scholarly journals Maternal and fetal outcome in emergency versus elective caesarean section

Author(s):  
Sonal Agrawal ◽  
Vimal K. Agarwal

Background: Caesarean section preferred as an emergency or elective procedure are entirely different entities according to measures taken, facilities and skilled staff available and preparation done. It has been shown that risk of surgical complications is greater with emergency compared with elective caesarean section.Methods: Present study is a retrospective study, designed to evaluate maternal and fetal outcomes in elective versus emergency caesarean section performed at our hospital from January 2016 to December 2016.Results: Out of 2156 caesarean, 1628 were emergency and 528 were elective caesarean section.  In our study overall intra operative complications were 11.08% which was mainly contributed to emergency group.Conclusions: The elective caesarean section shows less maternal and perinatal complications as compared to emergency caesarean sections. Increasing incidence of emergency caesarean section can be reduced by encouraging all pregnant females to visit antenatal clinics.

2017 ◽  
Vol 15 (2) ◽  
pp. 110-113
Author(s):  
Apurwa Prasad ◽  
Garima Bhandari ◽  
Rachana Saha

Background: There is a world-wide rise in caesarean section rateduring the last three decades and has been a cause of alarm and needs an in-depth study. The objective of this study was to determine the rate and clinical indications of Caesarean Section.Methods: A hospital based study was carried out from 15th June 2015 to 15th January 2016 in Department of Obstetrics and Gynecology at Kathmandu Medical College, Sinamangal, Nepal. Patients who delivered by caesarean section were included in the study. Basic demographic data and clinical indications were noted.

Results: A total of 1172 deliveries were carried out during the study period. Total number of caesarean section was 537 accounting to 45.81%. Most of the patients were of the age group of 25-29 years (42.8%). Most of the patients were primigravida (n=274; 51%). Emergency caesarean section was 411 (76.5%) and elective caesarean section was 126 (23.4%). Multigravida (71%) underwent more elective procedure than primigravida (25. 39%).The most frequent indication was fetal distress19.55% (n=105), failed induction 19.73%(n=106), and previous caesarean section 21.3% (n=115).Conclusions: The rate of cesarean section is quite high than that recommended by WHO which is (10-15%). Most of the caesarean sections were emergency caesarean section with previous caesarean being the leading cause.


2020 ◽  
Vol 18 (2) ◽  
pp. 186-189
Author(s):  
Naveen Darnal ◽  
Ganesh Dangal

Background: Caesarean section is one of the most performed surgical procedures all over the world. It is associated with high morbidity and mortality as compared to vaginal delivery. The present study was carried out to evaluate the maternal and neonatal outcome and complications in two groups of pregnant women who underwent elective and emergency cesarean section, so that measures can be taken to reduce morbidity and mortality in near future.Methods: It was hospital based descriptive cross-sectional study carried out at Paropakar Maternity and Women’s Hospital from October to December 2018. There were 340 patients enrolled in the study 170 in elective and 170 in emergency caesareans selected randomly. Ethical approval was obtained from the Institutional Review Board and informed consent was taken from the patients and patients’ guardians. Data were collected daily from the Operation Theater. Results: The rate of caesarean section in the hospital was 30.7%. Proportion of emergency caesarean section was 1324 (74.4%) and elective caesarean section was 456 (25.6%). Emergency Caesarean section was more common in younger age group and in primigravida while elective Caesarean section was more common in advanced age group and in multigravida. The most common indication for emergency Caesarean section was Fetal Distress and the most common indication for elective Caesarean section was previous cesarean with refused vaginal delivery after cesarean section. The maternal outcome in terms of post-operative wound infection, (post-partum hemorrhage, urinary tract infection need for blood transfusion, fever and need for maternal intensive care unit admission was significantly (p- value <0.05) higher in emergency Caesarean section than in elective Caesarean section .The fetal outcome in terms of birth asphyxia, meconium stained liquor and need for Neonatal ICU admission were significantly (p – value <0.05) higher in emergency Caesarean section than in elective Caesarean section. Conclusions: Maternal and fetal complications were significantly higher in the emergency caesarean section as compared to elective caesarean section group.Keywords: Fetal outcome; emergency cesarean section; elective cesarean section; maternal outcome.


Author(s):  
Amit A. Gurunule ◽  
Himangi S. Warke

Background: Caesarean delivery is defined as the birth of the foetus through an incision in the abdominal wall (i.e. laparotomy) and the uterine wall (hysterotomy). The purpose was to analyze the maternal and foetal outcome in elective versus emergency caesarean sections retrospectively in a tertiary care centre and to analyze the indications of elective versus emergency caesarean sections.Methods: A retrospective observational study of the cases undergoing caesarean sections in KEM hospital, Mumbai, India was carried out during the period of September 2013 to September 2015. Maternal and foetal outcome was studied. The data was collected and analyzed from the maternal medical records. The neonatology records were also examined.Results: Out of the 600 selected patients, 300 patients in each group of elective and emergency caesarean section were studied. The usual indications of emergency caesarean sections were foetal distress, followed by meconium stained amniotic fluid (MSAF) and cephalopelvic disproportion (CPD). The most frequent indicator for elective lower segment caesarean section (LSCS) was patient with previous LSCS not willing for vaginal birth, followed by breech presentation and previous multiple LSCS. There was a significant difference seen in the occurrence of fever, urinary tract infections and wound infections in the two groups. These were more common in the emergency caesarean section group. Significant difference was also seen in the incidence of postpartum haemorrhage in the two groups, which was more in the elective caesarean section group.Conclusions: The maternal morbidity, intra operative and postoperative complications were more in the emergency LSCS group as compared to patients who underwent elective LSCS.


Author(s):  
Anshu Sharma ◽  
Rajiv Acharya ◽  
Yashika Pehal ◽  
Bhawna Sharma

Background: Caesarean section is a life-saving surgical procedure when certain complications arise during pregnancy or labour. The use of CS worldwide has increased worldwide unprecedented levels although the gap between higher- and lower-resource settings remains. The present study evaluates the difference in maternal outcome in elective versus emergency caesarean sections in our institute.Methods: The study included first 65 cases of emergency caesarean section (group A) and during the study period, first 65 elective caesarean section (group B) if they fulfilled the inclusion criteria. Various intra operative and postoperative events were recorded which included intra operative complications, postpartum haemorrhage and transfusion indices.Results: The most common indication of caesarean section in group A was fetal distress (27.7%). In group B most caesarean sections were classified under 5 followed by class 6, the most common indication being previous caesarean section (27.6%). It was observed that pre-operative mean haemoglobin in group A was 10.6 g/dl and in group B was 11.2g/dl. A drop of 1.36 g/dl in group A and 1.10 g/dl in group B was observed in the post-op period. Cross match / transfusion ratio 1.5 in group A and  2 in group B, transfusion probability ratio was 60 % in group A and  66.7%  in group B and transfusion index was 1 in group A and  group B. There was significantly higher contraception acceptance in group B compared to group A.Conclusions: Elective caesarean section has more favourable maternal outcome as compared to emergency caesarean section as the former is done under controlled and planned circumstances.  However, there should be stringent audit to scrutinise indication of caesarean section, outcome of caesarean and blood transfusion practices.


2021 ◽  
Vol 2 (1) ◽  
pp. 60-65
Author(s):  
Jamila A Garba ◽  
Abubakar A Panti ◽  
Ahmed Yakubu ◽  
Eze A Ukwu ◽  
Ahmed T Burodo ◽  
...  

Background: Caesarean section is the most significant obstetrics operative intervention globally. Good postoperative experience after caesarean section is important because there is need for the mother to recover from surgery and take care of her baby. The aim of this study was to assess the experience of women that had caesarean section in the first 24 hours postoperatively. Materials/methods: This was a cross-sectional study conducted among women that had elective and emergency caesarean section. They were followed up to 24 hours post-operative. The primary outcome measures were pain score and satisfaction. Secondary outcome measures were time of mobilization, time of commencement of oral feeds and time of initiation of breastfeeding. Data analysis was carried out using Statistical Package for Social Sciences version 22. Results: The median pain scores among those that had emergency and elective caesarean section ranged between 2 and 3 at all points of pain assessment. The satisfaction was good among 66.1% that had emergency caesarean section and 71.2% among those that had elective caesarean section. However, the difference was not statistically significant (χ2 = 0.546, p = 0.761). More than 90% of the participants that had either emergency or elective caesarean section did not ambulate within the first 24 hours after caesarean section and there was no association between the time of ambulation and the type of caesarean section (χ2 = 0.005, p = 0.941). Conclusion: The participants had adequate pain relief and majority were satisfied with the pain relief. However, the optimum satisfaction was not achieved. The participants did not ambulate early and did not initiate breast-feeding early. Recommendation: Further research is recommended to assess other factors that affect patient's satisfaction and ambulation so as to improve on patient's postoperative care.


2020 ◽  
Vol 5 (3) ◽  
Author(s):  
Mullika Borisoot

PICO question In pregnant bitches due to whelp, is elective caesarean section more effective than vaginal delivery to improve puppy survival?   Clinical bottom line Category of research question The category of the research question is regarding the incidence of puppy mortalities as a result of vaginal delivery, emergency caesarean section and elective caesarean section. The number and type of study designs reviewed Two retrospective articles were reviewed and critically appraised; one retrospective study with high single canine breed bias and one study on different canine breeds but limited support in directly answering the PICO question. Strength of evidence The studies selected both had strong uses of experimental designs but together provided weak evidence to determine a definitive answer to the PICO question. Outcomes reported The outcomes from both retrospective studies suggests that the mortality rates of newborn puppies can be reduced if pregnant bitches are scheduled ahead for elective caesareans, in comparison to undergoing an emergency caesarean section when complications develop, particularly in breeds with higher risks of dystocia. Therefore, there is some evidence to support that it may be advantageous to consider the breed, age and overall health of the bitch during pregnancy to determine whether elective caesarean sections, for the safe delivery of puppies, should be considered. Conclusion There are currently insufficient studies, literatures and evidence in veterinary medicine for caesarean sections to become a routine procedure in first opinion practices. Future prospective studies should be conducted and include the optimum anaesthetic protocols with the lowest associated risks for the pregnant bitch and puppies.   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  


Author(s):  
S. Eli ◽  
D. G. B. Kalio ◽  
A. Dan- Jumbo ◽  
J. Ikimalo

Decision-Delivery interval when carrying out emergency caesarean section (EmCS) cannot be over-emphasized especially with regards to maternal and fetal outcome. There are variety of factors that may contribute to these intervals such as logistics, personal delay, delay in obtaining of informed consent, lack of blood, and availability of theatre space. Aim: To determine the decision-delivery interval and causes of delay in EmCS at the Rivers State University Teaching Hospital (RSUTH). Methods: It was prospective study conducted at the RSUTH between July 1, 2018 to January 31, 2019. Information was obtained using a self structured questionnaire and analyzed using version SPSS 25. Results: There were 481 patients admitted into labour ward for the period under review of which 71(14.8 %) had EmCS. The mean age was 31 years. The commonest indication for EmCS was Cephalopelvic disproportion (CPD) represented by 23 (32.4%) of the subjects. The average time for decision - delivery interval was 1 to 2 hours represented by 29 (40.8%). The shortest decision - delivery interval was less than 30 minutes 1(1.3%).The decision – delivery interval time greater than 5 hours were 9 (12.7%). The 3 commonest reasons for delay with respect to average decision – delivery intervals were personal delay 21 (20.8%), logistics 19 (18.8%) and lack of blood 13 (12.9%). Conclusion: The study revealed that the average decision - delivery interval was 1 – 2 hours represented by 40.5% of the subjects. This was relatively long when compared to developed countries of the world. The commonest reason for delay in carrying out EmCS was personal delay (20.8%). The commonest indication for EmCS was CPD (32.4%). Addressing the reasons for the decision – delivery interval will help improve our practice and reduce adverse effects to mother and baby.


1989 ◽  
Vol 17 (4) ◽  
pp. 492-495 ◽  
Author(s):  
R. W. Burgess ◽  
J. A. Crowhurst

During 1987 a confidential survey of all hospitals in Australia providing obstetric services was undertaken to determine the antacid medications used routinely as prophylaxis against acid aspiration pneumonitis. Of the 567 hospitals surveyed, 379 (67%) responded. Of these, 243 hospitals provide an obstetric service which includes caesarean section, and 67% of these perform less than 500 deliveries per annum. Aspiration prophylaxis during labour was used in 22.4% of responding hospitals. Prior to elective caesarean section, 11.5% used no prophylaxis, and 39.4% used particulate antacids such as magnesium trisilicate mixture (33.3%) or Mylanta® (6.1%). Sodium citrate mixture was the most popular therapy (37%). Results were similar in the emergency caesarean section group. The use of cimetidine or ranitidine was uncommon in all groups. Results of this survey suggest marked differences in attitudes towards acid aspiration prophylaxis between Australian and British obstetric anaesthetic practices.


2014 ◽  
Vol 26 (1) ◽  
pp. 01-03
Author(s):  
Kazi Shahnaz Begum ◽  
Neyamat Ullah Khan ◽  
Farhana Akter

This case series study was designed to determine the factors affecting the pregnancy out come in patients with previous one caesarean section. The study was conducted at Marie Stopes Clinic Primium-1 Dhanmondi from July 01, 2012 to January 31, 2013. A total of 150 patients with previous one caesarean section who presented at term were included in the study. The data were collected through proforma and subjected to statistical analysis. Out of 150 patients, 81 (54%) patients had trial of scar and the remaining 69 (46%) patients underwent repeat elective caesarean section. Among those who had trial of scar only 35 (43.2%) patients achieved successful vaginal delivery and remaining 46 (56.8%) had emergency caesarean section. Common indication for repeat emergency caesarean section was non progress of labour (47.8%). It was frequent in women who reported late to hospital after the onset of labour and in women who did not seek antenatal booking in pregnancy. Maternal complications like post partum hemorrhage, scar dehiscence, wound infection and febrile illness were more in those who had emergency caesarean section. There was no maternal mortality in the study. Perinatal outcome was not affected by the mode of delivery. There were two perinatal deaths which occurred in non-booked patients who underwent emergency caesarean section. Most of the women in our study had repeat caesarean section for failed progress. Regular antenatal check up and early report to hospital after the onset of labour can reduce the rate of repeat caesarean section. DOI: http://dx.doi.org/10.3329/medtoday.v26i1.21300 Medicine Today 2014 Vol.26(1): 01-03


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