scholarly journals Indications and rate of caesarean delivery at tertiary care hospital: a retrospective study

Author(s):  
Reena Sharma ◽  
Poojan Dogra

Background: Worldwide there has been an increase in the rate of caesarean delivery due to multiple factors. Objective of the study was to assess the prevalence and different indications of caesarean section in this institute.Methods: The aim of the study is to analyse the rates and indications of lower segment caesarean section (LSCS) in our institution. We conducted a retrospective study over a period of six months; 1st September 2016 to 1st March 2017 at SLBSGMC Mandi at Nerchowk. Total number of patients who delivered in our hospital during the defined study period was recorded and a statistical analysis of various parameters was done.Results: The total number of women delivered over the study period was 2075, out of which caesarean sections (CS) were 473. The overall CS rate calculated was 22.8%. Previous LSCS was the leading indication to the CS rate.Conclusions: Routine obstetric audits should be done to analyse the various indications of emergency and elective caesarean sections so that protocols and guidelines can be implemented to curtail the increasing trend of caesarean delivery.

Author(s):  
Shruti A. Gavhane ◽  
Shilpa N. Chaudhari

Background: Caesarean section is one of the commonly performed surgical procedures in obstetrics. An increasing trend has been observed in both primary and repeat caesarean sections. The reasons for its increase are multifaceted. So, this study was carried out to compare the rates of caesarean delivery and to analyse various indications contributing to it.Methods: This retrospective study was conducted over a period of three year from 1st January 2016 to 31st December 2018 at the department of obstetrics and gynaecology, tertiary care hospital Pune, Maharashtra, India. All caesarean delivery (primary and repeat) taken place during the study period. The rate and indications of caesarean section was calculated over the study period to find out the trends in caesarean delivery. The data so collected was presented with graphical representation. Statistical analysis was performed with SPSS software and t-test was used for continuous data and pearson chi square test for discrete data.Results: There were a total of 12373 deliveries during the study period out of which, 3701 had delivered via Caesarean Section. So, the rate of caesarean section in the study was found to be 29.91%.Conclusions: Being a tertiary care hospital, a high rate of caesarean deliveries was observed, Individualization of the indication and careful evaluation, following standardized guidelines, practice of evidenced-based obstetrics and audits in the institution, can help us limit caesarean section rates.


Author(s):  
Merin Baby ◽  
Sruthi M. V.

Background: Caesarean section is a surgical procedure done when vaginal delivery is contraindicated. The prevalence of caesarean section in Kerala showing an increasing trend. Even though the caesarean section is an emergency lifesaving procedure, various other factors like socio-demographic determinants, economic factors and patient’s or clinician’s preferences also influence this increasing trend. The present study was undertaken to compare the various determinants of caesarean section with normal delivery from a tertiary care hospital in Thrissur district.Methods: A hospital-based case control study was done taking mothers who had undergone caesarean section as cases and mothers who had undergone normal delivery as controls during two-month period. The sample size was calculated using the formulae: (Zα + Zβ)2x2xPQ/d2, and the calculated sample size was 88. The various determinants used were socio-demographic, obstetrics and cultural determinants.Results: In this study, it was found that the most common indications for C-section were previous C-section, PPROM and foetal distress. There was a statistically significant association between obstetrics determinants like complications during pregnancy, number of USG taken, period of gestation with mode of delivery. The present study also shows that mothers with educational status up to graduate/PG have lesser incidence of caesarean section. There was a statistically significant association between delivery date close to holidays/festival days and C-section.Conclusions: It is necessary to have health awareness sessions to pregnant mothers about the complication of pregnancy, benefits of normal delivery and complications of C-sections in-order to reduce the patients’ preference for C-section.


Author(s):  
Meenakshi Tanwar ◽  
Anjali Choudhary ◽  
Shweta Mishra

Background: Induction of labour (IOL) is a very common labour room procedure. Although labor is a natural physiological process, deliberate intervention in the form of induction may be required in many instances. It is needed in almost 20% of pregnant women for a variety of indications. The objective is to evaluate indications, different methods, and feto-maternal outcome of induced labour in tertiary care hospital.Methods: This was a retrospective study of IOL conducted in the department of obstetrics and gynecology, Shri Guru Ram Rai institute of medical and health sciences, Dehradun, Uttarakhand. Women who underwent IOL beyond 28 weeks gestation with single cephalic presentation with no contraindication for vaginal birth were included in the study. Statistical analysis was done with Microsoft excel.Results: A total of 1532 women delivered in the hospital during the study period. Among them, 498 women were induced (32.5%). Most common method of induction was misoprostol (40.36%) followed by prostaglandin E2 gel (26.90%).  Out of 498 inductions, 377 women delivered vaginally making success of induction around 75.70%. Among them, 335 women had normal delivery (67.26%) and 42 women required instrumental delivery (8.4%) and 121 women underwent lower segment caesarean section (LSCS) (24.29%).Conclusions: Elective inductions of labor in properly selected indications at optimized timings aid in achieving a favorable maternal and fetal outcome. Methods of inductions, timing and intrapartum monitoring plays an important role in influencing obstetric outcome.


Author(s):  
Lata Rajoria ◽  
Manisha Kala ◽  
Nupur Hooja ◽  
Smriti Bhargava ◽  
Brijesh Dadhich

Background: Caesarean section is the most commonly performed obstetric surgery. A change in the operative technique affects the postoperative outcome. The study was undertaken to study the postoperative outcome of the patient who underwent caesarean section by Pfannensteil Kerr and Misgav Ladach method of lower segment caesarean section.Methods: It was a hospital based interventional study done in a tertiary care hospital over one year. Postoperative condition of the women was assessed after caesarean section in women with Pfannensteil Kerr and Misgav Ladach method and compared.Results: Most cases in the Misgav Ladach method had breast fed early, had quicker return of bowel activity and earlier ambulation in comparison to the Pfannensteil Kerr method. This difference was statistically significant. Women with the Pfannensteil Kerr method had more postoperative pain, nausea and vomiting. The duration of hospital stay was less in Misgav  technique.Conclusions: Since Misgav Ladach method was a better technique than Pfannensteil Kerr, adopting it routinely would result in considerable reduction in maternal morbidity, decreased hospital stay, better patient satisfaction level and more cost effective.


Author(s):  
Neelam Sharma ◽  
Anshul Jhanwar

Background: Lower Segment Caesarean section (LSCS) is recommended when vaginal delivery might pose a risk to the mother or baby. Worldwide rise in LSCS rate during the last three decades, has been the cause of alarm and needs an in-depth study.Methods: It was a retrospective, observational study conducted in Obstetrics and Gynecology department of Jhalawar medical college, Jhalawar. Data were obtained from medical record database of patients admitted for deliveries from October 2017 to March 2018 over period of six months. The total number of patients delivered and the number of LSCS done were counted to find the incidence of LSCS in our hospital. Age, parity and gestational age of the patients who underwent LSCS were tabulated.Results: In present study the incidence of LSCS was 31.1%. Of these cases 91% belonged to age group 20 -29 yrs. Emergency LSCS (72.1%) and primary LSCS (66.5%) were more common. The commonest indication of LSCS was previous LSCS in 35% followed by foetal distress, breech presentation, severe oligohydrominos and pre-eclampsia.Conclusions: In present study LSCS rate was high as compared to the WHO standard. The scheme like Janani Suraksha Yojana (JSY) may have a great impact on accepting institutional deliveries by poor women which may be a reason of the increase of LSCS in India. Utilization of antenatal care, better doctor patient communication, doctor’s commitment to reduce the rate of LSCS, may help to reduce the increasing rate of caesarean delivery.


Author(s):  
K. Rama Lingam ◽  
Hari Babu Ramineni ◽  
Shaik Gulshan Firdous ◽  
P. Yamuna ◽  
B. Madhuri ◽  
...  

Background: Post-operative infections in obstetrics and gynecological settings have been higher compared to other specialties. Women undergoing caesarean section have 5 to 20-fold greater risk for infection compared with vaginal delivery. Many studies reported antimicrobial prophylaxis prevent post-operative infections. Hence this study concentrates the evaluation of the prescribing antimicrobial use and to assess the frequency of post-operative morbidity related to infection in subjects undergoing caesarean section. The aim of the study was to analysis the effectiveness, prophylactic antibiotics (amoxicillin versus ceftriaxone) and to evaluate the post-operative (caesarean) infections in patients undergoing lower segment caesarean section (elective and emergency).Methods: This is a prospective observational study which assessed the effectiveness and use of prophylactic antibiotics in patients undergoing cesarean section at department of obstetrics and gynecology. The study was conducted over a period of one year.Results: The corresponding mean age of all the study population in amoxicillin group (n=113) was 56.5±28.5 and in ceftriaxone group (n=97) was 48.5±26.5 respectively. The participant who underwent previous cesarean section in amoxicillin group is 65.48% similarly in ceftriaxone group is 47.42%. The patients with fetal distress in ceftriaxone group are 14.77% and in amoxicillin group is 8.92%. Failed induction in amoxicillin group is 9.82% and in ceftriaxone group is 6.81%. The number of days in hospital stay in amoxicillin group is 42.42% and in ceftriaxone group is 45.94%. The post-operative complications in amoxicillin group reported, with Febrile Illness are 40% and wound Infection is 60%.Conclusions: Administration of pre-operative antibiotics significantly reduce post-operative infections. Use of ceftriaxone as a prophylactic antibiotic in patients undergoing lower segment caesarean section (elective and emergency) is more effective than Amoxicillin in preventing post-operative infections.


Sign in / Sign up

Export Citation Format

Share Document