scholarly journals Analytical study on indications of primary cesarean section in tertiary care hospital

2019 ◽  
Vol 8 (8) ◽  
pp. 3179
Author(s):  
Arpitha S. Ballu ◽  
Asha M. B.
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Tertiary Care ◽  
Previous History ◽  
Fetal Distress ◽  
Tertiary Hospital ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Failed Induction

Background: Cesarean delivery is a commonest obstetric surgical procedure performed. WHO stated that regional cesarean section rate should not exceed 10 to 15%. However in many countries cesarean delivery has increased steadily over years. Hence present study is conducted to analyze various indications of primary cesarean section in a tertiary hospital, with an aim to reduce cesarean section rate.Methods: This is a retrospective study conducted in Cheluvamba hospital, Mysore Medical College Research Institute, Mysore, which is a tertiary care centre. For a period of 6months from 1st June 2018 to 31st November 2018Inclusion criteria: All primary cesarean section done at Cheluvamba hospital during study period were included.Exclusion criteria: Previous cesarean section, patients with previous history of laparotomy done for any obstetric or gynecological cause were excluded.Results: During the study period there was 3799 number of cesarean section. Amongst these 983 cases were primary cesarean section done for varying indications. Hence the rate of cesarean section in our hospital is 25.87%. There were 40.3% cases of fetal distress, failed induction (13.6%), breech (10%), CPD (8%), IUGR with poor BPP (1.8%) Ante partum haemorrhage (3%), DTA (3.5%).Conclusions: From our study, we would conclude that rising trend in cesarean section is an alarming issue. Measures need to be taken to reduce cesarean delivery like Regular use of partograph, Judicious use of amniotomy, oxytocin with inducing agents, Expertization of skills to conduct instrumental vaginal delivery, which is a lost art in modern obstetrics.

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.

scholarly journals Changing trends in indication of cesarean section in a tertiary care centre of Central India

2017 ◽  
Vol 6 (7) ◽  
pp. 2829 ◽  
Author(s):  
Pooja Patil ◽  
Malini Bhardwaj ◽  
Priyanka Sharma ◽  
Garima Chandrakar
Keyword(s):  
Cesarean Section ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
Central India ◽  
Fetal Distress ◽  
Tertiary Care Centre ◽  
Main Indication ◽  
Drastic Increase ◽  
Fetal Scalp ◽  
Failed Induction

Background: This study was carried out to find the rate of Cesarean section (CS) in our institute from 2012 to 2016 and also to find any change in the indications of CS over these five years.Methods: A retrospective analysis of data was done from the records of the patients who underwent CS and the rate of Cesarean section and the indications were noticed.Results: The rate of Cesarean section has increased from 43.85% in 2012 to 48.18% in 2016. There is increase in the number of Primary Cesarean cases from 61.8% in 2012 to 68.4% in 2016.The percentage of Elective CS has increased in last five years from 10.2% in 2012 to 23.6% in 2016 which is due to the drastic increase in Elective Repeat CS from 13.3% in 2012 to 43.4% in 2016. The first and second major indication of Primary CS over the years remained the same i.e. fetal distress and CPD. Other major contributing indications were Non-progress of labour, failed induction and Malpresentation. Oligohydraminos and IUGR, Multiple pregnancy and precious pregnancy have emerged as the major indication in last three years. Previous CS and Previous 2 CS contributed as the main indication for Elective CS.Conclusions: The rate of Cesarean section need to be reduced. The overall main indication for CS was Previous CS and thus Primary CS rate should be reduced. Fetal distress being the main indication for Primary CS should be further confirmed by fetal scalp pH findings and Repeat CS cases should be given more trial of labour.

scholarly journals Indication and complication of caesarean section at tertiary care hospital: a retrospective study

2019 ◽  
Vol 8 (4) ◽  
pp. 1646
Author(s):  
Bilal Ur Rehman ◽  
Hiba Gul
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Cesarean Delivery ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Bladder Injury ◽  
Care Hospital ◽  
Cross Sectional ◽  
Risk Pregnancy ◽  
Repeat Cesarean Section

Background: The incidence of cesarean section is steadily rising. Cesarean delivery has played a major role in lowering both maternal and perinatal morbidity and mortality rates.  There are various factors involved in the rise of rate of cesarean section like rising incidence of primary cesarean delivery, identification of high-risk pregnancy, wider use of repeat cesarean section, rising rates of induction of labor and failure of induction, no reassuring fetal status etc.Methods: A retrospective cross-sectional study was conducted. Data was collected from patient records of the hospital during 1st January 2018 to 30th June 2018. All patients (N= 602) who had delivered their baby by caesarean section were included in the study. Data were analyzed by help of SPSS version 21 after proper compilation.Results: Among all women who underwent cesarean section, majority were age group between 21 and 30 years (67.1%). Repeat cesarean section (48.5%), followed by fetal distress (18.9%), oligohydramnias (6.6%) and cephalopelvic disproportion (6.5%) were most common among all major indication of cesarean section. Intrapartum complication (2.0%) includes postpartum hemorrhage (1.2%), CS hysterectomy (0.5%), bladder injury (0.3%) and postpartum complication (2.3%) including UTI (0.8), wound infection (0.5%), sepsis (0.5%), lactation failure (0.5%) were major maternal complication of cesarean section.Conclusions: Reduction of number of primary cesarean section, successful VBAC, individualization of the indication and careful evaluation, following standardized guidelines can help to keep rate of cesarean section to the possible minimum level.

scholarly journals Feto-Maternal outcomes in Intrahepatic Cholestasis in Pregnancy in a Tertiary Care Centre in Eastern Nepal

2016 ◽  
Vol 5 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Sita Pokhrel Ghimire ◽  
Ashima Ghimire ◽  
Gauri Shankar Jha ◽  
Manisha Chhetry ◽  
Mahanand Kumar
Keyword(s):  
Intrahepatic Cholestasis ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Liver Function Tests ◽  
Maternal Outcomes ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Cholestasis Of Pregnancy

Background Intrahepatic cholestasis of pregnancy has poor feto-maternal outcomes. To date there has been sparse publications regarding impact of intrahepatic cholestasis in feto-maternal outcomes in our setting. Therefore, we aimed to study the feto-maternal outcome in patients with intrahepatic cholestasis of pregnancy.Material and Methods A hospital based prospective cross-sectional study carried out in department of Obstetrics and Gynecology of Nobel Medical College, Biratnagar, Nepal from 1st January 2014 to 30th December 2015 in women who presented with pruritus in third trimester of pregnancy and having deranged liver function tests. All the cases were followed from admission to discharge. Socio-demographic, clinico-laboratory profile and feto-maternal outcomes were recorded in a preformed structured proforma. Descriptive statistics was used to present the data.Results Among 6,780 women admitted for delivery, 80 had cholestasis of pregnancy with incidence of 1.15%. 83% were of 18-35 years and 65% were primigravida. Most distressing symptom was generalized pruritus (75.0 %). The cesarean delivery rate was 46.25% and labor induction rate was (47.5%). Fetal complications were seen in majority of cases that included meconium aspiration syndrome 26 (32.5%), intrapartum fetal distress 21 (26.25%) and requirement of: intensive care 38 (48.75%). There were 7 perinatal and 3 neonatal deaths.Conclusion Intrahepatic cholestasis of pregnancy seems fairly common among pregnant women. It may be responsible for a large number of perinatal and neonatal deaths especially after 36 weeks of gestation. A large prospective study is needed to address the problems in time.Journal of Nobel Medical College Volume 5, Number 1, Issue 8, January-July 2016, 20-25

scholarly journals An Audit of Rational Use of Antibiotics in a Tertiary Hospital

2014 ◽  
Vol 2 (2) ◽  
pp. 64-67 ◽  
Author(s):  
Tanzima Begum ◽  
Md Ismail Khan ◽  
Shamima Kawser ◽  
Md Ehsanul Huq ◽  
Nadira Majid ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Number Of Patients ◽  
Rational Use Of Antibiotics

Background: Drug can cure ailment when used rationally on the other hand they may become harmful or even may threaten a life when used irrationally. Absence of guidelines for antibiotic use, protocols for rational therapeutics and infection control committees, have led to overuse and misuse of antimicrobials even in different specialized units in hospitals. Objective: The study has been designed to get a picture of use of antibiotics in a tertiary care hospital of Bangladesh. Materials and method: Cross sectional study was conducted in the department of Medicine of Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh, for 3 months from 1st January 2009 to 31st March 2009. Admitted patients of Medicine unit-1 who got antibiotics were included in the study. Total number of patients was 1563. Results: Five hundred out of 1563 patients were prescribed antibiotics (38%). Out of 500 prescriptions, 68(14%) prescriptions were found irrational. Conclusion: Continuous surveillance should be carried out to reduce the irrational use of antibiotics. DOI: http://dx.doi.org/10.3329/dmcj.v2i2.20526 Delta Med Col J. Jul 2014; 2(2): 64-67

scholarly journals Prevalence and Outcome of Cesarean Section at Gandaki Medical College Teaching Hospital and Research Centre, Pokhara, Nepal

2017 ◽  
Vol 9 (2) ◽  
pp. 1-6
Author(s):  
Rubina Tamrakar Gurung ◽  
G Gurung ◽  
R Shrestha ◽  
T Gurung ◽  
P Sharma
Keyword(s):  
Cesarean Section ◽  
Teaching Hospital ◽  
College Teaching ◽  
Fetal Distress ◽  
Safe Motherhood ◽  
Research Centre ◽  
Cesarean Sections ◽  
Old Patients ◽  
Medical College ◽  
Failed Induction

Introduction: Gandaki Medical College Teaching Hospital is providing specialized obstetrician and gynecologist services since last one decade.Objectives: This study was conducted to know the prevalence and outcome of cesarean section at Gandaki Medical College Teaching Hospital and Research Centre during 2013 – 2015 A.D. (2070 – 2072 B.S.).Methods: It was a retrospective study of women undergoing cesarean section from 2013 to 2015 A.D. (2070 – 2072 B.S.).Results: During the period of three years 2013 – 2015 A.D. (2070 –2072 B.S.) otal deliveries were 2627. Among total deliveries cesarean section was performed in 1084 patients (41.26%). In 1084 patients 803 (74%) cesarean sections were performed as an emergency and 281(26%) were elective. In this study 15 to more than 35 years old patients were enrolled. Among cesarean sections done, 52% were primigravida, 46% were para and 2% were grandmulti. The indications for cesarean section were CPD (28%), fetal distress (25%), previous cesarean (14%), mal presentation (7%), premature rupture of membrane (5%), pre-eclampsia (6%), failed induction (5%), bad obstetric history (2%), antepartum hemorrhage (1%), and twins (1%).Conclusion: This study at Gandaki Medical College Teaching Hospital and Research Centre provided the prevalence, outcome and different indications of cesarean section which is life saving for both mother and newborn. And also the study can be useful to the hospital to improve facilities for safe motherhood and safety of newborn.Journal of Gandaki Medical CollegeVolume, 09, Number 2, July December  2016, Page: 1-6

scholarly journals THE RATE AND INDICATION OF CAESAREAN SECTION IN A TERTIARY CARE CENTRE

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Urvashi Kumawat ◽  
Neeta Natu
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Tertiary Care ◽  
Fetal Distress ◽  
The Elderly ◽  
Elderly Age ◽  
Tertiary Care Centre ◽  
Live Births ◽  
Cesarean Births ◽  
History Of

Method: The rate of caesarean section was only slightly higher than recommended by the WHO. Most of caesarean sections were emergency caesarean sections. Data on all live births were collected, including type of delivery, and indication was recorded if cesarean section was done. Total, primary, & repeat cesarean section rates were calculated for each year. The cesarean rate was calculated as the number of cesarean births divided by total live births. The rate for each indication was calculated annually as the number of cesarean births performed for each indication per 1,000 live births.   Result: These two groups constituted nearly 87.7% of total C-Sections. Only 3.4% of the cases belonged to the elderly age group of above 35 years. Maximum no. of caesarean sections was in multiparous females (54.3%).  Out of 550 caesarean deliveries 76.7% were from urban area. Also, result showed that only 68.7% were booked for antenatal care. Conclusion: The rate of cesarean section has increased with time with primary and repeat cesareans both showing an increase. In the primary CS rate, indications like labor arrest disorders & fetal distress show an increase more than the objective indications like malpresentation. In repeat CS, history of 02 or more previous sections & scar tenderness contributed more than the fetal distress. Keywords: Indication, Caesarean

scholarly journals Immediate outcome and risk factors determining the outcome of status epilepticus in children attending tertiary care centre

2017 ◽  
Vol 4 (4) ◽  
pp. 1289
Author(s):  
Murali Thandavarayan ◽  
Sureshkumar Ramaswamy ◽  
Priyadarsini Bose ◽  
Sivaraman Thirumalaikumarasamy
Keyword(s):  
Risk Factors ◽  
Status Epilepticus ◽  
Tertiary Care ◽  
Medical Emergency ◽  
Time Of Arrival ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Medical College

Background: Status epilepticus (SE) is a paediatric and neurological medical emergency, continuous seizure lasting more than 30 min, or two or more seizures without full recovery of consciousness between any of them. Determination of immediate outcome of SE in children in a tertiary care hospital and to identify the risk factors influencing the outcome was the objectives of the present study.Methods: A study was conducted in Dept of Pediatrics, Tirunelveli Medical College Hospital among the children from 1 month to12 years of age, who had admitted for SE in hospital’s pediatric causality from October 2009 to October 2010 were selected for the study.Results: Out of 92 patients, total 87 patients completed the study and out of those 74 have recovered and 13 have died. The risk factors significantly affecting the outcome were hypoxia at the time of arrival, decompensated shock, respiratory failure requiring intubation and acidosis.Conclusions: Proper prehospital therapy, early referral, proper care while transporting, anticipitating risk factors involved, and protocol based approach uniformly at all hospital can reduce the mortality due to status epilepticus in children. 

scholarly journals Prevalence of Cesarean Section and Its Indications in A Tertiary Care Hospital

2019 ◽  
Vol 57 (216) ◽  
Author(s):  
Smrity Maskey ◽  
Manisha Bajracharya ◽  
Sunita Bhandari
Keyword(s):  
Cesarean Section ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Hypertensive Disorder ◽  
Care Hospital ◽  
Previous Cesarean Section ◽  
Common Indication ◽  
Vaginal Deliveries ◽  
Previous Cesarean

Introduction: Cesarean section is a surgical procedure performed to deliver fetus through abdominal route. Increasing rate of cesarean section worldwide is an alarming concern for public health and obstetricians due to increase in financial burden and risk to health of the mother in comparison to vaginal delivery. The aim of the study was to find the prevalence of cesarean section and its most common indication in a tertiary care hospital. Methods: This descriptive cross-sectional study was done in a tertiary care hospital, from July 2016 to June 2018 after taking ethical clearance from institutional review board. Convenience sampling was done to reach the sample size. Data was collected and entry was done in microsoft excel, point estimate at 95% CI was calculated along with frequency and proportion for binary data and analysis was done. Results: Out of total deliveries conducted, 862 (36.8%) were CS deliveries, 1477 (63.1%) were vaginal deliveries, and 12 (0.51%) were instrumental deliveries. Prevalence of CS is 862 (36.8%) at 95% CI (34.82%-38.78%). Mean age±S.D of delivering mother was found to be 26.1±0.25 years. Primi cesarean section was more than repeat cesarean section. Most common indication of cesarean section was fetal distress 243 (28%) followed by previous cesarean section 165 (18%), non-progress of labour 106 (12%), oligohydramnios 59 (7%), malpresentation 59 (7%), cephalo pelvic disorders 52 (6.5%), and hypertensive disorder in pregnancy 33 (4%). Conclusions: Prevalence of cesarean section in a tertiary care hospital is high compared to WHO data. The most common indication of cesarean section are fetal distress and previous cesarean section.

scholarly journals A cross sectional observational study to evaluate the maternal and fetal outcome in postdated pregnancies

2020 ◽  
Vol 10 (1) ◽  
pp. 159
Author(s):  
Ritika Narayan ◽  
Sheela S. R.
Keyword(s):  
Observational Study ◽  
Cesarean Section ◽  
Tertiary Care ◽  
Significant Risk ◽  
Fetal Distress ◽  
Perinatal Complications ◽  
Tertiary Care Centre ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Increased Risk

Background: Post-dated pregnancy is when the gestation is more than 40 weeks or 280 days. They last longer than the estimated date of delivery. Postdated pregnancies are associated with increased perinatal and maternal complications. These risks are greater than it was originally thought. Risks have been underestimated in the past leading to increasing number of complicated postdated pregnancies which appears to be otherwise low risk. The maternal risks are very often underappreciated resulting in increased maternal morbidity.Methods: This cross sectional observational study was done to evaluate maternal and fetal complications associated with Postdated pregnancies was carried out in the department of obstetrics and gynecology in a tertiary care centre, Sir Devraj Urs Medical College and RL Jalappa Hospital, Kolar between July 2018 and July 2019, fulfilling all the inclusion and exclusion criteria.Results: 50 out of 100 patients had full term normal deliveries where as 45% patients required cesarean section. Most common indication for cesarean section was meconium stained liquor with fetal distress (25%). 42% of the babies born needed NICU admission. Most common maternal complication seen was Postpartum Hemorrhage.Conclusions: The present study we conclude that postdated pregnancy was associated with significant risk of perinatal complications such as fetal distress, meconium aspiration syndrome and IUGR. There was increased risk of obstetric complications as well like atonic PPH, oligohydramnios, obstructed labor.

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