scholarly journals Demographic profile in women undergoing second stage caesarean section

Author(s):  
Isha . ◽  
Prabha Lal ◽  
Vikram Dutta ◽  
Aayushi Kaushal

Background: Incidence of caesarean section is rapidly rising over the last two decades and 25% is contributed by second stage caesarean section. Demographic factors influencing fetomaternal outcome in second stage caesarean section include BMI, socioeconomic status, booking/ unbooking status, gravidity and maternal height.Methods: The present study was prospective observational study conducted in the department of obstetrics and gynaecology at Lady Hardanger Medical College New Delhi from December 2015 to March 2017. 80 women were enrolled in the study. A detailed history and examination of each patient was carried out. Women were observed during lab our till second stage caesarean section.Results: Mean age of population was 25.26±3.75 ranging from 19-40 year. 76.25% included in study were booked and 11.25% were unbooked, 42.5% belonged to lower middle class and 31.25% belonged to upper middle class. 47% women had height of <150 cm and 70% had a BMI between (25-29.9) kg/m. 43% women had gestational age between 39-40 weeks.Conclusions: Second stage caesarean section was more common in young age group and primigravidae. Higher BMI was not only operative but obstetrical risk as well.

Author(s):  
Nupur Gupta ◽  
Taru Gupta ◽  
Ritu Singh

 Background: The aim is to study neonatal and maternal outcomes of the caesarean sections performed in first stage versus second stage of labour. Methods: The retrospective analysis of data were done of caesarean section done at Department of Obstetrics and Gynaecology at ESI PGIMSR Basaidarapur New Delhi between January 2016 to December 2016. 45 women, who underwent second stage caesarean section were studied. For each case, two consecutive cases, who underwent caesarean delivery during the first stage of labour were taken as control for the study. Primary maternal outcomes of interest were uterine atonia, transfusion requirement, urinary system injury and postoperative complications. Results: Out of 4477 deliveries, 1466 had caesarean section with a rate of 32%. The rate of second stage caesarean section was 3% of total caesarean section and 1% of total deliveries. Second stage caesarean section had higher maternal and perinatal morbidity like atonic PPH (33.3%), lower uterine segment extension (7%), febrile morbidity (10%), and need for blood transfusion (15%). There were 15.5% NICU admission in second stage caesarean group while none in first stage group. Conclusions: Caesarean section in the second stage of the labour is associated with increased maternal and neonatal morbidities. Special attention is required to the patients undergoing caesarean section in the second stage of the labour. They should be handled by senior and experienced obstetrician. Neonatologist should be present for every second stage caesarean section.


Author(s):  
Veeramma . ◽  
Puneeta Mahajan

Background: The incidence of caesarean section is on the rise and has increased 2-3 folds from the initial rate of 10% during the last decade.  The objective of the present study was to compare maternal outcomes in successful and failed trial of labour in women with previous one LSCS.Methods: This prospective observational study was carried out in Department of obstetrics & Gynaecology, Sanjay Gandhi memorial Hospital, New Delhi during 2015-2016 and included 150 gravid women with previous LSCS.   The study was undertaken during March 2015 to May 2016. The ethical committee approval for the study has been taken.Results: out of 150 patients who had given a trial of labour, 64.7% (97) underwent successful VBAC and 35.3 %( 53) underwent emergency repeat LSCS. Majority of cases 59.3% were in age group <25 years followed by 36.7% in age group of 25-30 years. Most of the cases are para one 72.7% and remaining are multipara (27.3%). LSCS group: 83% para1 and 17% are multipara. VBAC group: 67.01 % para 1 and 32.9% multipara. There is no significant statistical difference between parity and mode of delivery. (p=0.591). Majority of cases 52.7% were in between 37-39 weeks and 47.3% cases were in between 39-42 weeks. Majority cases 89.3% had Bishop’s score 4-6 and 10.7% had Bishops score >6.Conclusions: This study reveals that successful VBAC rate was 64.7% and 35.3% emergency repeat caesarean section.


Author(s):  
Anubha Manu Prasad ◽  
. Manju Agrawal ◽  
Ankit Laddha

Background: The objective of the present study was to examine the etiological factors, both maternal and fetal, that caused IUFD. Methods: It was a hospital based prospective observational study conducted in the Department of Obstetrics and Gynaecology at Jhalawar Medical College from January 2020 to December 2020. 120 cases of IUFD of ?24 weeks of gestation or foetuses weighing ?500 gramswere included in the study. Results: The incidence of IUFD was 37.8/1000 total birth. IUFD occurredmainly in 25-35yrs age group (55%), unbooked cases (70%),multigravida (59.2%), preterm (<37 weeks of gestation). The risk factors were PIH (49.2%), infections (9.2%), hypothyroidism (5%), Rh negative with hydrops fetalis (5%),GDM (4.2%), chronic hypertension (2.5%), previous H/O LBW (2.5%), H/O prior stillbirth (5%), hyperthyroidism (1.7%), oligohydramnios (46.7%), APH (20.8%) and congenital fetal anomalies (19.2%). Conclusion: IUFD rate still remains high. Therefore, regular ANC check up and early identification of risk factors like PIH, anaemia, infections, genetic counselling and timely referral to well equipped centre may help prevent IUFD and maternal mortality and morbidity. Keywords: IUFD, ANC, Preterm


Author(s):  
Sunil Kumar Pandey ◽  
Surabhi Porwal

Background: Intrauterine foetal death is an immense emotional burden for everyone concerned specially in the last trimester. Therefore, it is very important to find out, what has happened. Evaluation of clinical and pathological profile of women presenting with intrauterine foetal death has evoked great interest among the obstetricians.Methods: The prospective observational study was conducted in the department of Obstetrics and Gynaecology N.S.C.B. Medical College Jabalpur during 1st June 2012 to 31st October 2013. A total of 155 intrauterine foetal death subjects admitted during this period were evaluated. Clinically and laboratory profile of subjects done.  Histomorphology of placenta was performed in each case. Full HPR finding were then correlated with clinical and laboratory findings of subjects.  Results: Poor vascularity of villi and fever were significantly associated (p<0.01). Hypertension and Convulsion and fibrinoid necrosis, syncytial knot and placental infarcts were significantly associated (p<0.001) Premature placenta is associated with cytotrophoblastic layer (p<0.01). Conversely post mature placenta is associated with calcification and infarction.  (p<0.01).  Conclusions: All placentae associated with foetal death have either gross or microscopic abnormalities. Present study is a step towards understanding and extrapolating the already known causes of intrauterine foetal death in the perspective of Jabalpur and its adjoining districts.


2019 ◽  
Vol 1 (Number 2) ◽  
pp. 6-10
Author(s):  
Monowar Ahmad Tarafdar ◽  
Nadia Begum ◽  
Shila Rani Das ◽  
Sultana Begum ◽  
Mehruba Afrin ◽  
...  

This is a cross sectional study conducted among Currently Married Women of Reproductive Age (CMWRA) with a sample size of 476 selected purposively using a semi-structured questionnaire in 2018 at Moulvibazar Sadar to explore the factors affecting fertility. The result shows that 55.26% respondents were within 35 years age whereas only 4.28% from age group 46-49 years age group, 33% of the respondents got married at <16 years of age and 18.70% were illiterate, 47.90% had primary education. It is evident that 76% of the respondents were from rural area; 88% were Muslims, 29.41% from lower middle class followed by upper middle class (25.42%) and poorest comprised only 7.56%. The result explored that 73.91% of the respondents were from age group 41-45 got married before 16 years of age followed by 36-40 years (68.24%), 46-49 years (66%), 20-25 and 26-30 years age groups 52.38% and 52.75% respectively; 73.33% of respondents from rural area got married at <16 years of age, 68.42% of the Muslim at <16 years. The study explored that 96.39% from poorer section and 83.33% from poorest section got married at <16 years of age. Current study revealed that 82.91% of the respondents having secondary education got married before 16 years of age followed by illiterate (82.02%). It is explored that the age at marriage is statistically associated with residence, education, wealth index and religion (p= 0.001, 0.03, 0.001, 0.001 respectively). We conclude that the sociodemographic condition contributes mostly to fertility differentials in Bangladesh.


2020 ◽  
pp. 60-62
Author(s):  
Narendra Nath Hait ◽  
Brahmarshi Das ◽  
Ratan Chandra Mandal ◽  
Haricharan Roy ◽  
Debarshi Jana

Background: Threatened abortion is till most common cause of early trimester bleeding PV and can be diagnosed and managed by early USG diagnosis. Materials and methods: This was a prospective observational study. Place of the study was Department of Obstetrics and Gynaecology and Department of Radiodiagnosis, Midnapore Medical College and Hospital from January 2019 to June 2020. Eighteen months. Result: When the clinical method to diagnose threatened miscarriage was compared to the sonographic method, it was evident that sonographic method was reliable than the clinical method and the difference was statistically significant. Conclusion: In case of missed miscarriage and complete miscarriage, although the percentage of discrepancy was 100%, on further statistical analysis, the discrepancy was not statistically significant. And the cause behind this was probably inadequate sampling.


Author(s):  
Shanmugapriya Kumaresan ◽  
Malarvizhi Loganathan

Background: There is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. With this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlights includes the rate of caesarean deliveries in the second stage of labour, the indications for delivery and the associated maternal morbidity in this cohort of women.  Methods: This was a prospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between July, 2016 and December 31, 2017 at government medical college hospital Dharmapuri. The main outcome measures were second stage caesarean section, indications and its maternal morbidity.Results: 250 women underwent caesarean delivery in the advanced labor. Among the 250 patient’s majority of them were in the age group of 21-30 yrs. about 76% of the patients were primigravidae and only the remaining 24% were multigravida. The commonest indications for doing caesarean section in the second stage of labor was cephalo pelvic disproportion and non-reassuring fetal heart rate patterns. The difficult task was delivery of the deeply engaged head, the increased likelihood of intraoperative and post-operative complications.Conclusions: Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and morbidity.


Author(s):  
N. Swathi ◽  
Voleti Vijaya Kumar ◽  
M. Farjana ◽  
M. Vishnu Vardhan ◽  
M. Munendra ◽  
...  

Objective: To determine the prevalence of hypothyroidism in a rural population of Nandyal.Methods: A prospective study was conducted in Santhiram medical college and general hospital, Nandyal from July 2017 to December 2017, to study the prevalence of hypothyroidism among the population. Results: In this study, 1000 patients were evaluated for the thyroid functioning, among them n=104(10.4%) showing positive results in hypothyroidism. The positive 104 patients showed that n=63 (60.57%) of the population are in the age limit of 21-40. Out of the same population are n=11 (10.6%) are male and female are n=93 (89.43%). In age group distribution more prevalence was observed in 21-30 y of age group n=36 (34.61%). In this study, sub-clinical hypothyroidism was prevalent in females n=80 (76.92%) than males n=10 (9.61%).Conclusion: Our study demonstrates that hypothyroidism was higher in a female with age group as 21-40 y and there is a significant prevalence of hypothyroidism in the study population.


2018 ◽  
Vol 5 (5) ◽  
pp. 1781 ◽  
Author(s):  
Atul Kumar Singh ◽  
Rajeev Dwivedi ◽  
A. P. S. Ghaharwar

Background: Peripheral venous canualation is indispensable in admitted patients in surgical ward, thrombophlebitis following infusion is seldom serious, but it effects on postoperative recovery, hospital stay and hence burden of disease are magnanimous. The main aim and objective of the study to find out the incidence of thrombophlebitis at the intravenous infusion site in surgical ward.Methods: This prospective observational study was conducted on 300 patients admitted in surgical ward of S.S Medical College and associated S.G.M. hospital, Rewa (M.P.) patients selected randomly. These Patients were visited daily for any sign and symptoms at infusion site. The incidence of thrombophlebitis according to age, sex and duration of infusion were recorded. The tool designed to collect the data were socio demographic performa and observational check list.Results: In total 300 patients the incidence of thrombophlebits is highest in age group of 41-50(20%), Male (64.66%) and incidence increases as the duration of infusion increased it is 100% after 5 days. The incidence of Grade -1 thrmbophlebitis (71.33%) is higher as compared to Grade- 2 (22.67%).Conclusions: Thrombophelebitis is still an important ongoing problem in admitted patients in surgical ward. Incidence of grade-I thrombophlebitis is higher. It is more in male in the age group of 40-50 and duration of infusion is main causative factor for development of thrombophlebitis.


2018 ◽  
Vol 27 (1) ◽  
pp. 68-71
Author(s):  
Tahamina Akhter ◽  
Tabassum Ghani ◽  
Subinoy Krishna Paul ◽  
Noorjahan ◽  
Afrina Begum ◽  
...  

Introduction : when a healthy pregnant woman with no obstetric or medical risk factors goes into spontaneous labour, she should anticipate a normal delivery. But still 580, 000 women in the world die from pregnancy and childbirth each year.1 Lack of attention to postpartum care in developing countries is neglected tragedy and requires immediate attention. This study evaluates the incidence of complications of early puerperium and also focuses the specific types of complications and to detect the risk factors associated with these complications. Aims and objectives : Main aim of the study is to evaluate the common complications in early puerperium with special attention to identify the risk factors. Materials and method : This study was carried out in Dhaka Medical College Hospital and Sir Sallimullah Medical College Hospital within the period of March ’2004 to August’ 2004. Two hundred patients were selected for this study who were delivered by caesarean section in these two institutions and complications occurring within 7 days excluding first 24 hours. Patients delivered outside the hospital and with known medical diseases were excluded from this study. Detailed history taking and appropriate clinical examination and specific investigations were done for diagnosis of complications. All relevant informations was noted in prescribed data sheet and results were tabulated and statistical analysis was done. Results : Among 200 cases only 44(22%) cases had early puerperal morbidity.Most of the patients who suffered complications underwent caesarean section for obstructed labour and fetal distress who had trial at home. Many of the patients suffered from wound infection and endometritis (40.9%). Among patients, age group -<20 years suffered from wound infection(53.8%) and endometritis(45.8%) were common in age group 21-30 years. VVF was common in patients in age <20 years.Endometritis (42.2%) was maximum in women with parity 1-3 and wound infection (50%) in women with parity 4-6. Some of the patients had more than one early puerperal morbidity. Maximum number of poor class suffered from wound infection (42.4%).Early puerperal morbidity was more prevalent in women with duration of labour <18 hours and Premature rupture of membrane had relationship with endometritis (15.9%), wound infection (13.6%) and UTI (11.4%). Conclusion : Incidence of early puerperal morbidities is still quite high (22%) and many patients experiences more than one problem at a time.Long term sequelae of early puerperal infectious morbidity should not be neglected as this may interfere quality of life of a woman. J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 68-71


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