scholarly journals Rising rates of second stage caesarean section and its impact on maternal outcome

2018 ◽  
Vol 7 (7) ◽  
pp. 2681
Author(s):  
Shanmugapriya Kumaresan ◽  
Malarvizhi Loganathan
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Adverse Outcomes ◽  
Cesarean Sections ◽  
Maternal Complications ◽  
College Hospital ◽  
Second Stage Of Labor ◽  
Medical College ◽  
Second Stage ◽  
Second Stage Of Labour

Background: There is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. With this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlights includes the rate of caesarean deliveries in the second stage of labour, the indications for delivery and the associated maternal morbidity in this cohort of women.  Methods: This was a prospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between July, 2016 and December 31, 2017 at government medical college hospital Dharmapuri. The main outcome measures were second stage caesarean section, indications and its maternal morbidity.Results: 250 women underwent caesarean delivery in the advanced labor. Among the 250 patient’s majority of them were in the age group of 21-30 yrs. about 76% of the patients were primigravidae and only the remaining 24% were multigravida. The commonest indications for doing caesarean section in the second stage of labor was cephalo pelvic disproportion and non-reassuring fetal heart rate patterns. The difficult task was delivery of the deeply engaged head, the increased likelihood of intraoperative and post-operative complications.Conclusions: Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and morbidity.

scholarly journals Caesarean Section During Second Stage of Labor in a Tertiary Centre

2017 ◽  
Vol 15 (2) ◽  
pp. 178-181 ◽  
Author(s):  
Padma Gurung ◽  
Sameer Malla ◽  
Sushma Lama ◽  
Anagha Malla ◽  
Alka Singh
Keyword(s):  
Caesarean Section ◽  
Post Partum ◽  
Caesarean Section Rate ◽  
Neonatal Morbidity ◽  
Adverse Outcomes ◽  
Perinatal Complications ◽  
Maternal Complications ◽  
Postoperative Fever ◽  
Second Stage Of Labor ◽  
Second Stage

Background: There is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. Within this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlight the feto-maternal outcome of caesarean section in second stage of labour.Methods: This was a retrospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between April 1, 2013 and March 30, 2017 at Patan Academy of Health Sciences. The main outcome measures were second stage caesarean section, indications and its maternal and fetal morbidity.Results: During the study period, there were 40,860 deliveries. A total of 18,011 (44%) babies were born by caesarean section, 10484 emergency and 7527 elective. Out of the emergency caesarean section, 200 (1.9 %) were performed in second stage of labor. In this study, the most common indication was cephalopelvic disproportion. (92.4%) were delivered without a trial of instrumental delivery. In terms of maternal complications, atonic post partum haemorrhage uterine incision extension 18 (12.5%), postoperative fever 27(18.8%), wound infection 7 (4.8%) were observed. In perinatal complications, meconium stained amniotic fluid 49(34.2%), neonatal hyperbilirubinemia 14(9.7%) and increased nursery admission 2(15.3%) and 2(1.3%) perinatal mortality were seen.Conclusions: Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and neonatal morbidity.

scholarly journals Management of prolonged second stage of labor

2018 ◽  
Vol 7 (7) ◽  
pp. 2527
Author(s):  
Sanjay Singh ◽  
Uttara Aiyer Kohli ◽  
Shakti Vardhan
Keyword(s):  
Caesarean Section ◽  
Perinatal Morbidity ◽  
Management Options ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Definition Of

Second stage of labour has been often neglected leading to increased maternal and perinatal morbidity. Recognising and managing prolonged second stage is a challenge even to an experienced obstetrician. This article reviews the changes in the definition of prolonged second stage over the years. It discusses the causes, recognition and management options along with the difficulties in delivering a patient with prolonged second stage of labour. Though adding an extra hour to the definition of second stage in patients may reduce the rate of caesarean section but some studies also show a rise in maternal and perinatal morbidity. Obstetricians are familiarized to the different techniques of delivery of the impacted head. Once diagnosis of prolonged second stage is confirmed, causes should be identified and addressed, and treatment should be individualised, and timing and mode of intervention planned.

Comparison of incidences and indications of multi primary caesarean with primi caesarean mothers in a tertiary care teaching hospital

2017 ◽  
Vol 6 (10) ◽  
pp. 4263
Author(s):  
M. Sujatha Alagesan ◽  
M. Meena
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Teaching Hospital ◽  
Tamil Nadu ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Foetal Distress ◽  
College Hospital ◽  
Medical College ◽  
Clinical Profiles

Background: The incidences and indications of caesarean sections between the primary caesarean multies and caesarean primies were comparable in respect of their demographical and clinical variables of mothers and their foetal outcomes. Aim and objective of the study was to analyze the incidences and indications of primary caesarean multies and caesarean primies. To compare the incidences and indications of mothers between the primary caesarean multies and caesarean primies. To compare the demographic and clinical profiles of the mothers and babies.Methods: During January to June 2016 total of 3583 deliveries were conducted in Tiruneleli Medical College Hospital, Tamil Nadu, India. Among them 89 and 1168 were primary caesarean multies and caesarean primies respectively. They had been compared according to the objectives.Results: The caesarean incidences were 62.5% among the primies and 4.8% among the multies as Primary. The primary caesarean incidences among the multies were statistically significantly lesser in the 15-24 ages than the primi (P<0.05). 25-29 age bracket the incidences were not differed significantly (P>0.05). After 30 years of age, the incidences were statistically significantly increased among the multies (P<0.05). The birth weight of babies did not show any statistically significant indications between the two groups (P>0.05). The indications of Foetal distress, Severe Oligo hydration and others did not show any statistically significantly difference between the groups (P>0.05). Mal presentation and Ante Partum hemorrhage were significantly more among the multies than primies (p<0.05) and Failed indication and CPD were the significantly lesser indication than the primies (P<0.05).Conclusions: Without reducing the caesarean section rate in primi we cannot bring down the overall caesarean rate of delivery.

scholarly journals Maternal and foetal outcome in second stage caesarean section: a prospective study

2021 ◽  
Vol 10 (4) ◽  
pp. 1644
Author(s):  
Shuchi Sharma ◽  
Poojan Dogra ◽  
Reena Sharma ◽  
Suraj Bhardwaj
Keyword(s):  
Caesarean Section ◽  
Prospective Study ◽  
Cervical Dilatation ◽  
Bladder Injury ◽  
Fetal Head ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Adjacent Structures ◽  
A Prospective Study

Background: Caesarean section is the most commonly performed abdominal operation in women all over the world. Caesarean sections during the second stage labour accounts for approximately one fourth of all primary caesareans.  Caesarean section at full cervical dilatation is technically difficult and is associated with increased trauma to the lower uterine segment and adjacent structures, as well as increased haemorrhage and infection. Aims and objectives were to determine the indications, maternal and foetal morbidity associated with caesarean section in the second stage of labour.Methods: This prospective study included consecutive 50 cases of caesarean section deliveries conducted in second stage of labor for singleton live pregnancies at term. The data collected in the study was analyzed in terms of maternal demographics, indications of caesarean section, intra-operative and postoperative complications and neonatal outcomes.Results: In our series of 50 deliveries, arrest of descent of fetal head due to malposition was the most common indication of caesarean section accounting for 74% and average procedure time was 45-70 minutes. PPH (62%) was the most common complication. Bladder injury was found in 14% cases. Neonatal outcome variables like APGAR<3 at 5 minutes, respiratory distress and neonatal death were observed in 7, 26 and 2 deliveries respectively.Conclusions: Women undergoing cesarean section in second stage of labour are associated with increased maternal and fetal morbidity. They require special care and hence operation should ideally be performed and supervised by an experienced obstetrician. A proper judgement is required to take a decision for caesarean section at full cervical dilatation.

scholarly journals Premature Rupture of Membrane - A Clinical Study In Comilla Medical College Hospital

2016 ◽  
Vol 28 (2) ◽  
pp. 82-87
Author(s):  
Shahela Nazneen ◽  
Farhana Begum ◽  
Shakila Nargis
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Pregnant Women ◽  
Caesarean Section Rate ◽  
Age Distribution ◽  
Medical College Hospital ◽  
Sociodemographic Characteristics ◽  
Premature Rupture ◽  
College Hospital ◽  
Medical College

Objective: To find out the sociodemographic characteristics, complications of pregnant woman with premature rupture of membrane (PROM) and asses the outcome of it.Materials and Methods: This prospective study was carried out at the department of Obstetrics & gynaecology of Comilla Medical College Hospital (CoMCH) from January 2009 to December 2009. All pregnant women admitted with PROM during this period were taken as study population. After taking proper history they were categorized as term or preterm PROM on the basis of duration of gestation estimated from 1st day of last menstrual period (LMP), previous antenatal records, clinical examination & also previous ultrasonography (USG) reports. Out of sociodemographic characteristics age distribution and gravidity were noted. Diagnosis was done on the basis of examination and investigations. All the women with PROM were then followed up, management was given according to protocol and caesarean section was performed according to indication. Birth weight and Apgar score of newborns were noted after delivery.Results: There were 198 cases of PROM recorded among 3142 admitted obstetrical patients over one year period. The hospital incidence of PROM was found to be 6.3%. Among them, 57.6% patients were admitted at term and 42.4% patients came before 37 completed weeks of gestation. Most of the pregnant women were between 20-24 years of age (54%), 41% were primigravida (59%) were multigravida. About 48.5% women presented with different complications associated with PROM. Among which 15.7% patients had oligohydramnios, 8.5% patients presented with chorioamnionitis suggested by culture report of high vaginal swab. Urine for culture and sensitivity was also done. About five (5.2%) developed premature labour before 37th week of gestation. About 10% women developed obstetric complications (failed trial) associated with medical diseases. Seventy seven patients were delivered by caesarean section, 16.2% vaginally, 4.04% patients responded to conservative management and 2.5% patients were referred to tertiary centre for extreme prematurity with associated complicating factors. Most of the babies (38.4%) were born with birth weight between 2.1- 2.5kg and 10.3% babies were less than 1.5kg.Conclusion: Term PROM was more in comparison to PPROM and most of them were multigravida. Caesarean section rate was high. Most common complication of was subclinical urogenital infection (53%) next oligohydramnios (25%) & (13.5%) women presented with chorioamnionitis.Bangladesh J Obstet Gynaecol, 2013; Vol. 28(2) : 82-87

scholarly journals Repeat Caesarean Sections: Complications and Outcomes

2019 ◽  
Vol 10 (2) ◽  
pp. 74-79
Author(s):  
Aforza Ghani ◽  
Israt Jahan Ila ◽  
Jannat Ara Ferdouse ◽  
Nasrin Sultana ◽  
Jesmin Sultana
Keyword(s):  
Caesarean Section ◽  
Placenta Praevia ◽  
Abdominal Adhesions ◽  
Maternal Complications ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
History Of ◽  
Study Population ◽  
Caesarean Hysterectomy

Background: The rising incidence of caesarean section all over the world has been of great concern both to the patients and obstetrician.1 Repeat caesarean section is one of the major reasons which have contributed greatly to high caesarean section (CS) rate.1,2 Although maternal death as a result of CS is now rare, reports of the short-and long-term consequences of the rising CS rate on the childbearing population are conflicting.3 Available data show that repeat caesarean section is associated with many maternal complications, specially intra-abdominal adhesions, central placenta praevia, uterine rupture, caesarean scar pregnancy, caesarean hysterectomy etc.4 Objective: To evaluate outcome and complications of multiple repeat caesarean section. Methodology: This was a cross sectional prospective study conducted in Shaheed Suhrawardy Medical College Hospital (ShSMCH) from 1st June’2016 to 30th November’2016 for a period of six months. The study population were 102 patients, selected randomly who were admitted in ShSMCH for repeat caesarean section. Results: Out of 102 patients admitted with history of previous caesarean section, maternal morbidity was 26 (25.49%), which includes intra-abdominal adhesions 19 (18.62%), excessive blood loss 6(5.88%), placenta praevia 4 (3.94%), placenta accreta 1 (.98%), postpartum haemorrhage 11 (10.78%), wound infection 12 (11.76%) etc. Conclusion: As the rate of repeat caesarean section continue to rise, surgeons should be more judgemental in doing caesarean section. J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 74-79

scholarly journals Comparing the Rate of Perineal Tears with and Without Episiotomy in Primigravida Women

2021 ◽  
pp. 61-66
Author(s):  
. Neelam ◽  
Kiran Batool ◽  
Sadia Kadir ◽  
Kaneez Fatima ◽  
Afshan Nadeem ◽  
...  
Keyword(s):  
Singleton Pregnancy ◽  
Perineal Tear ◽  
College Hospital ◽  
Medical College ◽  
Second Stage ◽  
Perineal Tears ◽  
Second Stage Of Labour ◽  
Group A ◽  
Group B ◽  
Labour Room

Objective: To compare the frequency of perineal tears (3rd and 4th degree) with and without episiotomy in primigravida women. Setting: Department of Obstetrics and Gynecology at peoples Medical College Hospital (PMCH) Nawabshah. Duration of Study: Six month from March 2015 to September 2015. Study Design: Randomized control trial. Subject and Methods: In this study 322 primigravida women with singleton pregnancy and cephalic presentation were included. The patients were kept in labour room till the second stage of labour. The patients were divided into two groups equally. In Groups-A, right mediolateral episiotomy was performed after infiltration with local anaesthesia at the time of crowing. The Group B in which episiotomy was not given. After delivery, patients were examined for extension of episiotomy in Group A and 3rd and 4th degree perineal tear in both groups. Results:  Mean age was 27.83±6.27 years in group A and 27.60±4.93 years in group B (p=0.724). Mean gestational age was 38.17±1.25 weeks was in group A and 38.11±119 weeks in group B (p=0.644). The rate of 3rd and 4th degree perineal tear was significantly higher in group A as compare to group B [60.87% vs. 47.83% p=0.019] and [39.13% vs. 26.09% p=0.013] respectively. Conclusion: Episiotomy was found to be an important risk factor for extension of the perineal tear. It should be practiced only where it is indicated like rigid perineum, any instrumental delivery and shoulder dystocia.

scholarly journals A prospective observational study of fetomaternal outcome in second stage caesarean section

2019 ◽  
Vol 8 (12) ◽  
pp. 4798
Author(s):  
Isha . ◽  
Prabha Lal ◽  
Vikram Dutta ◽  
Aayushi Kaushal
Keyword(s):  
Caesarean Section ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Caesarean Section Rate ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Bladder Injury ◽  
Intraoperative Complication ◽  
Second Stage ◽  
Second Stage Of Labour

Background: Incidence of caesarean section is rapidly rising over last two decades and one fourth is contributed by caesarean section in second stage. The objective of this study was to study of fetomaternal outcome in second stage caesarean section.Methods: Prospective observational study was done in 80 women undergoing second stage caesarean section from December 2015 to March 2017 at Lady Hardinge Medical Collage Delhi. These women observed from labour to caesarean section in second stage of labour till post-operative period for any complication. Intraoperative and postoperative complications were observed in these women.Results: Caesarean section rate was 22% in which 3.9% were done in second stage of labour. Most common gestational age being 39-40 weeks (47%). Most common indication being deep transverse arrest (41.25%). Intraoperative complication as bladder injury (5%), extension of uterine incision (23%), PPH (33%) and need for blood transfusion (31%) and post-operative complication as wound sepsis in 58% and 20% requiring resuturing, post-operative fever, prolong hospital stay, prolonged catheterization etc. neonatal complications as severe birth asphyxia (2.5%), respiratory distress (55%), need for mechanical ventilation.Conclusions: Thus, caesarean section done in second stage of labour is associated with increased maternal and neonatal morbidity.

scholarly journals Comparison of caesarean section rate and maternal complications in elective induction versus spontaneous labor

2021 ◽  
Vol 10 (11) ◽  
pp. 4249
Author(s):  
Salma Kousar Beigh ◽  
Samar Mukhtar ◽  
Nighat Firdous ◽  
Fariha Amaan
Keyword(s):  
Caesarean Section ◽  
Post Partum ◽  
Caesarean Section Rate ◽  
Fetal Distress ◽  
Induction Of Labor ◽  
Maternal Complications ◽  
Medical College ◽  
Vaginal Deliveries ◽  
Increased Risk ◽  
Elective Induction

Background: Elective induction of labor is defined as an initiation of labor, either by mechanical or pharmacological means at a time earlier than nature regardless of a medical or obstetric indication. Objectives were to estimate the proportion of caesarean sections and vaginal deliveries and magnitude of maternal complications following elective induction and spontaneous labor.Methods: The study entitled “comparison of caesarean section rate and maternal complications in elective induction versus spontaneous labor in LD Hospital, Kashmir” was a hospital based observational study, conducted in the Postgraduate Department of Obstetrics and Gynaecology, LallaDed Hospital of Government Medical College, Srinagar over a period of one and a half years.Results: Women in induced labor group had slightly increased risk of caesarean section than those in spontaneous group. Fetal distress was the most common indication for caesarean section in both the groups. There was no difference in both groups regarding maternal complications such as perineal lacerations; postpartum hemorrhage (PPH); need for blood transfusions and post partum hospital stay.Conclusions: Though induction of labor is associated with a slight increased risk of caesarean delivery, it is not related to other maternal complications. Therefore inductions are safe in hands of safe obstetricians.

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