scholarly journals Management of stillbirths: an observational analysis at a rural tertiary care centre in Kerala, India

2019 ◽  
Vol 8 (4) ◽  
pp. 1583
Author(s):  
Ajini K. K. ◽  
Reena R. P. ◽  
Radha K. R.
Keyword(s):  
Cesarean Section ◽  
Fetal Death ◽  
Tertiary Care ◽  
Induction Of Labour ◽  
Intrauterine Fetal Death ◽  
Elective Cesarean Section ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Elective Cesarean ◽  
Previous Cesarean

Background: Stillbirth is a distressing event, both for the expecting mother and the obstetrician. Several maternal, social and circumstantial factors influence its occurrence. These women with intrauterine fetal death need to be treated in a considerate manner. Our aim was to analyse different methods   of induction, management of labour and their outcomes in women with antepartum fetal demise.Methods: All women admitted to a tertiary care centre with intrauterine fetal death after 22 weeks during the study period of 24 months were recruited. Maternal sociodemographic characteristics and relevant investigations were studied. Induction of labour was achieved with mechanical and pharmacological methods.  Stillborn babies, placentae and umbilical cord were examined after delivery.Results: There were 175 women with IUFD   admitted during the study period. The stillbirth rate was 38.6 per1000 live births.148 women (84.57%) required induction of labour while16 women had spontaneous onset of labour. Among the 44 women with previous Cesarean section, 11 underwent elective Cesarean section. 19 women (57.6%) out of 33 cases of trial of labour after Cesarean had a successful vaginal delivery. There were 2 cases of rupture uterus and 10 women required ICU admissions. Intrauterine growth restriction was the leading cause of stillbirth (41.8%) followed by hypertensive disorders (27.7%).Conclusions: Present study has shown that vaginal birth can be achieved in most women with mechanical and pharmacological methods of induction within a reasonable period of time.

scholarly journals Classification of stillbirths by relevant condition at death (ReCoDe): a cross sectional study at a rural tertiary care centre in Kerala, India

2017 ◽  
Vol 6 (3) ◽  
pp. 1061
Author(s):  
Ajini K. K. ◽  
Radha K. R. ◽  
Reena R. P.
Keyword(s):  
Fetal Death ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Intrauterine Fetal Death ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Relevant Condition ◽  
Uterine Growth

Background: Stillbirths account for a major proportion of   perinatal deaths. The cause for a large number of stillbirths, remain unexplained. The ReCoDe system (classification of stillbirths by relevant condition at death) has helped to improve our understanding of the causes of stillbirths. We evaluated stillbirths and classified them by the ReCoDe system. The objective was to identify factors associated with stillbirths and to classify the causes of stillbirths using the ReCoDe system.Methods: We recruited all women admitted to a tertiary care centre with a diagnosis of intrauterine fetal death after 22 weeks of gestation. Maternal sociodemographic characteristics and relevant antenatal and intrapartum investigations were studied. We examined the stillborn babies, placenta and umbilical cord and classified them according to the ReCoDe system.Results: There were177 women with intrauterine fetal death admitted during the 2 year study period. The stillbirth rate was 38.56 per 1000 live births. We could explain the cause of stillbirth in 87.58% of   cases by using the ReCoDe system.  Intra uterine growth restriction (41.8%) was the commonest cause followed by hypertensive disorders (27.68%), congenital anomalies (15.81%) and diabetes (14.68%) in present study.Conclusions: We found the ReCoDe system useful in classifying the cause of stillbirths in resource limited settings.

Recurrent large uterine fundal dehiscence during cesarean section after hysteroscopic uterine septum resection with uterine perforation

2016 ◽  
Vol 5 (2) ◽  
pp. 85-87
Author(s):  
İbrahim Alanbay ◽  
Mustafa Öztürk ◽  
Mustafa Ulubay ◽  
Uğur Keskin ◽  
Emre Karaşahin
Keyword(s):  
Cesarean Section ◽  
Uterine Rupture ◽  
Late Complication ◽  
Uterine Wall ◽  
Elective Cesarean Section ◽  
Uterine Perforation ◽  
Elective Cesarean ◽  
Uterine Septum ◽  
Uterine Fundus ◽  
Previous Cesarean

Abstract Septum resection using hysterescopy is safe, rapid and efective, but some late complication of it may be seen as uterine rupture or dehiscence of uterine wall during pregnancy due to myometrial damage. We present a case of recurrent large uterine fundal dehiscence conscecutive to cesarean section in a patient who had previously undergone a uterine septum resection. The patient was a 35-year-old who presented at 39 weeks of gestation (Gravida 2, Parity 1) and was admitted for an elective cesarean section. Her reproductive history included a septum resection which resulted in uterine perforation, and one previous cesarean section in which a large fundal defect was found and repaired. Then the examination had shown an aproximately 5 cm large uterine fundus defect including all three layers of uterus which had been repaired. Perforation or excessively deep incision of uterine fundus during hysteroscopic metroplasty may cause chronic weakness of the uterine wall especially at fundal localization. Our case was an incidental uterine wall dehiscence during cesarean section. Patients with an uterine septum resection history should be followed up carefully for uterine rupture during pregnancy.

Safety of Scar on Repeat Second Cesarean Section in Patients with Previous One Cesarean Section

2009 ◽  
Vol 1 (2) ◽  
pp. 26-28
Author(s):  
Shahnaz Kouser ◽  
Shaheen Kouser ◽  
Bushra Anwar
Keyword(s):  
Cesarean Section ◽  
Tertiary Care ◽  
Teaching Hospitals ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Medical Disorders ◽  
Elective Cesarean ◽  
One Year ◽  
Operative Findings ◽  
Previous Cesarean

ABSTRACT Objective To evaluate the safety and integrity of scar at repeat cesarean section, in patients with previous one cesarean section performed at different settings. Study design A reterospective study in a tertiary care obstetric unit over a period of one year (2006). Material and methods All patients with previous one cesarean section, undergoing emergency and elective cesarean sections were enrolled at our institution. The variables noted were age, parity, residential area, location of previous cesarean section and associated complaints, e.g uterine contractions, vaginal leaking/ bleeding and comorbid medical disorders. Outcome measures Operative findings in terms of thinning of scar, dehiscence or rupture were recorded. The effects of skill level of surgeon and set-up of previous cesarean section were analyzed. Results Two hundred and seventy cesarean sections were performed for different indications in patients with previous one cesarean section over a period of one year. Out of all patients, extreme thinning of scar was noted in 36 (13.3%) patients. Seven patients(2.6%) had scar dehiscence. Only 3 (42.8%) patients with scar dehiscence had associated complaint of scar tenderness, while 22 (61%)of 36 cases of scar thinning were having scar tenderness. All 7 cases of scar dehiscence had their previous cesarean sections at teaching hospitals. No patient underwent hysterectomy and all patients with scar dehiscence had successful repair. Conclusion The study concludes relatively inadequate scar thickness rate but at the same time relatively acceptable scar dehiscence rate. Thus it will still be safe to subject the patients to trial of labor after meticulous scrutinization and individualization. At the same time adequate surgical training of doctors (trainees and community doctors) through different formats is recommended.

scholarly journals Cesarean Section Among all Deliveries in a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (241) ◽  
pp. 839-843
Author(s):  
Renuka Tamrakar ◽  
Sachin Sapkota ◽  
Deekshanta Sitaula ◽  
Rohit Thapa ◽  
Bandana Pokharel ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Care Centre ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Cesarean Deliveries

Introduction: Worldwide there is a tremendous increase in cesarean section rate over the last decades which has been a global public health issue. This study aimed to find out the prevalence of cesarean delivery in a tertiary care center of Nepal. Methods: A descriptive cross-sectional study was conducted among pregnant women at tertiary care centre from 15th September 2019 to 15th October 2020. Ethical clearance was taken from the Institutional Review Committee (Ref: CMC-IRC/077/078-200). Convenience sampling was done to reach the sample size. Basic demographic data, clinical indications and neonatal outcomes were noted. Data entry was done using Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 3193 total deliveries, cesarean deliveries were 1412 (44.22%) at 95% Confidence Interval (42.49-45.94). Among caesarean deliveries 1086 (76.9%) were emergency cesarean sections. Most common indication for cesarean section was fetal distress (24.9%). Among 1437 newborns, 1428 (99.4%) were live births, 1387 (98.2%) were singleton and 801 (55.7%) were male. Nearly one third 418 (29.1%) neonates required neonatal intensive care unit admission and transient tachypnoea of newborns (44.28% in emergency and 60.46% in elective cesarean delivery) was the most common indication for admission. Conclusions: The prevalence of cesarean delivery was found to be higher than that recommended by the World Health Organisation. Fetal distress was the leading indication for cesarean deliveries.

Report of a Case of Annular Pancreas of the Newborn in Two Consecutive Siblings

PEDIATRICS ◽  
1971 ◽  
Vol 48 (1) ◽  
pp. 148-150
Author(s):  
R. C. Montgomery ◽  
M. H. Poindexter ◽  
G. H. Hall ◽  
John E. Leigh
Keyword(s):  
Cesarean Section ◽  
Intestinal Obstruction ◽  
Duodenal Obstruction ◽  
Case Reports ◽  
Annular Pancreas ◽  
Elective Cesarean Section ◽  
Cesarean Sections ◽  
Elective Cesarean ◽  
Previous Cesarean ◽  
High Intestinal Obstruction

Annular pancreas presenting as high intestinal obstruction in the newborn has been reported on numerous occasions.14 The purpose of this paper is to report the occurrence of annular pancreas causing duodenal obstruction in the newborn in two consecutive siblings. Case Reports Case 1, D.B., a male, was born August 31, 1966. The mother was gravida III, para II. Her expected date of confinement was September 12, 1966. The pregnancy had been uneventful except that she had minimal polyhydramnios. The mother had been on no medications during her pregnancy except a prenatal vitamin and iron. On August 31, 1966 the mother underwent an elective cesarean section because of previous cesarean sections which were performed for cephalo-pelvic disproportion.

scholarly journals Analysis of factors responsible for intrauterine fetal death in rural pregnant women at tertiary care centre of Northern India

2017 ◽  
Vol 6 (9) ◽  
pp. 4071 ◽  
Author(s):  
Shaveta Garg ◽  
Naina Kumar
Keyword(s):  
Fetal Death ◽  
Tertiary Care ◽  
Intrauterine Fetal Death ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Northern India ◽  
Number Of Patients ◽  
Tragic Event ◽  
Abruptio Placenta ◽  
One Year

Background: Intrauterine fetal death (IUFD) is a tragic event for both the parents and obstetrician. Objectives of current study were to study the underlying etiology of Intra Uterine Fetal Death (IUFD) that can be helpful in formulating the preventive measures.Methods: This study was conducted over a period of one year from April 2016 till March 2017 at a tertiary rural care hospital. All patients with diagnosed IUFD at >24 weeks of gestation were included in the study.Results: Total eighty patients were admitted with diagnosis of intrauterine fetal death. Among these majority 58 (72.5%) were multigravida and only 22 (27.5%) were primigravida. Maximum number of patients, 61 (72.5%) were between age group of 20-30 years. Maximum number of IUFD were reported between 36-40 weeks of gestation (36.25%). Most of fetal deaths were due to preventable conditions like hypertensive disorders of pregnancy (28.75%), severe anemia (15%), abruptio placenta (11.25%), and rupture uterus (10%). Out of these patients 68 (85%) delivered vaginally and 7 patients were delivered by LSCS.Conclusions: The present study emphasizes the role of health education, regular antenatal checkups, early detection of complications and hospital delivery to reduce the overall preventable IUFD.

scholarly journals Intrauterine fetal death associated socio-demographic factors and obstetric causes: a retrospective study

2020 ◽  
Vol 9 (10) ◽  
pp. 4027
Author(s):  
Asma Hassan Mufti ◽  
Samiya Mufti ◽  
Nasir Jeelani Wani
Keyword(s):  
Fetal Death ◽  
Strong Association ◽  
Tertiary Care ◽  
Emergency Obstetric Care ◽  
Demographic Factors ◽  
Obstetric Care ◽  
Severe Anaemia ◽  
Intrauterine Fetal Death ◽  
Tertiary Care Centre ◽  
Socio Demographic Factors

Background: The death of a fetus is emotionally traumatic for the parents. It is also distressing for the treating obstetrician. Besides being emotionally challenging, fetal demise raises a lot of questions and increases an obstetrician’s medicolegal risk. The aim of this study was to identify various maternal conditions and socio-demographic factors associated with fetal death and to find the preventable causes of fetal death.Methods: A retrospective observational study was undertaken at Lalla Ded Hospital, Srinagar, Kashmir - a tertiary care centre. The cases of singleton intrauterine fetal deaths (IUFD) with either ultrasound reports proving IUFD or diagnosed on clinical examination by absence of fetal heart sound with gestational age >28 weeks were included. Exclusion criteria includes molar pregnancy and multiple pregnancy.Results: Still birth rate in our study was 19.6 per 1000. Most of the patients with stillbirth belonged to age group of 21-30 years accounting for 67.1% of all cases. Unbooked cases comprised of 58.9%. Most of the study patients i.e. 74.7% belonged to lower middle class. In our study 39% of stillbirth cases were in the range of 28-32 gestational weeks followed by 33.6% cases in 33-37 gestational weeks. Maternal hypertensive disorders had a strong association with IUFD 33.6% (pre-eclampsia 27.4%, eclampsia 6.2%). This was followed by placental abruption comprising 11.7%. Gestational diabetes and severe anaemia accounted for 6.2% and 3.4% respectively. Gross congenital anomalies and fetal infections contributed 2.7% and 2% respectively.Conclusions: Routine antenatal checkups with identification of high risk pregnancies, better access to emergency obstetric care especially during labor, emphasis on institutional deliveries community birth attendant training should help in reducing stillbirth rates in developing countries. Optimal evaluation for future pregnancy is necessary. Counseling and support group should be involved. 

scholarly journals PLACENTA PREVIA;

2019 ◽  
Vol 26 (03) ◽  
Author(s):  
IFAT BALOCH ◽  
Naseem Bajari ◽  
Sabrina Talpur ◽  
Saima Naz Shaikh
Keyword(s):  
Cesarean Section ◽  
Placenta Previa ◽  
Tertiary Care ◽  
University Hospital ◽  
Elective Cesarean Section ◽  
Care Hospital ◽  
Obstetric Hemorrhage ◽  
Emergency Cesarean ◽  
Precise Diagnosis ◽  
Elective Cesarean

Objectives: To determine the maternal and fetal outcomes in patients presented with major degree of placenta previa at tertiary care Hospital. Study Design: Descriptive cases series study. Setting: Department of Gynaecology and Obstetrics of Liaquat University Hospital Hyderabad. Period: One year from March 2015 to February 2016. Subject and Methods: All patients with major degrees of placenta previa were included in study. Following delivery the examination of neonate was carried out thoroughly including congenital abnormalities, weight of baby and Apgar score. Babies and mothers were examined within postoperative wards till stitches removal and systematically examined for any postoperative complication. All the data was entered in the proforma. Results: Total 50 patients with major degrees of placenta previa were selected. Majority of the women 40% belonged to the age group of 30-35 years. Most of the women 92.0%, were symptomatic and presented with painless vaginal bleeding. Elective cesarean section was performed among 20% patients while 80% patients underwent emergency cesarean section. 70% patients delivered preterm and 30% delivered at term. 3(6%) fetals were still births and 1(2.0%) presented macerated still birth. 16% fetuses developed respiratory distress syndrome, 6% had intrauterine growth restriction and only one had congenital abnormality (spina bifida). Neonatal weight less than 2500-grams was among 90%. Perinatal mortality was 6(12.0%), and according to maternal outcome, mortality rate was low i.e. just 1 subjects passed away. Conclusion: Major degree of placenta previais a significant contributor of obstetric hemorrhage in 02nd and 03rd trimesterof pregnancy as well as it adversely correlates with feto-maternal outcomes. Instant moving the case of obstetric hemorrhage to hospitals, precise diagnosis, sufficient transfusion provision, intervention without delay can reduce the fetomaternal morbidity and mortality.

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