scholarly journals Study of primary caesarean section in multigravida patients

2017 ◽  
Vol 7 (1) ◽  
pp. 185
Author(s):  
Neelam Rajput ◽  
Priyanka Singh ◽  
Yogendra Singh Verma
Keyword(s):  
Caesarean Section ◽  
Neonatal Mortality ◽  
Vaginal Delivery ◽  
Low Socioeconomic Status ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Normal Vaginal Delivery ◽  
Major Surgery ◽  
Medical Disorders ◽  
Number Of Patients

Background: Caesarean section is the most commonly performed major surgery among women. The aims and objective of this study was to know the incidence of primary Caesarean section in multigravidas, its indications and to know the maternal and foetal outcome among these patients.Methods: It was a prospective study of primary caesarean section in multigravida admitted at Kamla Raja Hospital, G.R. Medical College and J. A. Group of Hospitals, Gwalior (Madhya Pradesh, India) during the period of 1 year from September 2014 to August 2015. Multigravida with pregnancy of >28 weeks gestation (gravida 2 and above), each of whom has had a previous vaginal delivery of > 20 weeks gestation were included. Women with previous abortions and previous section and Pregnancy with medical disorders were excluded.Results: During the study period of one year, total 8185 deliveries occurred, out of which 3061 (37.39%) underwent caesarean section and 386 (12.61%) were primary caesarean section in multigravida. Out of these multigravida patients who underwent primary caesarean section- most of the patients were unbooked (77.72%). Majority of the cases were direct admission in the hospital (61.13%). Maximum number of the patients were in the age group of 25-30 years (55.95%). Two third of the patients were literate (69.44%) Maximum number of patients were Gravida 2 (49.72%). Almost all of them (95.85%) underwent emergency caesarean section. The most common indication for primary LSCS in multigravida patients was Malpresentation 115 (29.79%) followed by Fetal distress in 71 (18.39%) patients, APH in 71 (18.39%), Obstructed labour in 33 (8.55%), Severe preeclampsia and Antepartum eclampsia in 39 (10.1%), Twin pregnancy in 21 (5.44%). Most common maternal complication was pyrexia 40 (10.36%). Postoperative morbidity was 21.24% among unbooked, 14.25% in Referred, 23.58% in those operated as an emergency, 12.43% in patients belonging to of low socioeconomic status and 3.88%, in patients with moderate to severe anemia. Birth asphyxia was found in 6.21% of neonates. Neonatal mortality was 2.33%. Neonatal mortality is more in Unbooked cases (90.47%).Conclusions: Many unforeseen complications occur in women who previously had a normal vaginal delivery. It is recommended that all antenatal patients must be booked and receive proper and regular antenatal care. Also 100% deliveries in multigravida should be institutional deliveries in order to reduce maternal and perinatal morbidity and mortality.

CLINICAL STUDY OF PRIMARY CESAREAN SECTION IN MULTIPAROUS WOMEN AT OBSTETRICS AND GYNAECOLOGY DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

2021 ◽  
pp. 7-8
Author(s):  
Kumari Nisha ◽  
Renu Jha ◽  
Kumudini Jha ◽  
Debarshi Jana
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Placenta Previa ◽  
Fetal Distress ◽  
Normal Vaginal Delivery ◽  
Major Surgery ◽  
Obstetrics And Gynaecology ◽  
Emergency Cesarean ◽  
Study Results ◽  
Multiparous Women

Background: Caesarean section is the most commonly performed major surgery among women. The aims and objective of this study was to know the incidence of primary Caesarean section in multigravidas, its indications and to know the maternal and foetal outcome among these patients. Methodology: This was an observational study conducted at Department of Obstetrics and Gynaecology of Darbhanga Medical College and Hospital, Laheriasarai, Bihar. Aim of the study was to study the indication, maternal and fetal outcome in primary cesarean in multiparous women. All multiparous women admitted for delivery were included in the study Results: The total number of deliveries were 3064 and cesarean section were 1026 (33%).The total number of primary cesarean section in multiparous women were 84 constituting 2.7%. In this study, majority of women were Gravida 2. 91.6% of the cases were underwent emergency cesarean section and anesthesia was spinal. Majority of patients were between age group of 22 to 27 yrs (70%). Indications for cesarean section in our study were severe oligohydroamnios (22%), fetal distress (15.4%), and breech presentation (14%), premature rupture of membrane (12%).Intra operative ndings were meconium stained liquor, post partum hemorrhage, thinned out lower segment and extension of incision. Out of 84 cases, 48 cases needed intra operative or immediate post operative blood transfusion. The post operative morbidity was present in 6 cases i.e paralytic ileus, puerperal fever, urinary tract infection and wound gaping. Majority of babies, weighed in the range of 2-3kgs (55%).Out of 84 cases 7 were causes were placenta previa, obstructed labor and fetal distress. Conclusion: Many unforeseen complications occur in women who previously had a normal vaginal delivery. It is recommended that all antenatal patients must be booked and receive proper and regular antenatal care. Also 100% deliveries in multigravida should be institutional deliveries in order to reduce maternal and perinatal morbidity and mortality.

scholarly journals Incidence and indications of LSCS among Doctors Community of Chattogram

2021 ◽  
Vol 20 (2) ◽  
pp. 37-40
Author(s):  
Adiba Malik ◽  
Kamrun Nessa ◽  
Yasmin Ara Begum ◽  
M Jalal Uddin ◽  
Aklima Sultana ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Placenta Previa ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Left Ventricular ◽  
Subsequent Pregnancy ◽  
Cross Sectional ◽  
Lower Segment Caesarean Section

Background: Lower segment caesarean section (LSCS) is a surgical intervention, which is carried out to ensure the safety of mother and baby when vaginal delivery is not possible or when danger to mother and baby would be greater with vaginal delivery. This study is designed to identify indication of LSCS and detect complications if any among the respondents. Materials and methods: Cross sectional descriptive study where 95 female doctors of Chattogram were selected by convenient sampling without knowing their mode of delivery and if it is LSCS then indication of LSCS , maternal and neonatal complications were noted. Results: Age of the respondents at the time of interview were noted and most of them were between 31- 40 years 52 (55%), regarding income most of them between 100000 -200000 42(44%) most of the delivery occurred in the private clinics 92 (70%) regarding mode of delivery, LSCS was 92 (70%) vaginal delivery 40 (30%) regarding indications of LSCS most common was repeat caesarean section 27 (29%) and second common was LSCS due to maternal interest 18 (20%) and others were severe preeclampsia 10 (11%) fetal distress 08(09%) placenta previa, Diabetes with big baby, cephalopelvic disproportion, PROM with non progression of labour. PPH was the most common complication 05 (63%), next was paralytic ileus 02 (25%) and left ventricular failure 01 (12%). Common neonatal comoplications were low birth weight baby 904 (40%), prematurity 03 (30%) and birth asphyxia 03 (03%). Conclusion: LSCS is a major surgical procedure for delivery. Inspite of its low maternal morbidity and mortality due to improved surgical technique, modern aneasthetic skill and availability of blood and blood products, still it carries a slightly greater risk in subsequent pregnancy, so we should be rational in doing primary caesarean section. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 37-40

scholarly journals Clinical Outcome Following Induction of Labour with Misoprostol

2017 ◽  
Vol 6 (2) ◽  
pp. 49-52
Author(s):  
Serajoom Munira ◽  
Fatema Begum ◽  
Farhana Dewan ◽  
Sadia Mahfiza Khanam ◽  
Aftabun Nahar ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Perinatal Death ◽  
Fetal Distress ◽  
Maternal Outcome ◽  
Induction Of Labour ◽  
Maternal Distress ◽  
Normal Vaginal Delivery ◽  
Perineal Tear ◽  
Oral Misoprostol

Background: Induction of labour in the third trimester of pregnancy may be considered beneficial in many clinical circumstances.Objective: The aim of this study was to find the effectiveness and safety of a novel dosing regimen of oral misoprostol in a Bangladeshi sample.Methods: A cross sectional study was conducted in the Department of Obstetrics and Gynecology, Sir Salimullah Medical College & Mitford Hospital, Dhaka from October 2008 to September 2009 based on the guideline of American College of Obstetricians and Gynecologists. Fifty nine cases were enrolled according to inclusion criteria by clinical pelvimetry and bishop scoring. Contracted pelvis, evidence of cephalopelvic disproportion, placenta previa, unexplained vaginal bleeding, grand multipara, fetal malpresentation, previous uterine scar and fetal distress cases were excluded. Misoprostol was administered per orally. Maternal outcome was assessed by normal vaginal delivery, caesarean section, maternal distress, perineal tear, cervical tear, uterine hyper-stimulation and fetal outcome was assessed in the form of fetal distress, meconium stained amnions, neonatal admission, perinatal death and no complication. Statistical analysis was done using SPSS v 13. Probability value was set at P<0.05 for statistical significance.Results: Mean age was 25.69(5.04) years and mean age of gestation was 38.23(4.3) weeks and 59% were in regular antenatal checkup. Misoprostol was administered orally, 15% single, 37% double, 34% three and l4% were more than three doses. Following induction, 85% had normal vaginal delivery, 10% caesarean section and 5% had forceps delivery. For induction, 56% were due to preeclampsia, eclampsia & other pregnancy induced hypertension, 10% postdated pregnancy, 9% were unfavorable cervix, 7% IUD, l4% elective cases due to medical disorder, 2% had premature rupture of membrane, other causes were 3%. By bishop score assessment 54% had unfavorable and 46% had favorable cervix. In neonate's outcome, 34% had no complications, 19% meconium stained, 19% neonatal admission, 9% fetal distress and 20% had perinatal death including IUD. In maternal outcome, 69% no complications, 10% perineal tear, 10% caesarean section, 3% maternal distress, 3% cervical tear, 2% uterine hyper-stimulation, 2% episiotomy. There were no significant differences.Conclusions: Stepwise oral misoprostol was well tolerated with no increase in maternal side effects. There was also a trend towards more fetal safety in the oral misoprostol. Perhaps the most significant finding of our study is the lower cesarean section rate in the women who received the oral regimen.J Shaheed Suhrawardy Med Coll, 2014; 6(2):49-52

Breech Presentation: Vaginal Delivery or Caesarean Section?

2016 ◽  
Vol 2 (1) ◽  
pp. 153
Author(s):  
Tomescu Cezar Laurentiu ◽  
Rodica Sîrbu ◽  
Emin Cadar ◽  
Brezeanu Dragos ◽  
Aneta Tomescu
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Total Population ◽  
Population Sample ◽  
Breech Presentation ◽  
Current Paper ◽  
Clinical Hospital ◽  
Obstetrics And Gynaecology ◽  
Number Of Patients

The incidence of breech presentation is approximately 3,97%. Breech presentation is considered as being “borderline eutocic” and it requires carefully monitoring both the foetus and the mother. The aim of the current paper is to evaluate the preffered method of delivery in case of breech presentation. The paper presents a retrospective study performed in the Obstetrics and Gynaecology Departments of the County Emergency Clinical Hospital “Sf. Apostol Andrei” in Constanta, during a period of 5 years (2010-2014). The methods of birth were analyzed for a lot of 1104 patients with breech presentation with ages ranging between 16 and 44 years old. The total number of patients who gave birth through vaginal delivery was of 139 patients, amounting to 12.59% of the total population sample. The number of patients that gave birth through C-section was 965, which amounts to 87.4% of the total population sample. Birth through C-section is preferred by both obstetricians and patients alike, due to the fact that vaginal delivery is associated with a higher foetal risk in breech presentation.

scholarly journals On demand caesarean section: What’s women’s attitude?

1970 ◽  
Vol 2 (2) ◽  
pp. 12-15
Author(s):  
Nira S Shrestha ◽  
Sumita Pradhan
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
University Teaching ◽  
Normal Vaginal Delivery ◽  
On Demand ◽  
Assisted Delivery ◽  
The Right

Objectives: To evaluate the knowledge and attitude of Nepalese women towards mode of delivery and caesarean on demand. Study design: Hospital based cross sectional descriptive study where 200 pregnant women after 37 completed weeks of gestation were recruited randomly and interviewed, and their answers were analyzed. Results: Of the 200 interviewed pregnant women, all of them knew about normal vaginal delivery and caesarean delivery, but only 30% knew about instrumentally assisted delivery and 9% had heard about painless labour. Vaginal delivery was the preferred mode in 93% and 7% preferred caesarean delivery. Only 35% of the interviewed women believed that women should have the right to demand a caesarean section Conclusion: Knowledge assessment of two hundred women regarding the mode of delivery clearly indicates the need for strengthening counseling aspect of antenatal care and awareness program regarding mode of delivery. In Nepal on demand caesarean section is not provided in the University Teaching Hospital. However one third of women still felt that women should have the right to choose caesarean section on demand. Key words: Attitude, mode of delivery, Caesarean on demand. doi:10.3126/njog.v2i2.1448 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 12 - 15

scholarly journals Postpartum quality of life after normal vaginal delivery and caesarean section

2015 ◽  
Vol 2 (2) ◽  
pp. 13-18
Author(s):  
Yogendra Amatya ◽  
Samita Acharya
Keyword(s):  
Quality Of Life ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Elective Caesarean Section ◽  
Family Type ◽  
Normal Vaginal Delivery ◽  
Cross Sectional ◽  
Normal Delivery ◽  
Physical Health Composite Score

Introductions: Caesarean section is rising. The best method of delivery, vaginal or caesarean, for postpartum quality of life in women is a matter of controversy both from professionals’ perspectives and from women’s experience of childbirth. This study analyses quality of life after these two methods of deliveries.Methods: This was a cross-sectional comparative study in postnatal care outpatient department at Patan Hospital. Primipara women with normal delivery and elective caesarean section done in Patan Hospital were enrolled to analyse postpartum quality of life. The SF-12 questionnaire tool at 6 weeks post delivery was used to compare age, ethnicity, education, family type and employment. Data was analysed using ANOVA test for descriptive parameters.Results: There were 468 primipara, age 30-45 years, 94% in 15-30 years77.8% educated, 74.4% in joint family,73.5% housewife. Normal vaginal delivery was 360 (72.6%) and 128 (27.4%) elective caesarean. Vaginal delivery group had average SF score of Physical Health Composite Score of 68.7, Mental Health CompositeScore69.5 and total SF score 67.7. While in caesarean group, it was 64.8,64.1 and 63.4.Conclusions: Normal vaginal delivery had better quality of life resulting in both superior physical as well as mental health.Journal of Patan Academy of Health Sciences, Vol. 2, No. 2, 2015. page:13-18

scholarly journals A Comparative Study to Assess the Level of Anxiety among Primi Gravida Mothers Planned for Normal Vaginal Delivery and Caesarean Section in the Selected Hospital, Agartala, West Tripura

2021 ◽  
Vol 6 (2) ◽  
pp. 58-61
Author(s):  
Ishita Nath
Keyword(s):  
Caesarean Section ◽  
Comparative Study ◽  
Vaginal Delivery ◽  
Demographic Variable ◽  
Demographic Data ◽  
Sampling Technique ◽  
Normal Vaginal Delivery ◽  
Research Approach ◽  
Perinatal Anxiety ◽  
Anxiety Screening

A comparative study was conducted among 100 primi gravida mothers (50 mothers in each group) from MCH clinic and IPD of IGM hospital, Agartala, West Tripura, who had planned for normal vaginal delivery and caesarean section. Research approach used was non experimental quantitative approach and research design was descriptive comparative design. Purposive sampling technique was used to draw the sample. Socio demographic data and modified Perinatal Anxiety Screening Scale were used to collect data from the samples through interview method. Analysis revealed that 52% of the primi gravida who had planned for caesarean section and 44% mothers who had planned for normal vaginal delivery had mild symptoms of anxiety. Mean anxiety score of the mothers who planned for caesarean section and normal vaginal delivery was 27.3 and 19.7 respectively, median 28.855 and 18.915 respectively and SD 7.0715 and 8.038 respectively. The mean difference was 7.6 and unpaired ‘t’ value was 5.0198, which was significant at p<0.05. Analysis of variance result showed that there was significant association between the level of anxiety of the primi gravida mothers who had planned for caesarean section with their selected socio demographic variable ‘occupation of husband’. The calculated ‘F’ value was 3.33 at p<0.05. The researcher concluded that the primi gravida mothers who had planned for caesarean section had more anxiety than the mothers who had planned for normal vaginal delivery and the anxiety level of the mothers who had planned for caesarean section was dependent on selected demographic variable occupation of the husband. Keywords:Anxiety, primi gravida, normal vaginal delivery, caesarean section.

EFFECT OF HBA1C LEVEL ON MODE OF DELIVERY

2018 ◽  
Vol 6 (2) ◽  
pp. 781-784
Author(s):  
SAIMA PERVEEN ◽  
PARVEEN NAVEED ◽  
NAZISH HAYAT ◽  
NADIA RASHID
Keyword(s):  
Cesarean Section ◽  
Teaching Hospital ◽  
Gestational Age ◽  
Maternal Age ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Dominant Mode ◽  
Normal Vaginal Delivery ◽  
Number Of Patients ◽  
Sugar Levels

BACKGROUND: Perinatal outcome is related to the onset and duration of glucose intolerance. Theobjective of the study is to determine the effect of HbAlc on mode of delivery in Obs/Gynea departmentof Saidu Teaching Hospital, Swat.MATERIAL AND METHODS: This observational & descriptive study was carried out in theDepartment of Obstetrics and Gynecology at Saidu Teaching Hospital, Swat, from 1st March 2015 to29th Feb 2016. Total 313 pregnant women were included in the study, who had Gestational Diabetes orEstablished Diabetes.Detail history was taken regarding maternal age in years, gestational age in weeks.Abdominal examination was done for lie and presenting part of the fetus, and vaginal examination wereperformed. These patients were followed till the end of labour and their mode of delivery i-e; normalvaginal delivery, instrumental delivery or cesarean section was recorded. Maternal HbAlc level wasdone at the time of delivery and was categorized as Mild (< 6.5), Moderate (6.5-9) and severe (>9).Maternal HbAlc was measured in hospital laboratory. The numerical variables of mean HbAlc,maternal age in years and gestational age in weeks were analyzed by mean ± SD (range). Categoricalvariables like; grades of severity of HbAlc levels and frequency of modes of delivery were analyzed byfrequency (number) and relative frequency (percentages). SPSS 20 (SPSS Inc. Chicago, Illnios, USA)was used to analyze the data.RESULTS:The total number of patients was 313. Mean age of the study population was 27.85 ± 6.37(43 - 15) (95% Cl 28.39 - 27.30). The mean age of gestational amenorrhea, at which most of thepatients presented was 38.31 ± 3.02, ranging from 41 to 29, (95%CI 38.57 - 38.5). The meanglycosylated Hemoglobin (HbAlc) was 6.9 ± 1.69 (95% Cl 6.17 - 5.88). Majority of the patients hadpoorly controlled diabetes, i-e: 64%. In different levels of HbAlc levels, normal vaginal delivery wasthe pre dominant mode of delivery.CONCLUSION:^ patients with uncontrolled diabetes the rate of complications increased and so doesthe rate of macrosomia and fetal distress, leading to higher rate of cesarean section and instrumentaldelivery, so by strict control of the blood sugar levels in a diabetic patient one can reduce the risk ofoperative deliveries and complications.KEY WORDS:Hbalc levels, Mode of delivery, cesarean section

scholarly journals Delivery and Development: To what Extent can One Associate Cause and Effect?

1980 ◽  
Vol 73 (11) ◽  
pp. 786-792 ◽  
Author(s):  
Margaret Ounsted ◽  
Andrew Scott ◽  
Valerie Moar
Keyword(s):  
Caesarean Section ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Emergency Caesarean Section ◽  
Social Classes ◽  
Perinatal Factors ◽  
Case Histories ◽  
Handicapped Children ◽  
Cause And Effect ◽  
Risk Pregnancy

Data on 570 mothers and their children whose development was personally assessed from birth to four years were analysed. Strong associations were found between the incidence of fetal distress during labour, birth asphyxia, and delivery by emergency caesarean section. At the age of four years girls and children in the non-manual social classes were more advanced, developmentally, than boys and children in the manual classes. No associations were found between perinatal factors and total developmental scores; but highly significant differences were found between ‘at risk’ pregnancy groups according to their method of developmental scores. In only one of seven handicapped children could the handicap possibly have been attributable to delivery factors. Case histories of two children illustrate the dangers and difficulties of associating cause and effect in individual patients.

scholarly journals Amniotic fluid index versus maximum vertical pocket measurement in predicting perinatal outcome at 40 weeks or beyond

2018 ◽  
Vol 7 (12) ◽  
pp. 4887
Author(s):  
Nasreen Noor ◽  
Seema Amjad Raza ◽  
Shazia Parveen ◽  
Mohammad Khalid ◽  
Syed Manazir Ali
Keyword(s):  
Amniotic Fluid ◽  
Vaginal Delivery ◽  
Perinatal Outcome ◽  
Prospective Observational Study ◽  
Fetal Distress ◽  
Normal Vaginal Delivery ◽  
Amniotic Fluid Index ◽  
Institutional Ethics ◽  
Significant Difference ◽  
Baseline Demographic

Background: The aim of this study is to compare the use of amniotic fluid index with maximum vertical pocket for predicting perinatal outcomes.Methods: The present study was a prospective observational study and includes 140 The study include normal antenatal women at gestational age 40 weeks or beyond (by last menstrual period/1st trimester scan) referred from antenatal between 20 to 40 years were enrolled in this study from 2015 to 2017. After Institutional Ethics Committee approval all recruited women was assessed at the 3rd trimester visit for baseline demographic and obstetric data. After taking a detailed history and examination the women were subjected to ultrasonography for Amniotic Fluid index (AFI) and Maximum vertical pocket (MVP). The women were divided into 2 groups based on measurement of AFI and MVP ultrasonologically. The correlation of Amniotic fluid index and Maximum vertical pocket with perinatal outcome were computed for the 2 groups: Group Ia - women having normal AFI and normal MVP; Group Ib - women having decreased AFI and normal MVP.Results: In Group Ia, 31(34.44%) women were induced and in Group Ib 59 (65.56%) women were induced for oligohydramnios. 65 women (72.22%) had normal vaginal delivery versus 25women (27.28%) had undergone LSCS in Group Ia, while in Group Ib, 32 women (64%) versus 18 women (36%) had vaginal delivery and LSCS respectively. Higher rate of LSCS was observed in Group Ib. There was no significant difference in the rate of LSCS for fetal distress between Group Ia and Ib for fetal distress.Conclusions: Amniotic fluid index (AFI) compared with the maximum vertical pocket (MVP) excessively characterizes patients as having oligohydramnios, leading to an increase in obstetric interventions, without any documented improvement in perinatal morbidity and mortality. Thus, authors cannot find any objective reason to favour AFI over MVP.

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