scholarly journals Delivery by repeat caesarean section today: an overview

2018 ◽  
Vol 7 (10) ◽  
pp. 4127
Author(s):  
D. M. Christe ◽  
Shaanthy T. K. Gunasingh ◽  
V. Bharani
Keyword(s):  
Caesarean Section ◽  
Gestational Hypertension ◽  
Tertiary Care ◽  
Study Group ◽  
Age Group ◽  
Background Characteristics ◽  
Tertiary Care Centre ◽  
Postpartum Contraception ◽  
Maternal Deaths ◽  
Neonatal Deaths

Background: To find out the maternal and neonatal outcome and background characteristics of women delivering by repeat caesarean section in a tertiary care centre in Chennai, South India.Methods: Parturition records for the year 2017, were accessed and case records, for the calculated sample size were selected. Demographic features, obstetric history, gestational age and antenatal complications were recorded. Maternal outcome and baby details including sex of the baby, birth weight, APGAR and admission to New born Intensive Care Unit (NICU) data and acceptance of postpartum contraception was noted.Results: In the study group, 156 women delivered by repeat caesarean section.  The age group of women ranged from 20 years to 38 years.  Majority of 83.4% of women were Para one.  Threatening rupture was recorded in 2.6% of women. The risk of previous two CS scars was noted in 3.2% of women. More than 41% of women had other complications. Most often observed complications were Gestational hypertension, Gestational diabetes, preeclampsia and eclampsia. Pregnancy complications of oligohydramnios, twins, breech and abnormal presentation, were significant. 1% of women had associated medical complications of anaemia and hypothyroidism.  Maternal and Fetal causes were the most important indication for caesarean section in 74% of women. There were no maternal deaths in present study group. Postpartum contraception was accepted by 55 % of women.Conclusions: Majority of repeat caesarean section was observed most commonly in para one women in the age group of 26-30 years More than 41% of women had associated medical and obstetric complications. There were no maternal deaths in this study. Neonatal deaths were 2.5%.

scholarly journals A prospective study of the incidence and outcomes of eclampsia in a tertiary care hospital and teaching institute in India

2019 ◽  
Vol 8 (7) ◽  
pp. 2766
Author(s):  
Garima Gandhi ◽  
Kavita Chandnani
Keyword(s):  
Magnesium Sulphate ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Outcome Data ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Maternal Complications ◽  
Maternal Deaths ◽  
Neonatal Deaths ◽  
A Prospective Study

Background: Eclampsia is a common cause of maternal and foetal morbidity and mortality in India and the rest of the world accounting for nearly 10% of all maternal deaths. However, there is a relative scarcity of outcome data for patients with eclampsia in India. Our goal was to estimate the incidence of eclampsia, the maternal and foetal outcomes of patients presenting with eclampsia, and predictors of clinical outcomes in these patients. Objective of this study was to estimate the incidence of eclampsia in patients who delivered at a single tertiary care institution over a 2-year period and to study the maternal and perinatal outcomes in those patients.Methods: Prospective cohort study conducted from September 2008 to August 2010 on all patients with eclampsia admitted during the study period at Lok Nayak Hospital, New Delhi, India.Results: The incidence of eclampsia among total deliveries was 0.45%.  About 97% of these patients received parenteral magnesium sulphate as the primary anticonvulsant therapy. Caesarean section was performed in 22.7% and majorities were done for foetal distress. Maternal complications were encountered among 17% of patients. There were 2 maternal deaths (2.3%), 13 stillbirths (14.1%) and 7 early neonatal deaths (7.9%).Conclusions: The incidence of eclampsia among all deliveries over a 2-year period at a tertiary care centre in India was 0.45%. Parenteral magnesium sulphate was effective in the vast majority of these patients in controlling the seizures. Further studies to evaluate whether early registration for antepartum care improves maternal and foetal outcomes in patients with eclampsia are warranted.

scholarly journals A 3 year retrospective study of pregnancies complicated with placenta previa in a tertiary care centre

2021 ◽  
Author(s):  
Vatsala Kamath ◽  
Aparna C. Aravind ◽  
Nishita Shettian
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Pregnant Women ◽  
Neonatal Intensive Care ◽  
Placenta Previa ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
Age Group ◽  
Tertiary Care Centre

Background: Placenta previa describes when a placenta is implanted partially or completely over the internal OS. About one third of the ante partum haemorrhage belongs to placenta previa. The incidence is increased beyond the age of 35 years, with high birth order pregnancies, prior caesarean deliveries and in multiple pregnancy. The aim of the study was to determine maternal and fetal outcome in pregnancies complicated with placenta previa.Methods: A 3 year retrospective study done in OBG department of A. J. Institute of Medical Sciences, Mangalore from January 2017- January 2020. All pregnant women who are diagnosed with placenta previa during regular antenatal care (ANC) follow up, at or after admission and during caesarean delivery are included in the study. Data were collected from the hospital records.Results: During the study period, there were 34 pregnant women with placenta previa. Maximum were in the age group of 31-35 years of age and 8.82 percentage were in the age group more than 35 years. Out of the study subjects,76.5 percentage were multigravidas and 50 percentage were giving history of prior one caesarean section. 29.4 percentage of study subjects had true placenta previa and 85.2 percentage underwent elective caesarean section. There were significantly higher number of babies required neonatal intensive care unit (NICU) admissions.Conclusions: An increase in the incidence of women with advanced maternal age, multiparity, prior caesarean deliveries contributes to a rise in the number of pregnancies complicated with placenta previa.

scholarly journals Relaparotomy after Caesarean Section - An Obstetrician’s Ordeal

2020 ◽  
Vol 7 (52) ◽  
pp. 3126-3130
Author(s):  
Sandhyarani Behera ◽  
Sony Nanda ◽  
Puspanjali Khuntia ◽  
Jayashree Rout
Keyword(s):  
Caesarean Section ◽  
Postpartum Haemorrhage ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Primary Surgery ◽  
Initial Surgery ◽  
Total Incidence

BACKGROUND The term "Relaparotomy" (RL) refers to operations performed within 60 days in association with the initial surgery. The aim of current study was to investigate the indications, risk factors, procedures undertaken during relaparotomy after caesarean section (CS). METHODS We conducted a retrospective observational study in all patients undergoing relaparotomy after caesarean section, at a tertiary care centre in Odisha over a period of 2 years from January 2017 to December 2018. RESULTS The total incidence of relaparotomies was 0.7 % and the incidence among the sections conducted in our hospital alone was 0.2 %. Obstructed labour (20 %), oligohydramnios with fetal distress (20 %) are major indications of caesarean section. Most of the surgeries (60 %) took place within the first 24 hours of the primary surgery. Most common indication of relaparotomy in our study was postpartum haemorrhage (63.3 %). All women were in the age group of 20 - 35 years and most of them were multiparous (60 %). Pre-existing anaemia is the major (50 %) comorbid factor associated with atonic postpartum haemorrhage which leads to relaparotomy. Major indication of relaparotomy in the present study was haemorrhage (76.5 %). CONCLUSIONS Undertaking proper precautions to ensure proper haemostasis and asepsis, taking calculative decision before embarking a hasty decision is important in decreasing the incidence of relaparotomy. KEYWORDS Relaparotomy, Caesarean Section, Postpartum Haemorrhage, Asepsis

scholarly journals Study of early perinatal outcome in lower segment caesarean section in severe foetal distress at tertiary care centre

2020 ◽  
Vol 9 (3) ◽  
pp. 1259
Author(s):  
Chandrakant A. Jadhav ◽  
Tirankar V. R. ◽  
Gavandi P. S.
Keyword(s):  
Caesarean Section ◽  
Perinatal Outcome ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Time Interval ◽  
Study Group ◽  
Foetal Distress ◽  
Tertiary Care Centre ◽  
Significant Difference ◽  
Nicu Admission

Background: For asphyxia, the fetus reacts with a series of responses. First there is redistribution of blood flow to vital centres to limit the deleterious effects of oxygen limitation in the brain, heart and adrenal glands. A further compensatory response is that overall fetal oxygen consumption declines to values as low as 50% of the control.Methods: This was a prospective study. Early perinatal outcome of newborns delivered through Caesarean section due to clinical foetal distress in labour was compared with a group of newborns similarly delivered via Caesarean section without a diagnosis of clinical foetal distress. Data collected and analysed using appropriate standard statistical methods i.e. Chi-square (X2) test and ‘Z’ - test.Results: Most common indication for NICU admission in study group was MAS (Meconium Aspiration Syndrome 14%) followed by MAS with perinatal asphyxia (5.33%), MAS with Hypoxic ischaemic encephalopathy (HIE) - stage III (3.33%) paerintal asphyxia (2.66%), severe PNA with HIE - III (0.66%) and TTN (0.66%) meconium gastritis (0.66%) respectively.Conclusions: Clinical foetal distress (study group) was found to be significantly associated with low 1 min and 5 min. Apgar score. There was no significant difference in immediate NICU admission whether D-D (i.e. detection fetal detection to delivery interval) time interval <30 minutes or >30 minutes. But rate of mortality was high when D-D (i.e. detection fetal detection to delivery interval) was >30 minutes.

scholarly journals A randomised single blind control study to assess the effect of intrapartum amnioinfusion on maternal caesarean section rate and fetal outcome in a tertiary care centre

2017 ◽  
Vol 6 (10) ◽  
pp. 4347
Author(s):  
Michelle Fonseca ◽  
Jyotsna S. Dwivedi
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Meconium Aspiration Syndrome ◽  
Control Group ◽  
Study Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Meconium Stained Amniotic Fluid

Background: The procedure of instilling normal saline/Ringer’s lactate into the uterine cavity is called amnioinfusion. Objective of present study was to assess the effect of intrapartum amnioinfusion on maternal caesarean section rate and fetal outcome in a tertiary care centre in cases of meconium stained amniotic fluid.Methods: A total of 160 women at term in labor with meconium stained amniotic fluid were randomized into two groups: study and control group. The study group received transcervical amnioinfusion at detection of MSAF. The control group was given the routine obstetric care. Both groups were started on O2 and intrapartum monitoring. The outcomes in both groups were analyzed statistically.Results: The control group had caesarean section rate of 45% and in the study group it was 31.25%. The difference was statistically significant. The outcome in the neonate was assessed on the parameters such as respiratory distress, neonatal intensive care unit admission, meconium aspiration syndrome, neonatal deaths.Conclusions: Amnioinfusion in cases of meconium stained amniotic fluid cases significantly reduces the risk of meconium aspiration syndrome. It also decreases the need for operative intervention thus reducing the risk of maternal morbidity and mortality.

scholarly journals Detection and Enumeration of the Commonest Stool Parasites Seen in a Tertiary Care Center in South India

2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Vani Chandrashekar
Keyword(s):  
Entamoeba Histolytica ◽  
South India ◽  
Care Center ◽  
Tertiary Care ◽  
Age Group ◽  
Tertiary Care Center ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Stool Samples

The aim of this study was to identify common stool parasites in patients attending a tertiary care centre in South India. We evaluated 2355 stool samples and parasites were detected in 7.9% of samples. 41.1% of our patients were in the 45–58-year age group. Protozoal infections were the commonest seen in 7.8% of samples. Entamoeba histolytica was the commonest protozoa (4.6%) followed by Entamoeba coli (1.2%) and Giardia (0.8%). Entamoeba histolytica and Entamoeba coli were together seen in 0.63%, and they were the commonest organisms seen in samples with multiple-organism infection. Both were equally detected in diarrheal samples.

scholarly journals Pattern of Ear Diseases among Paediatric ENT Patient: An Experience from Tertiary Care Centre, Pokhara, Nepal

2012 ◽  
Vol 32 (2) ◽  
pp. 142-145 ◽  
Author(s):  
B Sigdel ◽  
R Nepali
Keyword(s):  
Tertiary Care ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Suppurative Otitis Media ◽  
Ear Diseases ◽  
Paediatric Age ◽  
One Year ◽  
A Prospective Study ◽  
Nose And Throat

Introduction: Ear diseases are common in children mainly due to altered anatomy of Eustachian tube which is straighter in children as compared to that in adults. However, the cause of hearing loss in children is more varied, including the etiologies. This study was done to find out the pattern of ear diseases in paediatric age group attending ear, nose and throat OPD in a tertiary care centre in Pokhara, Nepal. Materials and Methods: This is a prospective study done in paediatric patients attending ENT OPD over a period of one year from January 2010 to January 2011. The diagnoses were made on the basis of history and clinical examination. Results were expressed in numbers and percentages. Results: Out of 1632 Pediatric ENT patients, 944 had ear diseases, 59.2% were males and 40.8% females. Wax (33.4%) was the commonest diagnosis followed by Chronic suppurative otitis media (24.3%) and Acute ottitis media (13%). Conclusion: Ear diseases are most common condition in ENT OPD among paediatric age group. Wax, CSOM and ASOM were the three most common ear diseases. J. Nepal Paediatr. Soc. 32(2) 2012 142-145 doi: http://dx.doi.org/10.3126/jnps.v32i2.5673

TO DETERMINE THE PREVALENCE AND OCCURANCE OF VISUAL MORBIDITY IN PATIENTS OF PTERYGIUM ATTENDING EYE OPD IN A TERTIARY CARE CENTRE OF EASTERN INDIA

2021 ◽  
pp. 80-81
Author(s):  
Vandana Parasar ◽  
Vidyabhushan Kumar ◽  
Ankita Singh ◽  
Nilesh Mohan
Keyword(s):  
Socioeconomic Status ◽  
Tertiary Care ◽  
Living Condition ◽  
Age Group ◽  
Care Centre ◽  
Eastern India ◽  
Tertiary Care Centre ◽  
Male Preponderance ◽  
Uvb Exposure ◽  
Epidemiological Trends

To determine the prevalence and occurrence of visual morbidity in patients of pterygium attending eye opd in a tertiary care centre of Bihar. Methods: In this observational study a total of 193 patients, diagnosed with pterygium, underwent complete ocular examination by an ophthalmologist. Epidemiological trends including age, sex, occupation, effect of living condition and socioeconomic status were analyzed. Results: There is a male preponderance of 58.03%. The age incidence of the group showed that the incidence of pterygium was 10.36% in the age group of less than 30 years. It rises to a maximum of 29.53% in the age of 41-50 years and then gradually declines.. The incidence was found to be maximum among farmers(39.86%) followed by miners(31%). Conclusion: People who work outdoors are at a greater risk because they are subjected to involuntary UVB exposure. The highest exposure occurs during the two hours on either side of noon. Workers must be aware and should take appropriate measures like wearing protective glasses, caps, etc

A CLINICOEPIDEMIOLOGICAL STUDY ON PAEDERUS DERMATITIS IN A TERTIARY CARE CENTRE, CHENNAI

2021 ◽  
pp. 25-27
Author(s):  
P. Mohan ◽  
P. Revathi Guru ◽  
V. Sudha ◽  
L. Balamurugan ◽  
Pavithra Gunasekaran ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Sudden Onset ◽  
The Body ◽  
Care Hospital ◽  
Age Group ◽  
Common Condition ◽  
Tertiary Care Centre ◽  
Linear Lesions ◽  
Paederus Dermatitis

Paederus dermatitis is a form of irritant contact dermatitis due to contact with certain insects of the genus Paederus presenting with mostly erythematous linear lesions of sudden onset on exposed parts of the body. To study the clinico epi Aim: demiological features in patients with Paederus dermatitis. A retrospective analysis of clinicoepidemiological Materials & Methods: features of patients affected with Paederus dermatitis who had attended the Dermatology OPD, in a tertiary care hospital between January 2018 to December 2019 was done. All the required data had been collected from the OPD records and details were tabulated and analysed. A total of 56 patients had been affected with Result: Paederus dermatitis during the study period, of which 32 were males and 24 were females. 41out of 56 (73.21%) of patients presented between the months of August and December. Most common age group affected were between 11 to 30 yrs, with front and back of neck being the most common affected sites. In 42 out of the 56 patients the lesions resolved with post inammatory hyperpigmentation. Conclusion: Paederus dermatitis is a common condition that is often misdiagnosed and hence awareness is required for the clinicians and the general public to prevent it.

scholarly journals CLINICAL PROFILE OF INTUSSUSCEPTION IN CHILDREN ADMITTED TO A TERTIARY CARE CENTRE IN KERALA

2020 ◽  
Vol 4 (12) ◽  
Author(s):  
Neethu Jose ◽  
Aparna Namboodiripad ◽  
Regi George A N
Keyword(s):  
Tertiary Care ◽  
Spontaneous Resolution ◽  
Reduction Technique ◽  
Clinical Profile ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Hydrostatic Reduction ◽  
Duration Of Hospital Stay ◽  
Study Population

Background and objectives: Intussusception is the commonest cause of bowel obstruction and is one of the common abdominal emergencies in children younger than 2 years of age.The objective of the study was to assess the clinical profile of intussusception in children and the management and the outcome  and  to assess whether the characteristics mentioned in clinical profile are predictive of subsequent management and outcome of the disease. Methods: A hospital based descriptive study conducted in a tertiary care centre in Kerala, using purposive sampling technique. 120 children admitted with diagnosis of intussusception   fulfilling inclusion criteria and whose parents consented for study were included in the study population, during the study period from November 2018 to June 2020. Detailed history, clinical examination including per rectal examination  and USG was done to make diagnosis of intussusception in suspected cases. Follow up is done at 72 hours,1 week after the admission and 1month later. To assess the clinical profile and outcome of patients, frequency and percentage is used. To obtain the association of clinical profile with outcome chi square test is applied. Results: Outcome of the problem was correlated with age, sex, symptoms, risk factors sonological findings treatment protocol and duration of hospital stay. Out of the 120 children in study population, majority were males(65.8%) with male to female ratio 1.9:1 and majority was in the age group 7- 12 months, which is similar to many other similar studies. Maximum number of cases were in the month of February(14.2%) and November(15%).  Majority of the patients(57.5%) presented to healthcare facility within 24 hours of onset of first symptom.Irritability was the most common clinical symptom(62.5%) followed by vomiting(58.3%) and abdominal pain(49.2%). Ileocolic intussusception (96.7%) was the commonest type. Majority of the cases could be managed with hydrostatic saline reduction(73.3%) and significantly lesser number of patient went for surgical intervention(7.5%) and spontaneous resolution(19.2%). Conclusions: Incidence of intussusception is more common among males and more in the 7-12 month age group.  Majority of the cases presented to health care facility within 24 hours of onset of symptom and could be managed with hydrostatic reduction technique and had a shorter duration of hospital stay compared to surgical reduction technique. Even recurrent cases could be managed with hydrostatic saline reduction. Keywords: Intussusception;  Intestinal obstruction;  Hydrostatic reduction; Spontaneous resolution

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