods: This prospective study was done among 100 cases of hysterectomy of which 50 patients underwent NDVH and 50 underwent abdominal hysterectomy. This study included all emergency and booked patients having Size of uterus less than 12 weeks size, adequate uterine mobility, adequate access, adenomyosis, dysfunctional uterine bleeding, chronic PID & fibroid uterus.Results: Study found statistically significantly higher number of the participants with parity 3 & 4 in both the study groups. Bulky uterus followed by 12 and 10 weeks uterus in statistically significantly higher number of the participants of both the study groups. Duration of surgery statistically significantly less in NDVH group compare to TAH group. Fibroid was the main indication of hysterectomy in both the groups. Hemorrhage was the main intra-operative complication in both the groups. Fever & respiratory tract infection was the main post-operative complications in both the groups.Conclusions: Benefits of NDVH over TAH are Cosmetic advantage as less invasive, No discomfort of abdominal incision, shorter operative time, lesser blood loss, lesser intraoperative and postoperative complications, postoperative comfort is more, lesser requirement of postoperative analgesia, early ambulation and shorter hospital stay.

scholarly journals PLACENTA PREVIA;

2019 ◽  
Vol 26 (03) ◽  
Author(s):  
IFAT BALOCH ◽  
Naseem Bajari ◽  
Sabrina Talpur ◽  
Saima Naz Shaikh
Keyword(s):  
Cesarean Section ◽  
Placenta Previa ◽  
Tertiary Care ◽  
University Hospital ◽  
Elective Cesarean Section ◽  
Care Hospital ◽  
Obstetric Hemorrhage ◽  
Emergency Cesarean ◽  
Precise Diagnosis ◽  
Elective Cesarean

Objectives: To determine the maternal and fetal outcomes in patients presented with major degree of placenta previa at tertiary care Hospital. Study Design: Descriptive cases series study. Setting: Department of Gynaecology and Obstetrics of Liaquat University Hospital Hyderabad. Period: One year from March 2015 to February 2016. Subject and Methods: All patients with major degrees of placenta previa were included in study. Following delivery the examination of neonate was carried out thoroughly including congenital abnormalities, weight of baby and Apgar score. Babies and mothers were examined within postoperative wards till stitches removal and systematically examined for any postoperative complication. All the data was entered in the proforma. Results: Total 50 patients with major degrees of placenta previa were selected. Majority of the women 40% belonged to the age group of 30-35 years. Most of the women 92.0%, were symptomatic and presented with painless vaginal bleeding. Elective cesarean section was performed among 20% patients while 80% patients underwent emergency cesarean section. 70% patients delivered preterm and 30% delivered at term. 3(6%) fetals were still births and 1(2.0%) presented macerated still birth. 16% fetuses developed respiratory distress syndrome, 6% had intrauterine growth restriction and only one had congenital abnormality (spina bifida). Neonatal weight less than 2500-grams was among 90%. Perinatal mortality was 6(12.0%), and according to maternal outcome, mortality rate was low i.e. just 1 subjects passed away. Conclusion: Major degree of placenta previais a significant contributor of obstetric hemorrhage in 02nd and 03rd trimesterof pregnancy as well as it adversely correlates with feto-maternal outcomes. Instant moving the case of obstetric hemorrhage to hospitals, precise diagnosis, sufficient transfusion provision, intervention without delay can reduce the fetomaternal morbidity and mortality.

scholarly journals Clinical study of Misgav Ladach technique of caesarean section

2017 ◽  
Vol 6 (12) ◽  
pp. 5532
Author(s):  
Shrinivas N. Gadappa ◽  
Pratibha V. Dixit ◽  
Deepika Sharma ◽  
Yogita Gavit
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Suture Material ◽  
Tertiary Care ◽  
Operating Time ◽  
Individual Experience ◽  
Care Hospital ◽  
Section Technique ◽  
Duration Of Surgery ◽  
The Individual

Background: In the last decades caesarean section rates increased in many countries becoming the most performed intraperitoneal surgical procedure. The operative technique performed is made chiefly on the basis of the individual experience and preference of operators, the characteristics of patients, timing and urgency of intervention. Present study was undertaken to assess the benefits of the Misgav Ladach caesarean section technique in tertiary care hospital and evaluate the operative parameters like efficacy, safety, duration of surgery, blood loss, need for suture material, post-operative morbidity.Methods: Prospective surgical interventional study conducted in department of obstetrics and gynecology in tertiary care institute.Results: The duration of surgery, blood loss and post-operative complications were significantly less in the Misgav Ladach technique of LSCS.Conclusions: The choice of the Caesarean section technique is strictly linked to the individual experience and confidence of the surgical team. Misgav-Ladach technique proved to be associated to less complications, moreover, since its shorter operating time; it is to prefer in all that cases a prompt operation is required.

scholarly journals Total laparoscopic hysterectomy: an experience at a tertiary care hospital

2019 ◽  
Vol 8 (11) ◽  
pp. 4341
Author(s):  
Fatma M. Rentiya ◽  
Ajesh N. Desai
Keyword(s):  
Blood Loss ◽  
Prospective Observational Study ◽  
Tertiary Care Hospital ◽  
Demographic Data ◽  
Tertiary Care ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Safe Procedure ◽  
Care Hospital ◽  
Duration Of Surgery

Background: This study is aimed to review indications, demographic data of patients, clinical outcomes and safety of total laparoscopic hysterectomy.Methods: This is a prospective observational study of total 150 patients who underwent total laparoscopic hysterectomy (TLH) from 1st June 2017 to 30th November 2018 in GMERS Civil Hospital Sola.Results: ~45% patients were between 40-50 years age group; 60% patients had 2 or more deliveries; commonest indication was symptomatic adenomyosis ; uterine size in ~57% of patients were up to 6 weeks; duration of surgery in ~91% of patients <120 minutes; intraoperative blood loss in all cases <200ml; no intra-operative and postoperative complications were encountered.Conclusions: TLH is safe procedure with minimal blood loss, minimal postoperative pain and discomfort and shorter duration of hospital stay when performed via expert hands.

scholarly journals Assessment of Patient Satisfaction after Counseling by a Health Care Provider before Emergency Cesarean Section in a Tertiary Care Hospital

2017 ◽  
Vol 9 (1) ◽  
pp. 33-38
Author(s):  
Tehmina P Syed ◽  
Zakia Sheikh ◽  
Farah Hameed
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Cesarean Section ◽  
Health Care Provider ◽  
Care Provider ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean

ABSTRACT Introduction Patient satisfaction is one of the most frequently reported outcome measures for quality of health care. In recent years, effective counseling has become a very important tool to involve patient participation in decision-making. The objective of this study was to assess the patient satisfaction by the counseling of a health care provider before emergency cesarean section (C-section) in a tertiary care hospital. Materials and methods A descriptive cross-sectional questionnaire study of 53 women, who had their first babies by C-section or had C-section first time with previous normal deliveries, in Hamdard University hospital in 3 months. Data analysis Questionnaires were distributed among patients on their second postoperative day after emergency C-section. A good total response rate for patient satisfaction survey is in the 40 to 60% range. Statistical Package for the Social Sciences version 20 was used to analyze the data, patient satisfaction was analyzed by using descriptive statistics (%, frequency), and independent sample t-test and analysis of variance were applied to assess the satisfaction level for demographic indicators. Results Out of 53 women, 38 (71.7%) were satisfied with the counseling while 15 (28.3%) were dissatisfied; 35 (66%) were primigravida while 17 (32%) were multigravida. The majority was in the age group of 25 to 30 (41%) years; 21 (39.6%) were undergraduate, out of them 12 (55.2%) were satisfied; 32 (60.3%) were graduate, out of them 26 (82%0) agreed; 46 (86%) participants know their counselor; and 44 (83%) reported good attitude. A safe atmosphere was created by the counselor in 38 (71.7%) cases, and 24 (45%) participants reported that the counselor used medical jargons. Privacy was not maintained in 39.6%, and 18 (33.9%) reported negative feelings like anxiety and depression after their counseling. Conclusion Patient satisfaction is an important quality outcome indicator to measure success of the health care services. Evaluation of patient care is vital to provide opportunity for improvement like strategic framing of health plans. How to cite this article Syed TP, Sheikh Z, Hameed F. Assessment of Patient Satisfaction after Counseling by a Health Care Provider before Emergency Cesarean Section in a Tertiary Care Hospital. J South Asian Feder Obst Gynae 2017;9(1):33-38.

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