scholarly journals Towards optimizing caesarean section: a five-year review of caesarean sections at a Southern Nigeria hospital

2019 ◽  
Vol 9 (1) ◽  
pp. 205
Author(s):  
Nkencho Osegi ◽  
Olakunle I. Makinde
Keyword(s):  
Social Sciences ◽  
Caesarean Section ◽  
Collaborative Research ◽  
Caesarean Section Rate ◽  
Breech Presentation ◽  
Fetal Distress ◽  
Hospital Level ◽  
Cephalopelvic Disproportion ◽  
Study Centre ◽  
Previous Cesarean

Background: Monitoring caesarean sections at hospital level is essential to reduce unnecessary caesarean sections while still ensuring adequate access to caesarean section. This study was conducted to determine the caesarean section rate and indications for caesarean section at the study centre and provide objective data for institutional interventions towards reducing unnecessary caesarean sections in the centre.Methods: A retrospective descriptive study of patients that had caesarean sections between 1st January 2013 and 31st December 2017 at the Federal Medical Centre, Yenagoa, Nigeria. Data were analyzed using Statistical Package for Social Sciences version 22.Results: There were 5,793 deliveries and 1,654 were by caesarean section. The average caesarean section rate was 28.6%. The leading indications for caesarean section were cephalopelvic disproportion (26.6%), previous cesarean section (18.2%), suspected fetal distress (11.2%), severe preeclampsia/eclampsia (7.9%), obstructed labour (6%), and breech presentation (5.9%).Conclusions: The 28.6% caesarean section rate in this study falls within a widely varied rate across Nigeria at hospital level but is comparable to rates within the south-south geopolitical zone of Nigeria. The leading indications for caesarean section are modifiable, thus there is room for institutional intervention to reduce unnecessary caesarean sections. Collaborative research between institutions is required to assess peculiar regional determinants of caesarean section towards developing suitable interventions to reduce unnecessary caesarean sections regionally.

scholarly journals Caesarean section: its rates and indications at a tertiary referral center in Eastern Nepal

1970 ◽  
Vol 9 (3) ◽  
pp. 179-183
Author(s):  
S Chhetri ◽  
U Singh
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Placenta Previa ◽  
Caesarean Section Rate ◽  
Breech Presentation ◽  
Fetal Distress ◽  
Tertiary Referral ◽  
Common Indication ◽  
Tertiary Referral Center ◽  
Referral Center

Background: There has been a sustained increase in the rate of caesarean section in the last few years around the world. Data regarding the current caesarean rate and the trends of its indications in eastern Nepal have not been estimated earlier. Aim: To assess the rate of caesarean sections and the varying indications for caesarean section in a tertiary referral center in eastern Nepal. Methods: All hospital deliveries that took place in BPKIHS between January 2006 and December 2007 were recorded to assess the caesarean section rate and its indications. Results: A total of 5330 deliveries were conducted in 2006. Likewise the total number of deliveries conducted in 2007 was 6634. In 2006 caesarean sections were performed in 28.6% (1524) of all patients. The rate of caesarean sections in 2007 increased and was 33.7% (2239). The most common indication for caesarean section was meconiumstained liquor, which constituted 23.4% (883). The next frequent indication was previous caesarean section, which accounted for 17.2% (650), followed by breech presentation in 11.1% (417), fetal distress in 9.6% (364), non-progress of labor in 7.2% (270), cephalopelvic disproportion in 6.2% (234, and placenta previa in 4.4% (165). Conclusions: There is a increasing trend of performing cesarean section in the tertiary referral center in east era Nepal. The most common indication for cesarean section is meconium-stained liquor. Keywords: Caesarean section; caesarean delivery rates; Nepal DOI: http://dx.doi.org/10.3126/hren.v9i3.5587   HR 2011; 9(3): 179-183

scholarly journals A Descriptive Analysis of the Indications for Caesarean Section in Lumbini Zonal Hospital, Butwal

2018 ◽  
Vol 5 (2) ◽  
pp. 31-34
Author(s):  
Shreedhar Acharya ◽  
Bhaktabatsal Raut
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Caesarean Section Rate ◽  
Descriptive Analysis ◽  
Fetal Distress ◽  
Age Group ◽  
Medical Sciences ◽  
Cephalopelvic Disproportion ◽  
Case Files ◽  
One Year

AIM: This study was done to find out the incidence and to analyse the various indications for caesarean sections at Lumbini Zonal Hospital.MATERIALS & METHODS: This was a hospital based retrospective study done at Lumbini Zonal Hospital, Butwal. The case files of all the women who had caesarean delivery over the period of one year from 2071/4/1 to 2072/3/32 were reviewed. Various indications of caesarean sections were analysed for the incidence, age, parity, elective vs emergency caesareans.RESULTS: Out of 7589 deliveries, 1316 (17.34%) had caesarean section. Most common indications were previous caesarean 275 (20.89%), non progress of labour 245 (18.61%), cephalopelvic disproportion 222 (16.86%), fetal distress 215 (16.33%), etc. Majority of caesarean 1226 (93.16%) was done in the age group of 20-30yrs, primipara 702 (53.34%), and elective caesarean sections 766 (58.2%).CONCLUSION: Caesarean section rate at Lumbini Zonal Hospital was optimal. Most common indication was repeat caesarean. The overall reduction in caesarean section rate can be met through reduction of elective caesarean with the promotion of trial of labour.Study also concludes that there is a relation between working duration and health problems, and the problems increase as the duration at work increases.Journal of Universal College of Medical Sciences, Vol. 5, No, 2, 2017, Page: 31-34

scholarly journals Risk factors and between-hospital variation of caesarean section in Denmark: a cohort study

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e019120 ◽  
Author(s):  
Sonja Wehberg ◽  
Rikke Guldberg ◽  
Kim Oren Gradel ◽  
Ulrik Schiøler Kesmodel ◽  
Lis Munk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Caesarean Section ◽  
Breech Presentation ◽  
Emergency Caesarean Section ◽  
Secondary Outcome ◽  
Maternity Unit ◽  
Cephalopelvic Disproportion ◽  
Hospital Units ◽  
Hospital Variation

ObjectivesThe aim of this study was to estimate the effects of risk factors on elective and emergency caesarean section (CS) and to estimate the between-hospital variation of risk-adjusted CS proportions.DesignHistorical registry-based cohort study.Settings and participantsThe study was based on all singleton deliveries in hospital units in Denmark from January 2009 to December 2012. A total of 226 612 births by 198 590 mothers in 29 maternity units were included.Primary and secondary outcome measuresWe estimated (1) OR of elective and emergency CS adjusted for several risk factors, for example, body mass index, parity, age and size of maternity unit and (2) risk-adjusted proportions of elective and emergency CS to evaluate between-hospital variation.ResultsThe CS proportion was stable at 20%–21%, but showed wide variation between units, even in adjusted models. Large units performed significantly more elective CSs than smaller units, and the risk of emergency CS was significantly reduced compared with smaller units. Many of the included risk factors were found to influence the risk of CS. The most important risk factors were breech presentation and previous CS. Four units performed more CSs and one unit fewer CSs than expected.ConclusionThe main risk factors for elective CS were breech presentation and previous CS; for emergency CS they were breech presentation and cephalopelvic disproportion. The proportions of CS were stable during the study period. We found variation in risk-adjusted CS between hospitals in Denmark. Although exhaustive models were applied, the results indicated the presence of systematic variation between hospital units, which was unexpected in a small, well-regulated country such as Denmark.

scholarly journals Evaluation of caesarean section practices according to Robson's 10-group classification at a level two maternity ward in Conakry, Guinea

2019 ◽  
Vol 8 (11) ◽  
pp. 4468
Author(s):  
Daniel W. A. Leno ◽  
Mamoudou E. Bah ◽  
Jerry C. Moumbagna ◽  
Tamba M. Millimouno ◽  
David Lamah ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Medical Center ◽  
Caesarean Section Rate ◽  
Relative Size ◽  
Newborn Care ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Maternity Ward ◽  
Cross Sectional ◽  
Robson Classification

Background: The frequency of caesarean sections (CS) increased dramatically in the world over the last twenty years. The objective of this study was to evaluate caesarean section practices based on Robson classification in an urban referral hospital in Conakry, GuineaMethods: We conducted a cross-sectional study of 2,266 birthing records collected at the maternity ward of the Coronthie Communal Medical Center in Conakry, from January 1st to December 31st 2016. We included in the study all women who had a caesarean section and whose medical records were complete. Robson's classification was used to classify women into 10 groups based on maternal and fetal characteristics. The relative size of each group, its gross caesarean section rate as well as its contribution to overall caesarean section rate and the main caesarean section indications were calculated.Results: In 2016, 769 caesarean sections were performed out of 2,266 deliveries, corresponding to a hospital section rate of 33.9%. Groups 5 (11.0%), 1 (4.8%), and 3 (4.3%) of the Robson classification were the most contributors to registered hospital caesarean section rate. The main indications for caesarean section were uterine scar in group 5 and acute fetal distress in groups 1 and 3.Conclusions: The systematic reference to the Robson classification could help to identify and avoid the relative indications of the caesarean section in urban Guinea. Besides, increasing induction of labor and strengthening providers’ capacities in emergency obstetric and newborn care services could contribute to reduce caesarean section rates in Guinea.

scholarly journals Analysis of caesarean section rate in tertiary care hospital according to Robson`s 10 groups classification

2018 ◽  
Vol 7 (4) ◽  
pp. 1380
Author(s):  
Varija T. ◽  
Veerendra Kumar C. M. ◽  
Chandrasekhar Tarihalli
Keyword(s):  
Caesarean Section ◽  
Classification System ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Case Series ◽  
Breech Presentation ◽  
Group Classification ◽  
Care Hospital ◽  
Case Series Study ◽  
Group 5

Background: The caesarean section (CS) delivery rate is steadily increasing worldwide, including India. Identifying the proportion of women in various categories as per Robson's ten group classification system and CS rate among them is important to bring down the increasing CS rate.Methods: This case series study was conducted at Vijayanagar Institute of Medical Sciences (VIMS), a tertiary care teaching hospital in Ballari, Karnataka, India. All pregnant women who have been admitted for delivery were enrolled and the data was collected for the women delivered by CS during January 2016 to December 2016 and proportions in various groups as per Robson’s ten-group classification system were calculated.Results: Among a total of 6980 women delivered during study period, 2992 (42.8%) delivered by CS. The CS rates among various groups varied from 100% among women with abnormal lies and group 6-95% (all nulliparous breeches) group 5-94% (Previous CS, single cephalic, >37 weeks) to 10 to 15% among multiparous women with spontaneous labour having single cephalic pregnancy (group 3). Among women with previous section, CS rate was very high (89.6%). Women with previous CS (group 5) contributed maximum (40.24%) to the total number of CS.Conclusions: In the present study, all women with breech presentation and abnormal lies delivered by CS and repeat CS was the highest contributor to all CS deliveries.

scholarly journals Prophylactic amnioinfusion in oligohydramnios

2019 ◽  
Vol 9 (1) ◽  
pp. 305
Author(s):  
Dhiviya Narbhavi T. ◽  
Cicily T. J. ◽  
Kala B. S.
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Perinatal Outcome ◽  
Fetal Heart ◽  
Caesarean Section Rate ◽  
Fetal Distress ◽  
Study Group ◽  
Amniotic Fluid Volume ◽  
Fetal Complications ◽  
Labour Room

Background: Oligohydramnios causes many intrapartum maternal and fetal complications. Intrapartum amnioinfusion effectively increases amniotic fluid volume and thereby decreases FH decelerations. The objective of this study was to compare the frequency of fetal heart decelerations and its perinatal outcome with and without amnioinfusion in patients with oligohydramnios and the cesarean rates for fetal distress between them.Methods: In study group, 100 patients in labour with AFI < 5 cm, oligohydramnios and IUGR with normal doppler, postdated pregnancies with AFI ≤ 5 cm with normal doppler were selected and prophylactic amnioinfusion with 300 ml lukewarm saline is given aseptically for 15 minutes after amniotomy. Continuous CTG monitoring done till delivery. If FH decelerations occur, the bolus was repeated up to 3 times. 100 age matched controls managed with conventional methods without amnioinfusion were selected retrospectively from labour room case records.Results: Incidence of FH decelerations was lower in study group (59% versus 84%). Cesarean section for fetal distress was reduced (20.9% versus 79.1%) Perinatal outcome was better. Babies with normal 1-minute Apgar was 86% compared to 75% in controls. Frequency of FH decelerations was reduced (20% versus 73%). Occurrence of 2 FH decelerations were 13% versus 33%, 3 FH decelerations were 7% versus 27% and > 3 times was 0% versus 13%.Conclusions: Prophylactic amnioinfusion can easily and effectively reduce the FH decelerations and caesarean section rate for fetal distress in oligohydramnios improving both maternal and fetal outcomes with negligible risks.

scholarly journals Cholestasis of pregnancy: a prospective analysis from a South Andaman teaching hospital

2019 ◽  
Vol 8 (5) ◽  
pp. 1895
Author(s):  
Bhabani Pegu ◽  
Manju Mehrotra ◽  
Anita Yadav ◽  
Pinky S. K. Sahoo
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Fetal Distress ◽  
Complete Recovery ◽  
Liver Disorder ◽  
Favourable Outcome ◽  
Spontaneous Preterm Delivery ◽  
Increased Risk ◽  
A Prospective Study ◽  
Cholestasis Of Pregnancy

Background: Intrahepatic cholestasis of pregnancy (IHCP) is one of the commonest pregnancy related liver disorder. Although the maternal course is usually benign, there is an increased risk of spontaneous preterm delivery, fetal compromise, meconium stained amniotic fluid and even intrauterine fetal demise. The objective of this study was to study the incidence of IHCP and its impact on maternal and perinatal outcome.Methods: A prospective study carried out in 68 number of IHCP cases. Diagnosis was done on the basis of clinical and laboratory parameters. All the cases were followed up to the puerperium to find out maternal and perinatal outcome.Results: The incidence of cholestasis of pregnancy was 2.73%. Most (88%) of the cases were presented with generalized pruritus, relived with ursodeoxycholic acid and complete recovery was observed after delivery. The rate of instrumental delivery was 8.82% and caesarean section rate was 30.88%. Most common indication of caesarean section was fetal distress and non-progress of labour. There was one stillbirth at 35 weeks however none of the mother had complication during labour or puerperal period.Conclusions: Increased level of liver enzymes in patients of IHCP associated with poor perinatal outcome. Therefore, careful monitoring during antenatal period and termination of pregnancy at term will result in favourable outcome of both mother and baby.

External Cephalic Version at Term with Tocolysis

1988 ◽  
Vol 18 (3) ◽  
pp. 119-124 ◽  
Author(s):  
G Justus Hofmeyr
Keyword(s):  
Developing Countries ◽  
Caesarean Section ◽  
Breech Presentation ◽  
External Cephalic Version ◽  
Cephalopelvic Disproportion ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
High Prevalence ◽  
Large Families ◽  
Tocolytic Agents

The problems associated with breech presentation are of particular importance in developing countries. The risk of vaginal breech delivery may be increased because of a high prevalence of cephalopelvic disproportion. Caesarean section presents specific risks to women who may not have medical care in subsequent pregnancies and may desire large families. External cephalic version (ECV) before term has not been proved conclusively to influence the outcome of pregnancy. ECV performed at term (37 or more weeks gestation), using tocolytic agents to relax the uterus, has been shown in a technologically developed setting to reduce the incidence of breech presentation and of Caesarean section. The application of this procedure when technological facilities are limited is discussed and the technique is described.

scholarly journals A cross sectional study of 1000 lower segment cesarean section in obstetrics and gynecology department of P. D. U Medical College, Rajkot, Gujarat, India

2017 ◽  
Vol 6 (4) ◽  
pp. 1186
Author(s):  
Dolly Chavda ◽  
Kamal Goswam ◽  
Kavita Dudhrejiya
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Obstetrics And Gynecology ◽  
Sectional Study ◽  
Lower Segment ◽  
Cross Sectional ◽  
Medical College ◽  
Lower Segment Cesarean Section

Background: Though WHO recommends a rate of 10-15% caesarean section for a given hospital, there has been a rising trend worldwide. We estimated the recent incidence of caesarean section in Obstetrics and Gynecology Department, P.D.U. Medical College, Rajkot (Gujarat and correlated these rates with the socioeconomic, demographic, and health variables.Methods: We have studied 1000 cases of lower segment caesarean section (cross sectional study) at Obstetrics and Gynecology Department, P.D.U Medical College, Rajkot (Gujarat) to find out rate of caesarean section, common maternal and fetal indication and complications of lower segment caesarean section.Results: Caesarean section rate of the present study is 19.9%. Most common indication of LSCS was scarred uterus 39.9%.followed by fetal distress 19.1%, malpresentation 18.6%, and failed induction 7.3%. Maternal morbidities and mortalities in emergency LSCS in compare to elective LSCS. Analysis based on Robson’s ten-group showed that group 5 (Previous CS, single cephalic,>37 weeks) made the greatest contribution to total CS rate.Conclusions: Scientific advances, social and cultural changes, and medico legal considerations seem to be the main reasons for the increased acceptability of caesarean sections. The decision to perform a C-section delivery must be chosen carefully and should not be profit oriented. There is a possibility of keeping the rate to minimum by reducing number of primary caesarean sections, by proper counseling of the patients, proper monitoring and patience.

scholarly journals CAESAREAN SECTION

2018 ◽  
Vol 25 (07) ◽  
Author(s):  
Saeeda Bano ◽  
Myda Muzaffar ◽  
Masooma Zafar ◽  
Fareeha Yousaf
Keyword(s):  
Caesarean Section ◽  
Teaching Hospital ◽  
Placenta Previa ◽  
Breech Presentation ◽  
Fetal Distress ◽  
Obstructed Labor ◽  
Cross Sectional ◽  
Medical College ◽  
Life Saving ◽  
The Ideal

Introduction: Caesarean Section (CS) is a surgical procedure carried out for thedelivery of the baby when circumstances render the possibility of a safe vaginal birth. Thoughcaesarean section can be life-saving in many situations, its unnecessary use has become a globalhealth concern. For almost 3 decades, the ideal rate for caesarean sections was consideredto be between 10% and 15% but its consistently increasing frequency over the past years hasbrought it to limelight. Objective: To determine the frequency and indications of Caesareansection at DHQ Teaching Hospital, Sahiwal. Study Design: A Cross-sectional descriptive study.Setting: Department of Gynaecology and Obstetrics, DHQ Teaching Hospital, Sahiwal affiliatedwith Sahiwal Medical College, Sahiwal. Period: It was carried out over a period of 6 monthsfrom December, 2016 to May, 2017. Methods: All the caesarean sections carried out during thestudy duration were included. Both maternal and fetal indications were recorded. The patientsnot willing to participate were not included. Results: Out of the total, Caesarean Sectionaccounted for 44.7% of the total deliveries. 72.05 % were elective and 27.49% were emergencyprocedures. Most Common Indications were found out to be previous >2 C-Sections (36.4%),previous 1 C-Section (28.3%). Rest of them were breech presentation (2.69%), obstructed labor(1.68%), fetal distress (2.6%), placenta previa (8.08%), APH (2.02%), post-dated pregnancy(4.04%), uterine rupture (7.56%) and others (6.58%). Conclusion: It was concluded that >2previous C-Sections is the most common indication. The high frequency should be controlledby proper counselling and education of the mothers and families, regarding the complicationsof caesarean section.

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