scholarly journals Increasing rates of cesarean section, an upcoming public health problem: an audit of cesarean section in a tertiary care center of North India based on Robson classification

Author(s):  
Vinita Das ◽  
Namrata Kumar ◽  
Varsha Kumari ◽  
Anjoo Agarwal ◽  
Amita Pandey ◽  
...  

Background: Increasing rates of cesarean section during last three decades has become a cause of alarm since and a need for ongoing studies. Objective of present study was to investigate cesarean section rates as per modified Robsons Criteria and to determine area of concern which requires maximum focus to decrease overall caesarean rateMethods: This cross sectional study was conducted over a period of one year (From January 2016 to December 2016) in the Department of Obstetrics and Gynecology at King George’s Medical University, Lucknow.Results: Total number of deliveries for one year was 8526. Out of them, 4275 (50.1%) were vaginal and 4251 (49.9%) were abdominal. Overall maximum caesarean section rate was contributed by group 5 of modified Robsons criteria i.e. previous section, singleton, cephalic, ≥37 weeks (17.7%).Conclusions: Robson 10 group classification provides easy way in collecting information about Cesarean section rate which obtains good insight into certain birth groups. It is important that efforts to reduce the overall CS rate should focus on reducing the primary CS rate (group 1 and 2) and on increasing vaginal birth after CS (group 5). The caesarean rate is commonest in group 5 that is previous section (17.7%).

Author(s):  
Priyanka Kolusu ◽  
Palutla Himabindu

Background: High caesarean birth rates are an issue of international public health concern. Worries over such increases have led the WHO to advice that caesarean section rate should not be more than 15%. WHO proposes that the health care facilities to use the Robson’s 10 group classification system to audit their CS rates. Our aim was to investigate the CS rates in a period of 6 months using Robso’s 10 group classification.Methods: This was a cross sectional study conducted for a period of 6 months from July 2018 to December 2018 in Department of Obstetrics and Gynecology, Siddhartha medical college which is a tertiary care center .All women delivered during this period in labour ward were included. All relevant obstetric information (parity, mode of previous deliveries, previous CS and indications, gestational age, onset of labor) was entered on a questionnaire and classified into Robson’s 10 classes and percentages were calculated.Results: Total number of deliveries in 6 months is 4719 out of which C-sections are 1816 which accounts for 38.48%. Highest contribution was by group 5 and group 2. Together these two groups contribute to 62.4% of the total caesarean sections. Group 6 and group 9 by themselves did not contribute much but within their groups had 100% C-section rates.Conclusions: Robson’s 10 group classification provides easy way in collecting information about caesarean section rate which obtains good insight into certain birth groups. Number of women who attempt VBAC has declined over recent years due to fear of uterine rupture. Reducing primary C-section rates, adequate counseling and changing norms for non-reassuring fetal status could reduce contribution of Robson’s groups towards absolute C-section rates.


Author(s):  
Djiguemde Nebnomyidboumbou Norbert Wenceslas ◽  
Lankaonde Martin ◽  
Savadogo-Komboigo B. Eveline ◽  
S. I. B. Sansan Rodrigue ◽  
Ouedraogo Wendlassida Estelle ◽  
...  

Background: Objective was to study the indications and the prognosis of cesarean section in the obstetrics and gynecology department of CHR Koudougou from August 1st to October 16th 2018.Methods: This was a cross-sectional study for descriptive purposes with prospective collection of data over the month and monitoring of parturients up to the 42nd day post caesarean section. The study covered the period from August 1 to October 16, 2018. Gestures received in the work room and those hospitalized for a scheduled cesarean were involved in this study.Results: This study involved 316 deliveries. The caesarean section rate was 34.8% (n=110). The average age was 26.75 years with extremes of 12 and 42 years. Term pregnancies represented 90.9%. History of cesarean section was observed in 47, 3%. The main groups contributing to the caesarean section rate represent: Groups 5 (9.5%), Group 1 (9.2%), Group 3 (5.1%), the scar uterus (17.3%) and suffering fetal (14.6%). The reported complications were 15.5% including 3.6% parietal suppuration and 0.8% stillbirth.Conclusions: The caesarean section occupies an important place in the maternity service of the RHC of Koudougou. Robson's group 5 was the largest contributor to the overall cesarean rate in our study. Measures should be taken in this group so that the uterine scar does not become an absolute indication for cesarean.


2020 ◽  
pp. 1-2
Author(s):  
Deepak Abrol ◽  
Anuj Kapoor ◽  
Pawan Kumar

Introduction:Cancer is an important public health problem in India, with 10 lakh new cases occurring every year in the year. Cancer pattern varies in different regions and depends on genetic, environmental, dietary, social and other factors. Aim and objectives: This study was undertaken to determine magnitude and pattern of cancer cases reporting in the hospital. Methodology: This was a hospital-based retrospective study undertaken in the Government Medical College Kathua. GMC, Kathua is one among st the ve new medical colleges established in Jammu & Kashmir. The records of cancer patients generated from 1st November 2018 to 1 November 2019 were analyzed. All the cancer cases who reported either for diagnosis in any of the hospital OPD or for the treatment (radiotherapy/ chemotherapy/ surgery) were included. Data was entered in the MS Excel for analysis Results: Out of total 272 patients registered, females accounted for 56.6% and males for 43.3%. Hindu patients were in majority (84.2%). Most of the cases (37.1%) were in the age group 60-80. Pattern of cancer was different in the two sexes. In males, maximum cases were of lung cancer and in females, Ca breast was the most common followed by the cervical cancer Conclusion: This hospital-based study indicates the cancer prole in Kathua district. Females were found to be more affected than that of males with majority of the cases in the late 40s age group. Rural area and urban area distribution was found to be almost similar.


2021 ◽  
Vol 19 (2) ◽  
pp. 44-48
Author(s):  
Sushil Paudel ◽  
Niraj Parajuli ◽  
Sudip Dahal ◽  
Sudarshan Paudel

Introduction: Sexually transmitted infections (STIs) are the diseases that are transmitted by sexual contact if a partner is infected with agent known to cause infection of genitalia. This group of diseases pose a huge public health problem. This study aims to provide an insight on the prevalence of STIs in a tertiary care center dedicated to civil servants. Methods: This is a retrospective cross-sectional study. All patients diagnosed with STI in a dermatology out-patient of Civil Service Hospital, a tertiary care hospital situated in Kathmandu over a period of two years from January 1 2018 to December 30 2019 were included in the study. The diagnosis was made by clinical and laboratory investigations. Results: The total number 157 cases of STIs were enrolled in this study, of which 119 (75.8%) were males and 38(24.2%) were females. The mean age of patients was 27.8±8.8 years, ranging from 15 to 60 years. Seventy three (46.5%) patients were married, while 81 (51.6%) patients were unmarried. Unmarried males were significantly more vulnerable to acquire STIs (p=0.005). Males were having significantly more premarital or extramarital sexual exposures as compared to females (p<0.001). The most common presentation was condyloma acuminata in 84(53.5%) patients. Consistent use of condom was reported only in 3 (2.5%) males and 1 (2.6%) females in this study. No association was noted between the education level attained to the practice of safe sexual methods (p=0.535). Conclusion: The proportion of males was higher than females in our study which might be due to the reluctances of female to see doctor for sexual problems. The level of education did not seem to make people aware of practicing safe sex. Sexual education seems must in all level of education.


2021 ◽  
Vol 87 ◽  
pp. 341-347
Author(s):  
Vishal Gupta ◽  
Deepika Yadav ◽  
Sujata Satapathy ◽  
Ashish Upadhyay ◽  
Soniya Mahajan ◽  
...  

Background: Lichen planus pigmentosus can have a negative impact on the quality of life; however, this has not been studied in detail. Objectives: To study the quality of life in patients with lichen planus pigmentosus and compare it with patients with vitiligo and melasma. Methods: This was a cross-sectional study conducted in a tertiary-care center in north India from January 2018 to May 2019. Patients ≥ 18 years of age with lichen planus pigmentosus (n = 125), vitiligo (n = 113) and melasma (n = 121) completed the Dermatology Life Quality Index (DLQI) questionnaire and answered a global question on the effect of disease on their lives. In addition, patients with vitiligo completed the Vitiligo Impact Scale (VIS)-22 questionnaire, while those with lichen planus pigmentosus and melasma filled a modified version of VIS-22. Results: The mean DLQI scores in patients with lichen planus pigmentosus, vitiligo and melasma were 10.9 ± 5.95, 9.73 ± 6.51 and 8.39 ± 5.92, respectively, the difference being statistically significant only between lichen planus pigmentosus and melasma (P < 0.001). The corresponding mean modified VIS-22/VIS-22 scores were 26.82 ± 11.89, 25.82 ± 14.03 and 18.87 ± 11.84, respectively. This difference was statistically significant between lichen planus pigmentosus and melasma, and between vitiligo and melasma (P < 0.001 for both). As compared to vitiligo, patients with lichen planus pigmentosus had a significantly greater impact on “symptoms and feelings” domain (P < 0.001) on DLQI, and on “social interactions” (P = 0.02) and “depression” (P = 0.04) domains on VIS-22. As compared to melasma, patients with lichen planus pigmentosus had significantly higher scores for “symptoms and feelings,” “daily activities,” “leisure” and “work and school” domains of DLQI, and all domains of VIS-22. Female gender was more associated with impairment in quality of life in patients with lichen planus pigmentosus, while lower education, marriage, younger age and increasing disease duration showed a directional trend. Limitations: Use of DLQI and modified version of VIS-22 scales in the absence of a pigmentary disease-specific quality-of-life instrument. Conclusion: Patients with lichen planus pigmentosus have a significantly impaired quality of life. The psychosocial burden of lichen planus pigmentosus is quantitatively similar to that of vitiligo, but significantly greater than melasma.


Author(s):  
Abdulaziz Abdullah Alkathiry

Introduction: Several factors have been identified to influence concussion. Migraine has been identified as a common symptom reported after concussion which has been related to a worse prognosis. Concussion is a common brain injury that affects physical and cognitive performance. While several studies indicated that adolescents are more likely to develop concussion, in the last decade concussion has been mainly explored in adults. Aim: To investigate the effect of migraine on functional performance and self-reported symptoms in children with concussion. Materials and Methods: This cross-sectional study involved 35 symptomatic children with concussion aged 9-17 years recruited within one year from their concussion injury at a tertiary care center in Pittsburgh, PA, Unites States of America. Participants’ symptoms and functional performance were assessed using the Postconcussion Symptoms Scale (PCSS) and the Functional Gait Assessment (FGA) respectively. Statistical Package for the Social Sciences (SPSS) Statistics for Windows (version 22; IBM Corp, Armonk, NY) was used for all statistical analysis. Results: Mann-Whitney U Test showed that concussed children with migraine had significantly worse symptoms of fatigue and visual problems (p <0.05). The mean age of participants were mean age of 14.03±2.47 years and 66% were females. Conclusion: Although concussed children with and without migraine didn’t show any differences on functional performance, worse fatigue and visual symptoms were found in concussed children with migraine.


Author(s):  
Anjum Farhana ◽  
Shoaib Khan ◽  
Reyaz Khan ◽  
Umara Amin

Aims: To find out the prevalence, predominant risk factors and various clinico-demographic variables among patients infected with SARS-CoV-2 during the first year of the pandemic. Study Design: Hospital based, cross sectional study. Place and Duration of Study: Postgraduate department of Microbiology, Government Medical College, Srinagar, and associated hospitals, between March 2020 and March 2021. Methodology: Individuals with acute respiratory infection (ILI and SARI), high risk contacts and asymptomatic close contacts of COVID-19 positive patients, hospitalized patients dated for surgeries, pregnant women near expected date of deliveries, travellers were screened. A confirmed case of Covid-19 was defined as a positive result on real-time RT-PCR assay of nasopharyngeal and or Oropharyngeal swab specimens. A total of 2,17,665 samples were collected and processed over a period of one year. Results: Out of 2,17,665 samples, 61.3% were males and 38.7% were females, overall mean age was 34.3 years. 24,009 (11%) tested positive for SARS-CoV-2 infection, among them 63.5% were males while 36.5% were females, the mean age observed was 35.3 years. Highest positivity was observed in the age group of 30 – 39 years (22%), followed by 20 -29 years (20.4%), 12 (0.1%). Among positive cases, 19.4% had a history of contact with a lab confirmed case of SARS-CoV-2, 4.3% were HCW’s and 2.6% were pregnant females. 929 (3.9%) patients who tested positive had presented with SARI. Fever was the most common symptom (62%), followed by cough (41%) and fatigue was reported by 37% patients. Comorbidities were present in 23.2% patients, of which Hypertension 10.8% was the most common, followed by COPD 4.9% and Diabetes mellitus 4%. Conclusion: As evident from our study, COVID-19 has a high positivity (11%) in our region, with males twice more likely susceptible than females. High percentages (62%) of people were symptomatic at presentation, while severe disease was seen in only 3.9% patients. Early aggressive testing is essential to decrease the morbidity and mortality rates associated with COVID-19.


2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Khadija Murtaza ◽  
Madeeha Chaudhry ◽  
Shabana Nazeer ◽  
Sajid Malik

Objective: This study was aimed to elucidate the prevalence-pattern and determinant of cesarean section (CS) in a multiethnic cohort from Pakistan. Methods: Through a cross-sectional study design, women delivering at a tertiary care center were recruited during 2013-2017. Data on socio-demographic variables, obstetric complications and birth outcome were obtained. Descriptive statistics, bivariate and multivariate logistic regression analyses were performed. Results: A total of 5,275 pregnant women were recruited and 43% of the deliveries underwent CS. Odds of CS were significantly higher in subjects originating from Azad JammuKashmir and Sindh regions, speaking Potohari and Pahari languages, women in advance ages, and those who were housewives. CS had significantly lower odds of prenatal mortality but increased odds of postnatal mortality. Obstetric factors that appeared to be significant predictors of CS were multiparity, breech position, fetal distress, oligohydroamniosis, preeclampsia, and previous scar. Conclusion: This study revealed high variability in CS in various socio-demographic strata of study population. The obstetric complications highlighted in this study may be reduced by proper perinatal counseling and pregnancy monitoring and should be the focus of intervention programs as suggested in the Millennium Development Goals. doi: https://doi.org/10.12669/pjms.37.3.3186 How to cite this:Murtaza K, Chaudhry M, Nazeer S, Malik S. Prevalence-pattern and risk factors of Cesarean section in a multiethnic cohort. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3186 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 59 (236) ◽  
Author(s):  
Dhan Bahadur Shrestha ◽  
Ratna Khatri ◽  
Prakash Raj Oli ◽  
Rosy Malla ◽  
Cimona Shrestha ◽  
...  

Introduction: Cesarean section is a common obstetric procedure which is done to reduce complications in high risk pregnancies. The aim of study was to find out the prevalence of cesarean section in a maternity unit of a tertiary care center. Methods: A descriptive cross-sectional study was conducted among 497 pregnant women presenting in a maternity unit of a tertiary center of Kathmandu, Nepal over a period of six months from March to August 2017 after taking ethical approval from Institutional Review Committee (Ref. 24). In this study, the prevalence of cesarean section, perinatal outcome, maternal and neonatal complications if any were observed. Data and descriptive analysis were done using Statistical Package for the Social Sciences version 22. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: The prevalence of cesarean section was 171 (34.4%) at 95% Confidence interval (30.2-38.7). Most common indication for cesarean section was fetal distress 53 (31%). The maternal complications developed in 11 (6.4%) among those who delivered via cesarean delivery; Surgical Site Infection being the most common maternal complication. The neonatal intensive care unit admission rate among the newborns via cesarean section delivery was 48 (27.43%) and neonatal sepsis 14 (8%) was most common adverse neonatal outcome. Conclusions: The cesarean rate at the study center is higher than standard target rate of World Health Organization. Neonatal and maternal adverse outcome in current study were comparable with existing literatures.


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