scholarly journals A study on peripartum hysterectomy in a tertiary referral government hospital

2019 ◽  
Vol 8 (12) ◽  
pp. 4971
Author(s):  
Chaithra M. ◽  
Tejeswini K. K. ◽  
Savitha C.
Keyword(s):  
Caesarean Section ◽  
Postpartum Haemorrhage ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Peripartum Hysterectomy ◽  
Obstetrics And Gynaecology ◽  
Vaginal Deliveries ◽  
Life Threatening ◽  
Emergency Peripartum Hysterectomy

Background: Emergency peripartum hysterectomy (EPH) is a major surgical venture invariably performed in the setting of life-threatening haemorrhage during or immediately after abdominal and vaginal deliveries. Aim of the study was to study the frequency and indications for peripartum hysterectomy and to assess the maternal outcome of peripartum hysterectomy.Methods: Cross sectional study was done in the department of obstetrics and gynaecology, Vanivilas hospital, Bangalore from September 2018 to august 2019. This study consists of 24 cases of emergency peripartum hysterectomy within 24 hours of delivery, operated at Vanivilas hospital.Results: The frequency of peripartum hysterectomy was 1.102/1000 deliveries and following caesarean section and vaginal deliveries are 3.544/1000 deliveries and 0.248/1000 deliveries respectively. Among 24 cases who had peripartum hysterectomy, 16 cases were delivered by caesarean section and 4 cases delivered by vaginal route while another 4 cases delivered by laparotomy for rupture uterus. 22 cases (91.67%) survived with major number of cases having morbidities and there were 2 (8.33%) maternal death.Conclusions: The most common mode of delivery before peripartum hysterectomy was Caesarean section. The most common indication was atonic postpartum haemorrhage. Better protocols for induction and augmentation of labour will decrease the necessity of peripartum hysterectomies.

scholarly journals Peripartum hysterectomy and its risk factors

2019 ◽  
Vol 9 (1) ◽  
pp. 27-31
Author(s):  
Renuka Tamrakar ◽  
Upendra Pandit ◽  
Sabita Shrestha ◽  
Basant Sharma ◽  
Rakshya Joshi
Keyword(s):  
Placenta Accreta ◽  
Length Of Hospital Stay ◽  
Cross Sectional Study ◽  
Morbidity Rate ◽  
Sectional Study ◽  
Cross Sectional ◽  
Peripartum Hysterectomy ◽  
Estimated Blood Loss ◽  
Severe Hemorrhage ◽  
Emergency Peripartum Hysterectomy

Background: Emergency Peripartum Hysterectomy (EPH) is an important lifesaving surgical procedure considered in cases of severe hemorrhage unresponsive to medical and conservative management. The objective is to review incidence, identification, intervention and impact of emergency peripartum hysterectomy. Methods: The retrospective, cross-sectional study designed was to used. EPH data were collected from January 2014 to December 2018.Descriptive statistics was used to analyzed data and presented in tables and charts. Results: Incidence of Emergency Peripartum Hysterectomies was 2.3% out of 252(2.6%) cases of obstetrical emergencies and 0.06% that is 1 in 1600 deliveries. Most common indications for EPH were uterine rupture (33.3%); placenta accreta (33.3%) followed by retained placenta (16.6%) and endometritis with pyometritis (16.6%). Estimated blood loss 1916 ml., timeliness from delivery to hysterectomy was 140 minutes; most common post-operative complication was surgical site infection (33.3%) and length of hospital stay 11.7 days. Maternal morbidity rate was 33.3%. There was no maternal mortality recorded. Conclusions: The timely intervention improves the outcome in Peripar­tum Hysterectomy, which is frequently associated with abnormal placen­tation as a consequence of increasing caesarean deliveries rate.

scholarly journals Factors affecting the fetal & maternal outcome in a trial of labour after previous one caesarean section

2019 ◽  
Vol 10 (2) ◽  
pp. 1110-1117
Author(s):  
Aseel Ghazi Rifat
Keyword(s):  
Caesarean Section ◽  
Gestational Age ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Safe Alternative ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Fetal Complications ◽  
History Of ◽  
Maternal Bmi

This study was designed to evaluate maternal and obstetrical factors associated with a successful trial of labour after one caesarean section (TOLAC) as well as evaluating the associated fetal and maternal outcomes and to determine the rate of vaginal delivery and repeated C/S. A prospective cross-sectional study was done on 237 women with previous one C/S then patients were selected for the trial of labour based on the department protocol. Those who were chosen for TOL were strictly monitored & observed for the progress of labour and the outcomes were recorded in terms of mode of delivery, maternal & fetal complications and were analysed and compared with those who had repeated C/S. Seventy-three (30.8%) patient was delivered by elective C/S without trial, 109 (46%) of the patients who were admitted to labour room delivered vaginally while 55 (23.2%) delivered by emergency C/S. It has been found that maternal BMI of (<25), history of vaginal birth after C/S (VBAC) and smaller gestational age were significantly associated with the success of TOL and can predict the outcome. Higher maternal & fetal complications rates were reported in cases delivered by emergency C/S compared to those who delivered vaginally or through elective C/S. The trial of labour after one caesarean section is a safe alternative to repeated C/S and decreases the associated morbidities with repeated C/S. The success rate of TOLAC reported in this study was (66.5%). A successful TOLAC is associated with normal maternal BMI, smaller gestational age and history of the previous VBAC.

scholarly journals Influence of maternal age and hospital characteristics on the mode of delivery

2020 ◽  
Vol 73 (suppl 4) ◽  
Author(s):  
Thales Philipe Rodrigues da Silva ◽  
Bruna Luiza Soares Pinheiro ◽  
Karolina Yukari Kitagawa ◽  
Renato Camargo Couto ◽  
Tânia Moreira Grillo Pedrosa ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Maternal Age ◽  
Diagnosis Related Groups ◽  
Mode Of Delivery ◽  
Length Of Hospital Stay ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Public And Private ◽  
Public Care ◽  
Vaginal Deliveries

ABSTRACT Objectives: to analyze the relationship between maternal age and the source of healthcare payment with mode of delivery in public and private national hospitals between the years 2012 to 2017, and the length of hospital stay. Methods: cross-sectional study of 91,894 women who had children in public and private hospitals between 2012 and 2017. Data were collected from the Diagnosis-Related Groups Brazil system and a comparative analysis was performed between patients in public care and those in supplementary healthcare. Results: in public care, the majority were vaginal deliveries and the reverse occurred in supplementary health. The proportion of cesarean sections was higher in the age group 31 to 40 years old in both services. The hospital stay was longer among women who underwent a cesarean section. Conclusions: high maternal age and the source of healthcare payment influence the mode of delivery, which interfere with the length of hospital stay.

scholarly journals Prevalence and Outcome of Induction of Labor in a Tertiary Care Center of Kathmandu, Nepal

2019 ◽  
Vol 14 (2) ◽  
pp. 54-56
Author(s):  
Dhan Bahadur Shrestha ◽  
Rosy Malla ◽  
Reeta Manandhar ◽  
Ratna Khatri ◽  
Cimona Shrestha ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Induction Of Labor ◽  
Maternity Unit ◽  
Tertiary Care Center ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Vaginal Deliveries

Aim: To study the prevalence of induction of labor and obstetric and neonatal outcome among delivery cases in the maternity unit of a tertiary care center. Methods: This is a prospective cross-sectional study conducted on pregnant ladies presenting to maternity unit of Shree Birendra Hospital, Chhauni over a period of six months from March to August 2017. All pregnant ladies in labor during the study period were enrolled. Induction of labor, mode of delivery, perinatal outcome (gestational age at delivery, birth weight), and maternal complications if any were recorded. Results: Among 497 deliveries in the study period, induction of labor was performed in 117 (23.5%) cases with post-date pregnancy being the most common indication. Induction was successful with vaginal deliveries in 82(70.1%) cases, while in the rest, IOL failed. Among the induced cases, 17 (14.5%) neonates had poor APGAR at 5 minutes and there was significant association of IOL with low APGAR. There was normal post-natal recovery in 108 (92.3%) induced cases while 9 (7.7%) cases developed some maternal complications. IOL has no significant association with maternal and neonatal complications or perineal injury (p>0.05). Conclusions: The prevalence of induction in this center is slightly higher than other centers. The IOL has significant association with low APGAR at 5 minutes but no significant association with the neonatal and maternal complications.

scholarly journals Perinatal determinants of D-dimer levels in a cross-sectional study of low risk pregnant women

2016 ◽  
Vol 9 (2) ◽  
pp. 78-82
Author(s):  
NM Murphy ◽  
AS Khashan ◽  
DI Broadhurst ◽  
O Gilligan ◽  
K O’Donoghue ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Elective Caesarean Section ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
D Dimer ◽  
In Pregnancy

Background To examine perinatal determinants of the antenatal levels of D-dimers. Methods Cross-sectional study of 760 low risk pregnant women recruited into five gestational groups. Variables examined in antenatal groups included maternal age, body mass index, parity, smoking, family history venous thromboembolism (VTE) and previous use of the oral contraceptive pill (OCP). Onset of labour and mode of delivery were also examined in the post-natal group. Results D-dimer levels in group 4 (38–40 + 6) were significantly lower in the women with a history of taking the OCP when compared to those that had not taken it in the past ( P = 0.027). In the day 2 post-natal group, the median level of D-dimer was significantly higher in primparous when compared to multiparous women ( P = 0.015). The median D-dimer levels were significantly lower in the elective Caesarean section group in comparison to spontaneous onset ( P = 0.003) and induction of labour ( P = 0.016). When the mode of delivery was examined, the median D-dimer levels were significantly lower in those that had an elective Caesarean section when compared to normal vaginal delivery ( P = 0.008) and instrumental vaginal delivery ( P = 0.007). Women post elective Caesarean section had a significantly lower D-dimer than those after emergency Caesarean section ( P = 0.008). Discussion There are some significant differences in D-dimer levels when certain perinatal determinants are examined. This work is potentially beneficial to the future diagnosis of VTE in pregnancy as it supports previously published recommended D-dimer levels for the diagnosis of VTE in pregnancy.

scholarly journals Frequency of common factors leading to primary postpartum haemorrhage in patients presenting at Nishtar Hospital Multan.

2019 ◽  
Vol 26 (10) ◽  
pp. 1799-1804
Author(s):  
Hajira Masood ◽  
Sobia Mazhar ◽  
Syed Muhammad Ali ◽  
Muhammad Sajjad Masood ◽  
Saima Yasmin Qadir ◽  
...  
Keyword(s):  
Postpartum Haemorrhage ◽  
Mode Of Delivery ◽  
Significant Risk ◽  
Common Factors ◽  
Numerical Data ◽  
Cross Sectional Study ◽  
Uterine Atony ◽  
Delivery Mode ◽  
Cross Sectional ◽  
Maternal Deaths

Objectives: The objective was to determine the frequency of common factors leading to Primary postpartum hemorrhage. Study Design: Cross-sectional study. Setting: Study was conducted in obstetrics and Gynaecology ward of Nishtar Hospital Multan. Period: From 15-9-2017 to 14-03-2018. Material and Methods: Total 2119 deliveries were done in hospital during study period. Patients with loss of blood greater than 500 ml in vaginal delivery and 1000 ml in abdominal delivery were included. Main variables of study were age, paity, duration of delivery, mode of delivery. analysis was done by using SPSS for Window (version 10.0) Mean and stranded deviation was calculated for numerical data like ages of the patients and parity, while frequencies and percentages was calculated for qualitative data like mode of delivery. Results: 61.07% of the patients delivered vaginally and duration of labour was prolonged in 27.51% of cases. The single most frequent factor leading to primary postpartum haemorrhage was uterine atony i.e. in 48.99% of cases. Conclusion: Uterine atony was the most significant risk factors of primary postpartum haemorrhage. Our findings confirm the importance of previously recognized factors. Timely identification & management of these factors can help in reducing the incidence of maternal deaths.

scholarly journals The results of different labour induction approaches: A Cross sectional study

2021 ◽  
Vol 12 (2) ◽  
pp. 108-111
Author(s):  
Jorge Duro Gómez ◽  
María Dolores Lara Dominguez ◽  
Antonio De La Torre Gonzalez ◽  
Araceli Lopez Jimenez ◽  
Beatriz Pineda Reyes ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Perinatal Outcomes ◽  
Clinical History ◽  
Cross Sectional Study ◽  
High Rate ◽  
Labour Induction ◽  
Sectional Study ◽  
Cross Sectional ◽  
Vaginal Deliveries ◽  
Twin Pregnancies

Background and Purpose: To evaluate the use of prostaglandins and oxytocin in labour induction according to different indications. Perinatal outcomes, rate of vaginal delivery and complation of labour were studied and compared. Methods: Cross-sectional descriptive study from January 2012 to December 2012. 530 women who required labour induction were included. Seven groups were created according to the methods of induction. Women with twin pregnancies, induction of dead foetus, two previous caesarean sections or an incomplete clinical history were excluded. Results: The rate of vaginal deliveries in women that only received prostaglandins the first day was 84.6%; similar in women with prolonged pregnancies, 85.2%. The induction with oxytocin directly showed the highest rate of caesarean section. The rate of vaginal deliveries was 50% in women with previous caesarean section. Conclusions: A high rate of vaginal deliveries with a single dose of prostaglandin and within 24 hours of beginning induction. Administration of prostaglandins must be used when cervix is unfavorable and previous to oxytocin stymulation.

scholarly journals Study of maternal and fetal outcome in postdate pregnancy in tertiary care hospital

2020 ◽  
Vol 9 (9) ◽  
pp. 3585
Author(s):  
Patel Yogeshkumar Pransukhbhai ◽  
Poonam Londhe
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Medical College ◽  
Vaginal Deliveries

Background: Fetal, neonatal and maternal complications associated with pregnancy beyond 40 weeks have always been underestimated. However emerging evidence demonstrates that the incidence of complications increases after 40 weeks of gestation. The present study was conducted to find out the fetomaternal outcome of such prolonged pregnancy.Methods: This was a prospective cross-sectional study of 70 patients with uncomplicated prolonged pregnancy fulfilling the inclusion and exclusion criteria and admitted in department of obstetrics and gynecology at a tertiary care hospital B. J. Medical College, Ahmedabad, Gujarat, India.Results: Out of 70 patients, majority of the subjects belongs to 26-30 years of age (50%). The gestational age of 90% of patients were between 40-42 weeks. About 42-44% of the foetus had a birth weight of 2.5-3.5 kgs. Maximum patients underwent vaginal deliveries in spontaneous group (57%) and 64% underwent LSCS in induced group. Mode of delivery is significantly associated with presence of adequate liquor.Conclusions: With regular antenatal check-up, incidence of postdate pregnancy can be decreased and it is important because of definite risk to fetus as pregnancy continuing beyond 40 weeks of gestation is associated with increased perinatal morbidity and mortality especially those who do not come for regular antenatal check-up.

scholarly journals Risk factors for composite adverse outcomes of postpartum haemorrhage in a low-resource setting: a single-centre cross-sectional study in Mpilo Central Hospital, Bulawayo, Zimbabwe

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 211
Author(s):  
Solwayo Ngwenya
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Caesarean Section ◽  
Postpartum Haemorrhage ◽  
Cross Sectional Study ◽  
Adverse Outcomes ◽  
Prior History ◽  
Cross Sectional ◽  
History Of ◽  
Independent Risk Factors

Background: Primary postpartum haemorrhage continues to cause considerable global maternal morbidity and mortality. The aim of this study was to determine the risk factors for composite adverse outcomes in postpartum haemorrhage using multivariable logistic regression. The findings could potentially be used to anticipate and prevent composite adverse outcomes in postpartum haemorrhage. Methods: This was a retrospective cross-sectional study carried out at Mpilo Central Hospital, a government tertiary referral centre, covering the period 1 July 2016 to 30 November 2019. Participants were included in the study if they had a diagnosis of postpartum haemorrhage. Those variables that had a p<0.2 from the univariate logistic regression analyses were considered for multivariable logistic regression. The association between independent variables and the dependent variable was assessed using odds ratio with 95% confidence intervals, to identify independent risk factors for composite adverse outcomes in PPH. Results: The independent risk factors for composite adverse outcomes in postpartum haemorrhage were place of dwelling (AOR 4.57, 95% CI 1.87-11.12, p=0.01), prior history of a Caesarean section (AOR 2.57, 95% CI 1.10-6.00, p=0.03), APH (AOR 5.45, 95% CI 2.23-13.27, p<0.0001), antenatal haemoglobin level (AOR 19.64, 95% CI 1.44-268.50, p=0.03), and delivery by Caesarean section (AOR 10.21, 95% CI 4.39-23.74, p<0.0001). Blood loss was also an independent risk factor for composite adverse outcomes in postpartum haemorrhage with the following blood loss; 1001-1500 ml (AOR 9.94, 95% CI 3.68-26.88, p<0.0001), 500-1000 ml (AOR 41.27, 95% CI 11.32-150.54, p<0.0001), and 2001 ml (AOR 164.77, 95% CI 31.06-874.25, p<0.0001). Conclusions: This study found that the independent predictors for composite adverse outcomes in PPH were rural dwelling, prior history of a Caesarean section, antenatal haemoglobin level, delivery by Caesarean section, and blood. In low- and middle-income countries, such information should help in increasing clinical vigilance and preventing maternal deaths.

scholarly journals A root cause analysis of increasing caesarean section rates in a tertiary care private hospital in North India

2019 ◽  
Vol 8 (11) ◽  
pp. 4531
Author(s):  
Bela Makhija ◽  
Deepika Verma ◽  
Asif Mustafa
Keyword(s):  
Caesarean Section ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Cultural Factors ◽  
North India ◽  
New Delhi ◽  
Care Hospital ◽  
Cross Sectional ◽  
Group 2

Background: Increase in the incidence of caesarean section is a matter of concern worldwide. Robson’s criteria which is universally accepted now as a way for calculating caesarean rates takes into account only the obstetrical consideration, however, it is noteworthy that many socioeconomic and cultural factors also have a role to play. This study takes into account both Robson’s criteria and common socio-cultural factors which lead to increased caesarean rates with an attempt to suggest ways to curtail this trend.Methods: The study was a hospital based cross-sectional study at a private tertiary care hospital in New Delhi. 1200 consecutive live births after 34 weeks of gestation were analysed over a period of one year.Results: LSCS was the most common mode of delivery 733 (61.1%). 329 (27.4%) had induced labour of which 260 (76.2%) had LSCS. 333 women had elective LSCS. Rates of CDMR were 185 (25.2%) which is very significant. As per Robson’s criteria maximum number of women (318) were in group 2, of which 226 (71.1%) underwent caesarean section.Conclusions: High caesarean rates can be attributed to a multitude of factors. Robson’s criteria are an effective way for analysis of obstetric indications. Other added factors include comorbidities, CDMR, fear of litigations, etc which were analysed.

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