scholarly journals Study of incidence, trends and determinants of caesarean section in tertiary care hospital of Rajasthan, India

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):  
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):  
Uma Mohanraj ◽  
A. Adhirai

Background: Aim of the study was to optimize the fetomaternal outcome using different modes of delivery in breech presentation and objective of the study was to optimize the maternal and perinatal outcome in various modes of breech delivery.Methods: Among 150 mothers with different parity and gestational age having singleton breech were studied during May 2019- October 2019 for the period of 6 months at KAPV government medical college. Fetomaternal outcome was compared in various modes of breech delivery during this study period in our institute. This study was a prospective analytical study.Results: Incidence of breech presentation was 3.3% of total deliveries in this institute. Around 4 (26.6%) cases by emergency LSCS, 48 (32%) cases delivered vaginally, 62 (41.3%) cases by elective LSCS. Comparatively, large number of cases were delivered by planned caesarean section in our institute. The maternal and perinatal morbidity and mortality was found to be less in planned caesarean section compared with other modes of delivery in this study.Conclusions: In view of insignificant difference in the fetomaternal outcome balanced decision about mode of delivery on a case by case basis will go a long way in improving both fetal and maternal outcome. Regular drills and conduct of assisted vaginal breech delivery should be pursued in all maternity hospitals.


2018 ◽  
Vol 5 (5) ◽  
pp. 1733
Author(s):  
Ratan Kumar Das ◽  
K. Trimal Subudhi ◽  
Ranjan Kumar Mohanty

Background: Caesarean section is one of the most widely performed surgical procedures in obstetrics worldwide. It was mainly evolved as a lifesaving procedure for mother and foetus during the difficult delivery. To analyze the rate and indications for C-Section and associated maternal morbidity and mortality were the main objectives of present study.Methods: This retrospective study was conducted over a period of one year from 1st May 2017 to 30th April 2018 at the Department of Pediatrics and OBG, IMS & SUM Medical college and Hospital, Bhubaneswar (Odisha), eastern India. Data of Patients who delivered by C-Section in our hospital during the defined study period was recorded and a statistical analysis of various parameters namely, the caesarean section rates, its indications, the patient’s morbidity and mortality was done.Results: The total numbers of women delivered over the study period were 1619, out of which C-Sections were 574.The overall CS rate was 35.45%. Previous LSCS was the leading indication to the CS rate (29.96%) followed by arrest of labour (13.94%), CPD (11.84%), foetal distress (10.97%), breech presentation (5.74%), oligohydroaminous/IUGR (5.21%), failed induction of labour (5.21%), pregnancy induced hypertension(PIH) (4.87%) and multifetal gestation (3.84%), prematurity (3.31%). 12.01% patients had various complications mainly infection (6.27%) and hemorrhage (3.48%). There was no mortality during this period.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 CSR.


2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e27-e27
Author(s):  
Sarah McKnight ◽  
Bishal Gautam ◽  
Michael Miller ◽  
Bryan S Richardson ◽  
Orlando da Silva

Abstract BACKGROUND The optimal mode of delivery for preterm infants remains controversial, and routine Caesarean sections (C/S) are not recommended, except for maternal indications. Nonetheless, many preterm infants are delivered by C/S, particularly those in breech presentation, and recent retrospective data have suggested that these infants may have improved outcomes. OBJECTIVES To examine whether C/S as the mode of preterm delivery is associated with decreased mortality and improved short term outcomes. DESIGN/METHODS This retrospective, population-based cohort study examined infants with a gestational age between 23 0/7 weeks and 32 6/7 weeks, born between January 1, 2007 and December 31, 2016, and admitted to the Neonatal Intensive Care Unit at a single Canadian Tertiary Care hospital. Infants with major congenital anomalies were excluded. Data were abstracted from the local Neonatal-Perinatal database for all infants. Two groups, those delivered vaginally and those delivered by C/S, were compared for major neonatal outcomes including the primary outcomes of death and severe intraventricular hemorrhage (IVH), defined as grade 3 or higher. RESULTS A total of 1442 infants met inclusion criteria (784 born by C/S and 658 vaginally). There was no significant difference in neonatal mortality (7.0% vs 7.1%, p=0.925) or severe IVH (6.1% vs 7.4%, p=0.317). There was, however, a significant difference in the incidence of IVH, any grade (19.9% vs 27.5%, p=0.001), which remained after controlling for other significant predictors. There were no other significant differences in the secondary outcomes examined including need for extensive resuscitation, respiratory distress syndrome, bronchopulmonary dysplasia, patent ductus arteriosus, necrotizing enterocolitis, periventricular leukomalacia, or retinopathy of prematurity. CONCLUSION Caesarean section was not associated with decreased mortality in preterm infants, relative to vaginal births. Caesarean section was associated with a reduced rate of IVH (any grade) and there was a trend towards decreased severe IVH which may warrant further study.


Author(s):  
Varija T. ◽  
Veerendra Kumar C. M. ◽  
Chandrasekhar Tarihalli

Background: The caesarean section (CS) delivery rate is steadily increasing worldwide, including India. Identifying the proportion of women in various categories as per Robson's ten group classification system and CS rate among them is important to bring down the increasing CS rate.Methods: This case series study was conducted at Vijayanagar Institute of Medical Sciences (VIMS), a tertiary care teaching hospital in Ballari, Karnataka, India. All pregnant women who have been admitted for delivery were enrolled and the data was collected for the women delivered by CS during January 2016 to December 2016 and proportions in various groups as per Robson’s ten-group classification system were calculated.Results: Among a total of 6980 women delivered during study period, 2992 (42.8%) delivered by CS. The CS rates among various groups varied from 100% among women with abnormal lies and group 6-95% (all nulliparous breeches) group 5-94% (Previous CS, single cephalic, >37 weeks) to 10 to 15% among multiparous women with spontaneous labour having single cephalic pregnancy (group 3). Among women with previous section, CS rate was very high (89.6%). Women with previous CS (group 5) contributed maximum (40.24%) to the total number of CS.Conclusions: In the present study, all women with breech presentation and abnormal lies delivered by CS and repeat CS was the highest contributor to all CS deliveries.


2018 ◽  
Vol 9 (2) ◽  
pp. 124-130
Author(s):  
Mahmud Ekram Ullah ◽  
Amreen Faruk ◽  
Rajibul Haque Talukder ◽  
Farukuzzaman ◽  
Noor A Alam

Background: Fournier’s gangrene is a vascular disaster of infective origin occurring about male external genitalia. Diabetes Mellitus is an important predisposing factor. A good number of patients of this rare clinical entity are admitted frequently in our centre. Till now the disease has the potential for significant morbidity and also mortality.Objective: The study was designed to be conducted among patients suffering from Fournier’s gangrene to identify the possible source of sepsis, to denote pattern and extent of area involvement and microorganisms isolated and to observe the treatment course and outcome.Methods: This prospective observational study was carried out in BIRDEM General Hospital, Dhaka among 60 patients of Fournier’s gangrene admitted under surgery department during the period of October 2016 to January 2018 using purposive sampling method.Result: The results of this study suggest that majority of the study population were in 51 to 60 years (Mean 52±4.9) age group. All the patients were diabetic with grossly elevated blood glucose level (Mean RBS=17.3 mmol/dl). In addition to scrotum, perineum, penis, buttock and lower abdomen were also affected to variable extent (73.3%). All patients required major debridement which had to be repeated in 68.3% cases. Steptococcus pyogens was the most common organism isolated (43.3%) followed by Eschericia coli (35%) and majority were of polymicrobial type (61.6%). Mortality rate was 8.3%.Conclusion: The diagnosis and treatment of Fournier’s gangrene is enigmatic and challenging to the physician. Urgent surgical debridement along with other appropriate supportive measures can reduce morbidity and mortality.Anwer Khan Modern Medical College Journal Vol. 9, No. 2: Jul 2018, P 124-130


2014 ◽  
Vol 2 (2) ◽  
pp. 64-67 ◽  
Author(s):  
Tanzima Begum ◽  
Md Ismail Khan ◽  
Shamima Kawser ◽  
Md Ehsanul Huq ◽  
Nadira Majid ◽  
...  

Background: Drug can cure ailment when used rationally on the other hand they may become harmful or even may threaten a life when used irrationally. Absence of guidelines for antibiotic use, protocols for rational therapeutics and infection control committees, have led to overuse and misuse of antimicrobials even in different specialized units in hospitals. Objective: The study has been designed to get a picture of use of antibiotics in a tertiary care hospital of Bangladesh. Materials and method: Cross sectional study was conducted in the department of Medicine of Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh, for 3 months from 1st January 2009 to 31st March 2009. Admitted patients of Medicine unit-1 who got antibiotics were included in the study. Total number of patients was 1563. Results: Five hundred out of 1563 patients were prescribed antibiotics (38%). Out of 500 prescriptions, 68(14%) prescriptions were found irrational. Conclusion: Continuous surveillance should be carried out to reduce the irrational use of antibiotics. DOI: http://dx.doi.org/10.3329/dmcj.v2i2.20526 Delta Med Col J. Jul 2014; 2(2): 64-67


Author(s):  
Pritpal Singh Ahluwalia ◽  
Mirza Shiraz Baig ◽  
Amarnath Awargaonkar ◽  
Varsha Nandedkar

Background: Drug utilisation studies in present clinical practice have played significant role to promote rational drug use in the current health care system. The aim of present study was to analyse the prescribing pattern of drugs for various ocular conditions in Ophthalmology Department of Government Medical College and Hospital, Aurangabad, Maharashtra, India.Methods: Study was prospective, observational open label and descriptive clinical study which included 100 patients in OPD and IPD during November 2018 to February 2019 fulfilling inclusion criteria.Results: Out of the 100 study subjects, 56% were males and 46% were females, with the maximum number of patients falling in the age group 61-80 years. 38.26% patients received antibiotics as most prescribed drug while 69 % patients received analgesics and 47% anti-inflammatory. Among the antibiotics prescribed, fluoroquinolones were the most prescribed antimicrobial class. WHO prescribing indicators as analysed from the data collected were: average number of drugs per prescriptions was 3.79. Percentage of medicines prescribed by branded name- 33.79% and generic were 66.21%. 54% of the total drugs prescribed were from the National List of Essential Medicines 2017.Conclusions: Ocular ailments and conditions are frequently associated with high levels of utilization of drugs for their treatment. Thus, analysis of utilization of these drugs becomes very essential. In the present study, the drugs prescribed at our tertiary care hospital were found rational.


2021 ◽  
Vol 8 (2) ◽  
pp. 289
Author(s):  
Abid Ahmad Shairgojri ◽  
Khalid Mohiuddin ◽  
Amber Bashir ◽  
Muzafar Jan

Background: Cardiomyopathy constitutes a group of diseases that directly affect the structural or functional ability of myocardium. They are the most common form of heart diseases that are inherited in children and responsible for sudden deaths in healthy young adults. The Aim of our study was to provide a detailed description of clinical profile, epidemiology and etiology of cardiomyopathies in children.Methods: This was a hospital based prospective observational study, conducted over a period of two and half years from September 2017 to March 2020 in the Post Graduate Department of Pediatrics Government Medical College Srinagar. Study group included all patients aged between 1 month and 18 years diagnosed with cardiomyopathy. They were subjected to a detailed clinical history and physical examination. All the patients underwent echocardiography.Results: During the study period 37 patients were diagnosed with different types of cardiomyopathies. Dilated cardiomyopathy was commonest seen in 19 (51.35%), followed by hypertrophic cardiomyopathy 13 (35%) cases. Fast breathing was most common presenting complaint in dilated cardiomyopathy while most of cases with hypertrophic cardiomyopathy were asymptomatic. There was one case of distinct form of cardiomyopathy isolated left ventricular hypoplasia. Males were more involved 21 (56.76%) cases. Majority of patients 18 (48.64%) were less than one year at time of diagnosis. Parental consanguity was seen in 6 (16.22%) cases. Underlying cause was identified in 10 (27.02%) cases with myocarditis being the commonest cause.Conclusions: Pediatric cardiomyopathy represents a considerable percentage of children with cardiac disorders. Dilated cardiomyopathy is the most common type usually presented with congestive heart failure, majority of cases of hypertrophic CMP were asymptomatic. Male preponderance was seen in dilated and hypertrophic cardiomyopathy. Parental consanguinity was seen in significant number of patients. Myocarditis and inborn error of metabolism was seen in significant number of patients.


Sign in / Sign up

Export Citation Format

Share Document