scholarly journals Trial of scar in post caesarean pregnancies

2018 ◽  
Vol 7 (3) ◽  
pp. 1173
Author(s):  
G. Kuppulakshmi ◽  
S. Saranya
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Uterine Wall ◽  
Perinatal Morbidity ◽  
Surgical Incision ◽  
Medical College ◽  
Caesarean Birth ◽  
Obstetric Management ◽  
One Year ◽  
Present Pregnancy

Background: The term caesarean delivery used to describe the delivery of a fetus through a surgical incision of the intact anterior uterine wall. The objective of this study was to analyse the maternal and perinatal morbidity between successful VBAC and failed vaginal delivery in cases selected for trial of labour.Methods: Prospective study conducted in Government RSRM Lying In Hospital, Government Stanley Medical College, Chennai over a period of one year from January 2017 to December 2017.Results: Trial of labour in previous caesarean section was more successful when the interval between previous caesarean and present pregnancy was between two to four years 86.40%. Conclusions: Most patients with a prior caesarean birth are candidates for VBAC. In properly selected women, a trial of labour after one previous low transverse caesarean section constitutes the best and safest form of obstetric management.

scholarly journals Timely relaparotomy after caesarean section of a moribund patient can save the life

2015 ◽  
Vol 23 (1) ◽  
pp. 41-47
Author(s):  
Mukti Rani Saha ◽  
Iffat Ara ◽  
Suvash Chandra Roy ◽  
Tapan Kumer Saha ◽  
Nandita Paul ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Rectus Sheath ◽  
Case Fatality ◽  
Near Miss ◽  
College Hospital ◽  
Medical College ◽  
Primary Surgery ◽  
Internal Iliac ◽  
One Year

The aim of this study was to find out the outcome of cases requiring relaparotomy following caesarean delivery during the puerperium. This was a retrospective descriptive study set in a tertiary referral and teaching hospital i.e. Dhaka Medical College Hospital, Dhaka. Over a period of one year from January 1st to 31st December 2010, there were 5027 caesarean deliveries (53%-94%) out of a total of 9320 deliveries. Relaparotomy was done in 48 patients (0.95%) of the caesarean sections. The indications of repeat laparotomy were secondary postpartum haemorrhage (PPH) in 28 cases (58.33%), primary PPH due to uterine atony in 15 cases (31.3%), uterine sepsis with haemorrhage in 2 cases (4.17%), rectus sheath haemotoma in 2 cases (4.13%), internal haemorrhage after caesarean section in 1 case (2.08%). Of these 48 cases, in14 cases, primary caesarean section was done in this institution while 34 had caesarean delivery at other hospitals and clinics at (13 cases) and outside Dhaka (21 cases). Main surgeries performed at relaparotomy were subtotal hysterectomy in 29 cases, total hysterectomy in 9 cases, drainage of haematoma and peritoneal toileting in 4 cases, resuturing of uterine incisions in 5 cases, internal iliac arteries in 1 case. More than one procedure was often performed in one case. There were 6 maternal deaths following relaparotomy caused by shock following PPH, septicaemia and internal haemorrhage. Repeat laparotomy within six weeks of caesarean delivery was required 1 in 200 cases in this institute. Case fatality rate was (12.5%). Near miss fatalities were common. Majority on these were preventable. Identification of risk factors, adequate attention during primary surgery, expert decision, prompt intervention and proper case management during relaparotomy will improve the outcome. Centers carrying out caesarean section should have efficient blood transfusion service in the first place. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22693 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 41-47

scholarly journals A Descriptive Analysis of the Indications for Caesarean Section in Lumbini Zonal Hospital, Butwal

2018 ◽  
Vol 5 (2) ◽  
pp. 31-34
Author(s):  
Shreedhar Acharya ◽  
Bhaktabatsal Raut
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Caesarean Section Rate ◽  
Descriptive Analysis ◽  
Fetal Distress ◽  
Age Group ◽  
Medical Sciences ◽  
Cephalopelvic Disproportion ◽  
Case Files ◽  
One Year

AIM: This study was done to find out the incidence and to analyse the various indications for caesarean sections at Lumbini Zonal Hospital.MATERIALS & METHODS: This was a hospital based retrospective study done at Lumbini Zonal Hospital, Butwal. The case files of all the women who had caesarean delivery over the period of one year from 2071/4/1 to 2072/3/32 were reviewed. Various indications of caesarean sections were analysed for the incidence, age, parity, elective vs emergency caesareans.RESULTS: Out of 7589 deliveries, 1316 (17.34%) had caesarean section. Most common indications were previous caesarean 275 (20.89%), non progress of labour 245 (18.61%), cephalopelvic disproportion 222 (16.86%), fetal distress 215 (16.33%), etc. Majority of caesarean 1226 (93.16%) was done in the age group of 20-30yrs, primipara 702 (53.34%), and elective caesarean sections 766 (58.2%).CONCLUSION: Caesarean section rate at Lumbini Zonal Hospital was optimal. Most common indication was repeat caesarean. The overall reduction in caesarean section rate can be met through reduction of elective caesarean with the promotion of trial of labour.Study also concludes that there is a relation between working duration and health problems, and the problems increase as the duration at work increases.Journal of Universal College of Medical Sciences, Vol. 5, No, 2, 2017, Page: 31-34

scholarly journals Feto-maternal outcome in second versus first stage caesarean delivery in a tertiary medical care centre

2018 ◽  
Vol 7 (12) ◽  
pp. 5084
Author(s):  
Nupur Gupta ◽  
Taru Gupta ◽  
Ritu Singh
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Maternal Outcomes ◽  
New Delhi ◽  
Perinatal Morbidity ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Obstetrics And Gynaecology ◽  
Nicu Admission ◽  
Febrile Morbidity

 Background: The aim is to study neonatal and maternal outcomes of the caesarean sections performed in first stage versus second stage of labour. Methods: The retrospective analysis of data were done of caesarean section done at Department of Obstetrics and Gynaecology at ESI PGIMSR Basaidarapur New Delhi between January 2016 to December 2016. 45 women, who underwent second stage caesarean section were studied. For each case, two consecutive cases, who underwent caesarean delivery during the first stage of labour were taken as control for the study. Primary maternal outcomes of interest were uterine atonia, transfusion requirement, urinary system injury and postoperative complications. Results: Out of 4477 deliveries, 1466 had caesarean section with a rate of 32%. The rate of second stage caesarean section was 3% of total caesarean section and 1% of total deliveries. Second stage caesarean section had higher maternal and perinatal morbidity like atonic PPH (33.3%), lower uterine segment extension (7%), febrile morbidity (10%), and need for blood transfusion (15%). There were 15.5% NICU admission in second stage caesarean group while none in first stage group. Conclusions: Caesarean section in the second stage of the labour is associated with increased maternal and neonatal morbidities. Special attention is required to the patients undergoing caesarean section in the second stage of the labour. They should be handled by senior and experienced obstetrician. Neonatologist should be present for every second stage caesarean section.

scholarly journals Pregnancy Outcome in Women with One Previous Caesarean Delivery - A Prospective Longitudinal Study in a Peripheral Medical College of West Bengal

2021 ◽  
Vol 8 (21) ◽  
pp. 1608-1613
Author(s):  
Saheli Chandra ◽  
Anjan Dasgupta ◽  
Pradip Kumar Saha ◽  
Kamal Kumar Dash ◽  
Abirbhab Pal ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
West Bengal ◽  
Vaginal Birth ◽  
Safe Procedure ◽  
Prospective Longitudinal Study ◽  
Medical College ◽  
Prospective Longitudinal ◽  
Vaginal Birth After Caesarean

BACKGROUND Pregnancy with one prior Caesarean section (CS) constitutes a high-risk group with associated medical and legal implications. The dictum ‘once a Caesarean always a Caesarean’ has now judiciously been replaced with ‘once a Caesarean, trial of labour after selection’ because low transverse uterine incision has much lesser chance of scar rupture. Though vaginal birth after Caesarean (VBAC) or trial of scar (TOS) brings a significant change in modern obstetric practice in terms of lower maternal and perinatal morbidities, apprehension of accidental scar rupture during trial of labour with its undesirable consequences still prevents a good number of obstetricians adopting this process. The purpose of the study was to determine the outcome of pregnancy in relation to mode of delivery, i.e., either elective repeat Caesarean section (ERCS) or vaginal birth after Caesarean (VBAC) with maternal and perinatal complications in each mode. METHODS A hospital based prospective, longitudinal, and observational study of 300 pregnant women with previous one Caesarean delivery attended labour emergency or out-patient department (OPD) at Midnapore Medical College of West Bengal, was carried out, approved by the institutional ethical committee. Gestational age < 37 weeks and > 42 weeks and h\o previous uterine surgery like myomectomy, hysterotomy, classical CS were excluded from the study. Data collected was analysed using statistical package for the social sciences (SPSS) software version 20. Descriptive statistics were used to analyse the continuous and categorical data and expressed in the form of mean and percentage whereas proportions were analysed using chi-square test. A P - value ≤ 0.05 was considered statistically significant. RESULTS Out of 300 pregnancies, 140 subjects were given trial of labour (TOL). Of which 89 subjects (63.6 %) had successful VBAC and 51 subjects (36.4 %) had repeat Caesarean sections. Among 211 subjects of repeat Caesarean section, 53 subjects (25.12 %) had indicated for scar tenderness and 73 subjects (34.59 %) had elective repeat Caesarean section (ERCS) due to protracted or arrested cervical dilatation. Those having previous vaginal delivery (VD), had more incidences of VBAC in present pregnancy than those who had no previous VD (P ≤ 0.005); Maternal morbidity (33.65 % ERCS versus 10.11 % VD group, P ≤ 0.05) and neonatal morbidity (12.3 % ERCS versus 2.46% VD group, P ≤ 0.05) was significantly higher in ERCS group. CONCLUSIONS Trial of labour (TOL) should be given in well-equipped hospital. In carefully selected cases, it is a safe procedure and often rewarding, thus incidence of repeat CS can be reduced. Those who had a history of vaginal delivery, VBAC often successful. KEYWORDS VBAC, Trial of Scar, Elective Repeat Caesarean Section, Trial of Labour

scholarly journals Trend of caesarean section at two Government Medical College in Madhya Pradesh, India over one year of time period: a retrospective comparative study

2018 ◽  
Vol 7 (6) ◽  
pp. 2212
Author(s):  
Poonam Mathur ◽  
Alka Patel
Keyword(s):  
Caesarean Section ◽  
Short Circuit ◽  
Madhya Pradesh ◽  
Chi Square ◽  
Medical College ◽  
Tertiary Centre ◽  
Group 2 ◽  
One Year ◽  
Retrospective Comparative Study ◽  
Group 1

Background: There is a massive public interest and debate on both the cause and appropriateness of increasingly employing a surgical procedure to short circuit or entirely bypass labour and delivery. The indications of caesarean sections vary among institutions as there is no standard classification system exists for indications of C-Section. Present study analysed pattern of caesarean section at two tertiary centre in Madhya Pradesh, India.Methods: A structured proforma was filled up for every case and results were recorded on excel sheet. All the cases included in study were further divided in group 1 (deliveries conducted in year 2014-2015 at Govt. Medical College Indore, M.P.), group 2 (deliveries conducted at Govt. Medical College Rewa at same time. Comparative analysis between study group1 and group 2 was done using Pearson Chi square test.Results: In group 1 there were 10525 deliveries out of which 3705 were delivered by caesarean section (35.2%), in group 2 there were 8674 deliveries out of which 1182 were delivered by caesarean section (13.6%). This difference in caesarean section at both medical college may be due to the more no. of referrals from the periphery to the medical college Indore and having more no of private institutions and district hospital which cater the normal delivery.Conclusions: There is a reliable and reproducible framework is required for audit and analysis of Caesarean section trends in specific obstetric subgroups to permit comparisons of practice between different institutions and over time in the same institution.

scholarly journals Caesarean Delivery: Increases Subsequent Risk of Placenta Praevia

1970 ◽  
pp. 13-17
Author(s):  
Nasreen Banu ◽  
Nasima Begum
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
Subsequent Pregnancy ◽  
Placenta Praevia ◽  
Chi Square ◽  
College Hospital ◽  
Medical College ◽  
Chi Square Test ◽  
Control Study

This case control study was conducted in the Department of Obstetrics and Gynecology, Chittagong Medical College Hospital, in the period from April 07 to March 08. A total of 232 multiparous pregnant women were included in this study; among them 51 were cases (with placenta praevia) and 181 were similar matched control. Past mode of delivery were explored in both the groups and analyzed statistically.Out of 232 subjects, prior caesarean delivery had 25.5% (n=13) in cases and 44.2% (n=80) in controls. After statistical analysis, caesarean section was considered as a risk factor for placenta praevia in subsequent pregnancy. The odds ratio = 0.43 (CI 0.22 – 0.86) and chi square test = 5.80 (df =1; p= 0.016). Key words: Placenta praevia; caesarean section. DOI: 10.3329/bjpp.v25i1.5740Bangladesh J Physiol Pharmacol 2009; 25(1&2) : 13-17

scholarly journals First versus second stage caesarean section: a comparison of maternal and neonatal outcomes

2017 ◽  
Vol 6 (8) ◽  
pp. 3477
Author(s):  
Sushma Sinha ◽  
Surya Malik ◽  
Mala Dixit
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Caesarean Delivery ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
P Value ◽  
Neonatal Complications ◽  
Second Stage ◽  
Number Of Patients ◽  
One Year

Background: A retrospective study was done to compare the maternal and neonatal complications of caesarean delivery performed in the second stage compared with the first stage of labor.Methods: This is a one year retrospective study done in a 100-bedded hospital, govt of NCT OF Delhi, New Delhi from 1st November 2015 to 31st October 2016.  Total number of deliveries in this one year duration were 1785, including both normal and caesarean deliveries. Total number of patients who underwent caesarean delivery in the first stage of labor were 159, and in 2nd stage of labor were 15 during this time period. These were designated into two groups, group 1 and group 2. These two groups were then compared in terms of maternal demographics, labor characteristics, maternal outcomes and neonatal outcomes. Numerical variables were compared between groups by calculating P-value for each variable. P-value <0.05 was considered statistically significant.Results: Caesarean deliveries performed in the second stage were associated with increased maternal morbidity in terms of blood loss, unintended extensions, blood transfusions, prolonged hospital stay, febrile morbidity. Similarly, Neonatal morbidity was much higher in the patient who underwent LSCS in 2nd stage of labor compared to 1st stage. There was increase in neonatal complications, for e. g. –5 minute Apgar <7, NICU admissions >24 hrs, neonatal septicaemia, (P-value <0.05).Conclusions: In conclusion, present study suggests that women undergoing caesarean section in the second stage of labor have increased maternal and fetal morbidity. Therefore, selection of birthing method should be made very carefully and meticulously to decrease maternal and neonatal morbidity.

scholarly journals Analysis of caesarean sections using Robson’s classification system in a tertiary care centre in Northern India: an emerging concept to audit the increasing caesarean section rate

2021 ◽  
Vol 10 (6) ◽  
pp. 2281
Author(s):  
Deepika Jamwal ◽  
Pallavi Sharma ◽  
Anil Mehta ◽  
Jiteshwar Singh Pannu
Keyword(s):  
Caesarean Section ◽  
Classification System ◽  
Caesarean Delivery ◽  
Tertiary Care ◽  
Group Classification ◽  
Health Concern ◽  
Medical College ◽  
Clinical Scenarios ◽  
Group 5 ◽  
Group 2

Background: There has been an increase in rate of caesarean section over last five decades. This is a matter of international public health concern as it increases the caesarean section related maternal morbidity. The aim of the present study was to evaluate that in a new medical college which clinical situation contributed and led to caesarean deliveries as per Robson’s classification system and to audit the increasing rate of caesarean section.Methods: This study was performed in Government Medical College Kathua in the Union territory of Jammu and Kashmir from November 2020 to April 2021. In the present study, all cases delivered by caesarean section during the period of six months were recorded and classified according to Robson's 10 group classification system.Results: Out of total 1366 women delivered, 630 underwent CS (46.12%). It was observed that majority of caesarean sections belonged to group 2 and group 5 of Robson criteria. Group 5 comprised of patients with one or more previous caesarean section with cephalic presentation according to Robson criteria and maximum number of caesarean sections done in the present study belonged to this group that is 40.3%. Group 2 that is nulliparous singleton cephalic >37 week induced labour or caesarean section before labour comprised 29.2%. Breech pregnancies (groups 6 and 7) had >90% caesarean rates.Conclusions: Women with a previous caesarean delivery represent an increasing proportion of caesarean deliveries. Use of the Robson criteria allows standardized comparisons of data and identifies clinical scenarios driving changes in caesarean rates. Hospitals and health organizations can use the Robson 10-Group Classification System to evaluate quality and processes associated with caesarean delivery.

scholarly journals Myomectomy during Caesarean Birth in Fibroid-Endemic, Low-Resource Settings

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
J. O. Awoleke
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Randomized Trials ◽  
Length Of Hospital Stay ◽  
Conclusive Evidence ◽  
African Continent ◽  
Caesarean Birth ◽  
Careful Patient ◽  
Safe Management ◽  
Duration Of Surgery

If myomectomy during caesarean delivery becomes a widespread practice, it could potentially eliminate multiple surgeries for both indications. However, many surgeons have been reluctant to adopt this policy without conclusive evidence demonstrating its safety. This study reviews the publications on caesarean myomectomy especially from the African Continent with respect to duration of surgery, blood loss, length of hospital stay, and blood transfusions. Judging from the lack of large studies on caesarean myomectomy, the proportion of surgeons who attempt the procedure is largely low because of concerns about its safety. However, most of the authors suggested that the complications and morbidity following caesarean myomectomy do not significantly differ from those occurring during caesarean section alone, while fertility is apparently not compromised by this treatment. With careful patient selection, adequate experience, and efficient haemostatic measures, the procedure does not appear as hazardous as was once thought. This piece of information is relevant for counseling women who request for the simultaneous removal of previously diagnosed fibroids during caesarean section. Staff and facilities for safe management of haemorrhage are a requisite for the procedure. Large randomized trials are needed to guide decisions as to the best clinical practice regarding myomectomy during caesarean delivery.

scholarly journals Primary Causes of Caesarean Section among the Primigravida in Rajshahi Medical College Hospital

2019 ◽  
Vol 31 (2) ◽  
pp. 54-58
Author(s):  
Mosammat Nargis Shamima ◽  
Mst Rawson Ara Khatun ◽  
Rubayet Zereen ◽  
Nurjahan Akter ◽  
Nargis Zahan ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Observational Study ◽  
Skilled Birth Attendance ◽  
Middle Income Country ◽  
Medical College Hospital ◽  
College Hospital ◽  
Middle Income ◽  
Medical College ◽  
Birth Attendance ◽  
One Year

Background: Bangladesh recently became a middle income country and despite of its relatively low skilled birth attendance (26.5%) nevertheless experience a rise in caesarean section (CS) rate. But now the rate of CS increased almost seven fold from 3.5% in 2004 to 23% in 2016. Objective: To find out the cause and incidence of caesarean section among the primigravid mother in Rajshahi medical college hospital performed in between January 2017 to December 2017. Methods: This prospective type of observational study was performed in Rajshahi Medical College Hospital (RMCH) over a period of one year from January 2017 to December 2017. All primigravida who underwent caesarean section in RMCH were included. Result: During the study period there were 11018 deliveries. Overall CS rate was 40.98%. The rate in primi was 30.70% and last year it was 25.58%. Conclusion: The vast majority of CS was not medically indicated. A number of policies and program had been launched to counteract this increasing rate of CS but virtually there was no impact. TAJ 2018; 31(2): 54-58

Sign in / Sign up

Export Citation Format

Share Document