scholarly journals Primary lower segment caesarean section in multipara: materno-fetal outcomes

2018 ◽  
Vol 8 (1) ◽  
pp. 279
Author(s):  
Grishma P. Agrawal
Keyword(s):  
Caesarean Section ◽  
Tertiary Care ◽  
Primary Objective ◽  
Perinatal Morbidity ◽  
Lower Segment ◽  
Safe Delivery ◽  
Lower Segment Caesarean Section ◽  
Vaginal Deliveries ◽  
The Status ◽  
Almost All

Background: All-natural birth has a purpose and a plan; who would think of tearing open the chrysalis as the butterfly is emerging? Who would break the shell to pull the chick out?” ~ Marie Mongon. It is of particular interest, in light of increased incidence of abdominal delivery throughout the country and in the world, to judge the validity of this procedure when used for the first time in the multipara.Methods: All the cases of Primary caesarean delivery in multipara over a period of 18 months were studied with regards to the indication, associated risks factors, and perinatal morbidity and mortality. The primary objective of the study was to find out the status of primary Lower Segment Caesarean Section (LSCS) in multipara in tertiary care center.Results: The overall incidence of LSCS was 30.7%. The incidence of Primary LSCS in multipara was 23.4%. The most common indication of LSCS was Foetal Distress i.e. 40.8%. Almost all caesarean sections were done in Emergency (99.2%). 12.3% of patients underwent PPH intra-operatively with 0.7% patient requiring Obstetric hysterectomy. Majority of the neonates were admitted in NICU for Respiratory Distress (30%). Major cause of Post-operative morbidity was wound gape seen in 10.8% patients.Conclusions: The fact that a multipara has had one or more vaginal deliveries should be regarded as an optimistic historical fact, not as diagnostic criteria for spontaneous delivery of the pregnancy at hand. Hence a multiparous woman in labour requires the same attention as that of primigravida and may still require a caesarean section for safe delivery. Good antenatal and intrapartum care and early referral will help reduce the maternal and perinatal morbidity.

scholarly journals An analytical study of intraoperative, immediate post-operative and perinatal complications in previous two caesarean section

2018 ◽  
Vol 7 (10) ◽  
pp. 4239
Author(s):  
Prachi Singh ◽  
Ritika Agarwal ◽  
Shweta Yadav
Keyword(s):  
Caesarean Section ◽  
Analytical Study ◽  
Placenta Previa ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Perinatal Complications ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Adherent Placenta ◽  
Maternal Morbidity And Mortality

Background: Lower segment caesarean section is one of the commonest operations performed now a day.It has been seen that in cases with previous caesarean section there is increased maternal morbidity and mortality due to placenta previa, adherent placenta and caesarean hysterectomy.The present study was conducted to know the fetomaternal outcome and intra and immediate post-operative complications in cases with previous two lower segment caesarean section.Methods: The present study was conducted in TMMC Moradabad between January 2017-January 2018.Total 68 cases were previous two lower segment caesarean section were included in the study. Neonatal outcome and intraoperative and immediate postoperative complications were seen in these cases.Results: In the present study majority of the cases were in 30-34 years age group (39.7%), the maximum number of caesarean sections were done between gestational age of 37-39.6 weeks (47.1%). Intraoperatively adhesions between uterus, anterior abdominal wall and bladder was seen in less than half of the cases i.e. in 42.6% cases. Out of 68 cases with previous two lower segment caesarean operated 13 cases had placenta previa and 4 cases had adherent placenta.Conclusions: The present study shows that the maternal and perinatal morbidity and mortality is increased with increasing number of caesarean sections. So, there should be reduction in rate of primary caesarean section which can reduce the rate of placenta previa and adherent placenta in subsequent pregnancies.

scholarly journals Indications and rate of caesarean delivery at tertiary care hospital: a retrospective study

2017 ◽  
Vol 6 (10) ◽  
pp. 4367
Author(s):  
Reena Sharma ◽  
Poojan Dogra
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Caesarean Delivery ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Number Of Patients ◽  
Increasing Trend

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.

scholarly journals Evaluation of postoperative outcome of different techniques of lower segment caesarean section

2019 ◽  
Vol 8 (3) ◽  
pp. 951
Author(s):  
Lata Rajoria ◽  
Manisha Kala ◽  
Nupur Hooja ◽  
Smriti Bhargava ◽  
Brijesh Dadhich
Keyword(s):  
Caesarean Section ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Postoperative Outcome ◽  
Cost Effective ◽  
Care Hospital ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
One Year ◽  
Obstetric Surgery

Background: Caesarean section is the most commonly performed obstetric surgery. A change in the operative technique affects the postoperative outcome. The study was undertaken to study the postoperative outcome of the patient who underwent caesarean section by Pfannensteil Kerr and Misgav Ladach method of lower segment caesarean section.Methods: It was a hospital based interventional study done in a tertiary care hospital over one year. Postoperative condition of the women was assessed after caesarean section in women with Pfannensteil Kerr and Misgav Ladach method and compared.Results: Most cases in the Misgav Ladach method had breast fed early, had quicker return of bowel activity and earlier ambulation in comparison to the Pfannensteil Kerr method. This difference was statistically significant. Women with the Pfannensteil Kerr method had more postoperative pain, nausea and vomiting. The duration of hospital stay was less in Misgav  technique.Conclusions: Since Misgav Ladach method was a better technique than Pfannensteil Kerr, adopting it routinely would result in considerable reduction in maternal morbidity, decreased hospital stay, better patient satisfaction level and more cost effective.

scholarly journals Effectiveness and use of prophylactic antibiotics in elective and emergency caesarean section at tertiary care hospital

2020 ◽  
Vol 9 (5) ◽  
pp. 2053
Author(s):  
K. Rama Lingam ◽  
Hari Babu Ramineni ◽  
Shaik Gulshan Firdous ◽  
P. Yamuna ◽  
B. Madhuri ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Antimicrobial Prophylaxis ◽  
Tertiary Care ◽  
Prophylactic Antibiotic ◽  
Febrile Illness ◽  
Prophylactic Antibiotics ◽  
Care Hospital ◽  
Lower Segment ◽  
Lower Segment Caesarean Section

Background: Post-operative infections in obstetrics and gynecological settings have been higher compared to other specialties. Women undergoing caesarean section have 5 to 20-fold greater risk for infection compared with vaginal delivery. Many studies reported antimicrobial prophylaxis prevent post-operative infections. Hence this study concentrates the evaluation of the prescribing antimicrobial use and to assess the frequency of post-operative morbidity related to infection in subjects undergoing caesarean section. The aim of the study was to analysis the effectiveness, prophylactic antibiotics (amoxicillin versus ceftriaxone) and to evaluate the post-operative (caesarean) infections in patients undergoing lower segment caesarean section (elective and emergency).Methods: This is a prospective observational study which assessed the effectiveness and use of prophylactic antibiotics in patients undergoing cesarean section at department of obstetrics and gynecology. The study was conducted over a period of one year.Results: The corresponding mean age of all the study population in amoxicillin group (n=113) was 56.5±28.5 and in ceftriaxone group (n=97) was 48.5±26.5 respectively. The participant who underwent previous cesarean section in amoxicillin group is 65.48% similarly in ceftriaxone group is 47.42%. The patients with fetal distress in ceftriaxone group are 14.77% and in amoxicillin group is 8.92%. Failed induction in amoxicillin group is 9.82% and in ceftriaxone group is 6.81%. The number of days in hospital stay in amoxicillin group is 42.42% and in ceftriaxone group is 45.94%. The post-operative complications in amoxicillin group reported, with Febrile Illness are 40% and wound Infection is 60%.Conclusions: Administration of pre-operative antibiotics significantly reduce post-operative infections. Use of ceftriaxone as a prophylactic antibiotic in patients undergoing lower segment caesarean section (elective and emergency) is more effective than Amoxicillin in preventing post-operative infections.

scholarly journals Maternal and neonatal outcome in pregnancy with previous lower segment caesarean section undergoing trial of scar

2021 ◽  
Vol 10 (9) ◽  
pp. 3434
Author(s):  
Monika Dalal ◽  
Smiti Nanda ◽  
Jagjit S. Dalal ◽  
Samiksha Kaushik ◽  
Meenakshi Chauhan ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
P Value ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Emergency Caesarean ◽  
Vaginal Birth After Caesarean

Background: Women with previous LSCS often have to make a decision about mode of delivery of their second baby. As the rate of caesarean section is continuously increasing, vaginal birth after caesarean section (VBAC) is a good strategy to decrease caesarean rate. The present study was planned to assess the fetomaternal outcome in pregnancies with previous lower segment caesarean section undergoing trial of scar and to identify the factors, which can influence the outcome of trial of scar.Methods: This was a prospective observational study on 100 patients at a tertiary care institute. Pregnant women with previous LSCS were selected randomly for the study on the basis of the inclusion and exclusion criteria. Each labor monitored closely using a partogram. Decision for repeat emergency caesarean was taken by consultant. All women included in the study were followed through delivery and till discharge.Results: Out of 100 pregnant women 49 % cases had successful VBAC, 50% had emergency caesarean and one patient had laparotomy for rupture uterus. In women, who also had a prior vaginal delivery, 72% delivered vaginally, as compared to 40% of the women who did not undergo prior vaginal delivery (p value=0.003). Women who were in spontaneous labor, 59.21% delivered vaginally, whereas women who were induced, 16.6% delivered vaginally. The rate of perinatal complication was more in the patients who required an emergency CS after a failed trial. Conclusions: Our findings may encourage obstetricians to encourage VBAC in the properly screened ANC patients and decrease the rate of recommending caesarean section.

scholarly journals Outcome of Assisted Vaginal Deliveries in a Tertiary Care Centre in Bengaluru

2021 ◽  
Vol 10 (40) ◽  
pp. 3538-3542
Author(s):  
Sivasambu Gayatri ◽  
Sujani B. K. ◽  
Urvashi Urvashi ◽  
Priyanka Sinha
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity ◽  
Assisted Vaginal Delivery ◽  
Safe Delivery ◽  
Vaginal Deliveries

BACKGROUND The lower segment caesarean section (LSCS) audit shows an increase in caesarean section rates worldwide. Assisted vaginal delivery and, if needed, emergency caesarean section are options available to the obstetrician to handle challenges in the second stage when spontaneous and safe delivery is not imminent. Judicious use of the instrument as well as continuing medical education in the art of assisted vaginal delivery is a must to achieve the twin goal of containing the surging caesarean section rate as well as bring about a successful and safe assisted vaginal delivery. The objective of this study was to quantify the various morbidities associated with assisted vaginal deliveries among patients in a tertiary care teaching hospital in Bengaluru. METHODS It is a retrospective study carried for four years between July 2016 and June 2020 at Ramaiah Medical College at Bengaluru. The total number of vaginal deliveries was 6318 out of which 1020 had a successful assisted vaginal delivery and were studied in terms of outcomes, maternal and foetal indications and morbidity. RESULTS Out of 1020 assisted vaginal deliveries, 86.96 % were vacuum-assisted, 3.9 % were forceps assisted and 9.11 % were both vacuum and forceps assisted. The success rate of forceps deliveries was more compared to vacuum. No significant maternal and neonatal mortality and morbidity were observed in our study. CONCLUSIONS In this study, vacuum was the most used method of assisted vaginal delivery and was safer for mothers and babies. It is also easier to teach and learn. Forceps delivery was more used in preterm delivery. KEY WORDS Assisted Vaginal Delivery, Vacuum, Forceps, Sequential use of Instruments, Maternal and Neonatal Morbidity.

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