scholarly journals A sonographic assessment of previous caesarean section scar: is a reliable safeguard for trial of labour?

2020 ◽  
Vol 9 (4) ◽  
pp. 1520
Author(s):  
Vandana Dhama ◽  
Sonam Gupta ◽  
Rachna Chaudhary ◽  
Shakun Singh
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Prospective Observational Study ◽  
Previous Caesarean Section ◽  
Practical Application ◽  
Singleton Pregnancy ◽  
Common Indication ◽  
Sonographic Assessment ◽  
Previous Cesarean ◽  
Caesarean Delivery Rate

Background: Over the time the caesarean delivery rate has significantly increase worldwide from 18.2% in 2002 to 30.3% in 2012. In parous women, previous caesarean section has been found to be the most common indication for caesarean delivery in as high as 67% cases. Unsecure prediction of the integrity of the scarred LUS during labor appears to be one of the reasons for high repeat caesarean rates. The purpose of this study was to assess the usefulness of sonographic measurement of the lower uterine segment scar before labour for deciding whether it is a reliable safeguard for trial of labour or not in a woman having previous one caesarean delivery.Methods: This study was a prospective observational study, carried out on 108 pregnant women having previous one CS, gestational age >37, singleton pregnancy, cephalic presentation. Trans-abdominal USG was done to measure scar thickness. Trial of labour was given to each patient irrespective of scar thickness. Pregnancy outcome were noted in terms of successful VBAC or emergency LSCS and compared with scar thickness. Correlation between sonographic and intra-operative finding of scar were noted.Results: Result shows strong correlation between scar thickness and successful trial of labour. Scar thickness increases chances of successful vaginal deliveries.Conclusions: Sonographic assessment of previous scar has a practical application to predict the thickness and thinness of previous scar and can be taken as a reliable safeguard for trial of labour after previous cesarean but cut off value above which vaginal delivery could be considered safe is yet to be identified.

scholarly journals A study of feto maternal outcome in primary caesarean section

2021 ◽  
Vol 11 (1) ◽  
pp. 183
Author(s):  
Maitry Mandaliya ◽  
Arti Patel ◽  
Devanshi Shah
Keyword(s):  
Decision Making ◽  
Caesarean Section ◽  
Caesarean Delivery ◽  
Caesarean Section Rate ◽  
Normal Vaginal Delivery ◽  
Previous Caesarean Section ◽  
Common Indication ◽  
Medical College ◽  
Multiparous Women ◽  
A Prospective Study

Background: Primary caesarean section is defined as caesarean section to be performed in women who have not had previous caesarean delivery. The increase in the rates of primary caesarean section is not only due to increased caesarean section in nulligravida but also due to upward rise in caesarean section rates in parous women. Through this study we aimed to examine the frequency and the indications of primary caesarean section in nulliparous and multiparous women.Methods: A prospective study was carried out in the OBGY department of smt. SCL Hospital, NHL municipal medical college from April 2020 to April 2021. All multiparous women with previous normal vaginal delivery who underwent caesarean section this time were included in this study. Patients with previous caesarean section <28 weeks of gestation, patients who did not give consent were excluded from the study.Results: 92% were 20-30 years and are gravida 2 or 3 patients. 85% patients were booked patients. Most common indication of primary caesarean section in parous women was MSL+FD (31%). Difficulty in delivery of the baby was encountered in 45% of cases. Major cause of admission in NICU was MAS.Conclusions: Primary caesarean section has become a major driver of overall caesarean section rate. Decision making on primary caesarean section should be carefully scrutinized, introducing a diagnostic second opinion for all primary caesarean section. Primary caesarean section in both multigravida and primigravida becomes mandatory in many cases to prevent maternal and feta morbidity.

scholarly journals Caesarean delivery rate and indications at a secondary healthcare facility in Ibadan, South Western Nigeria: a five-year review

2021 ◽  
Vol 21 (1) ◽  
pp. 320-6
Author(s):  
Waheed O Ismail ◽  
Ibrahim S Bello ◽  
Samuel A Olowookere ◽  
Azeez O Ibrahim ◽  
Tosin A Agbesanwa ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Care Setting ◽  
Primary Care Setting ◽  
Caesarean Section Rate ◽  
Healthcare Facility ◽  
Surgical Skill ◽  
Maternal Morbidity And Mortality ◽  
Study Population ◽  
Caesarean Delivery Rate

Background: Caesarean delivery is an essential surgical skill within the primary care setting aimed at reducing maternal morbidity and mortality. Objectives: To determine the rate and indications for caesarean deliveries with a view to improving on the service delivery in the study area. Methods: A retrospective review of all caesarean deliveries over a five-year period, January 1st, 2012 to December 31st, 2016. Results: A total of 2321 deliveries were recorded during the study duration and 481 of them were through caesarean sec- tion (CS) giving a caesarean section rate of 20.4%. The rate was higher in the multigravida 255 (53.1%). The commonest indication for caesarean section was previous caesarean section 131 (27.2%). Emergency caesarean delivery accounted for 278 (57.8%). Only 16 (3.3%) stayed more than five days postoperatively while the rest, 465 (96.7%), stayed less than five days. There was a gradual yearly increase in rate from 12.1% in 2012 to 19.5% in 2016. Conclusion: The rate of CS in this study has shown a gradual yearly increase with emergency CS having a higher percentage. Early diagnosis and referral of high-risk pregnancies from peripheral hospitals could reduce emergency CS among the study population. Keywords: Caesarean section; rate; secondary healthcare; Nigeria.

scholarly journals P25.16: Sonographic assessment of lower uterine segment at term in women with previous Caesarean section

2014 ◽  
Vol 44 (S1) ◽  
pp. 335-335
Author(s):  
P. Uharcek ◽  
A. Brestansky ◽  
J. Ravinger ◽  
A. Manova ◽  
M. Zajacova
Keyword(s):  
Caesarean Section ◽  
Lower Uterine Segment ◽  
Previous Caesarean Section ◽  
Sonographic Assessment

scholarly journals Factors associated to Caesarean delivery in public and private health care systems

2016 ◽  
Vol 50 (5) ◽  
pp. 733-740 ◽  
Author(s):  
Rosana Rosseto de Oliveira ◽  
Emiliana Cristina Melo ◽  
Elisiane Soares Novaes ◽  
Patrícia Louise Rodrigues Varela Ferracioli ◽  
Thais Aidar de Freitas Mathias
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Minimum Wage ◽  
Caesarean Delivery ◽  
Family Income ◽  
Previous Caesarean Section ◽  
Cross Sectional ◽  
Factors Associated ◽  
Per Capita ◽  
In Pregnancy

Abstract OBJECTIVE Identifying factors associated to Caesarean sections among the residents of Maringá-PR, according to the financing source for delivery. METHODS A cross-sectional study with data from 920 postpartum women interviewed between October 2013 and February 2014. Association analysis was performed by logistic regression. RESULTS Caesarean section rates were 55.5% in the Unified Healthcare System (SUS) and 93.8% in the private system. Factors associated with Caesarean section in the SUS were: previous Caesarean section (OR=8.9; CI=4.6-16.9), desire for Caesarean section early in pregnancy (OR=2.0; CI=1.1-3.6), pregestational overweight/obesity (OR=1.8; CI=1.1-2.8), and per capita family income higher than one minimum wage (OR=2.1; CI=1.3-3.4). In the private system, desire for Caesarean section early in pregnancy (OR=25.3) and a previous Caesarean section (OR=11.3) were strongly associated to its performance. CONCLUSION It is necessary to properly orientate all pregnant women who desire a Caesarean delivery, from both the SUS and the private system, about the inherent risks of the surgical procedure without indication. In the public health sector, guidelines should be focused on pregnant women with previous Caesarean delivery, with a per capita income higher than one minimum wage and those who are overweight or obese, as these women are more likely to have a Caesarean section.

scholarly journals Study of the indications for caesarean sections between 20 and 28 weeks of gestation

2017 ◽  
Vol 6 (3) ◽  
pp. 787
Author(s):  
Sudha R. ◽  
Anjali R.
Keyword(s):  
Caesarean Section ◽  
Gestational Age ◽  
Caesarean Delivery ◽  
Caesarean Section Rate ◽  
Scientific Information ◽  
Major Change ◽  
Progressive Increase ◽  
Past Century ◽  
Previous Caesarean Section ◽  
The Common

Background: Major change in the practice of obstetrics over the past century is progressive increase in the frequency of caesarean delivery and recent scientific information show improved survival or decreased morbidity for the neonate when caesarean delivery is performed for extreme prematurity. This study was done to determine the caesarean section rate for sections done between 20 and 28 weeks of gestation and to analyze the indications for such sections.Methods: Institutional based retrospective observational study done in the Obstetrics and Gynaecology Department, Cheluvamba Hospital, MMC&RI, Mysore, Karnataka, India. Caesarean sections done over 5 years from January 1st 2010 till December 31st 2014 are considered for the study. The total number of Caesarean sections done for gestational age between 20 and 28 weeks are noted. The data obtained is analyzed for the indications at the respective gestational ages.Results: Frequency of caesarean section at gestational age between 20 and 28 weeks is seen to be <1%. Out of total 15,906 LSCS cases, 97 (0.6%) patients under went caesarean section between 20 and 28 weeks of gestation. Of the 97 cases, 54 cases (55.67%) were operated at 28 weeks, 17 cases (17.52%) at 26 weeks, 20 cases (20.61%) at 24 weeks, 4 cases (4.12%) at 22 weeks and 2 cases (2.06%) at 20 weeks of gestation. APH in 33 (34.0%), pre-ecclampsia and ecclampsia in 30 (30.9%) cases are found to be the indications for delivery in 61 cases (64.9%). The indications for caesarean sections in 44 (45.3%) cases were previous caesarean section associated with or without pre-ecclampsia and APH as contributory factors.Conclusions: Caesarean section rate for gestational age between 20 and 28 weeks’ gestational age is <1% and there is decreasing trend. Previous caesarean section, APH, ecclampsia and pre-ecclampsia with their complications are the common indications for such sections. The decision to perform first caesarean section and the indication for it is of prime importance.

scholarly journals Vaginal birth after previous caesarean section in women at Al-Wahda hospital Derna, Libya

2021 ◽  
Vol 10 (12) ◽  
pp. 4337
Author(s):  
Soad Ajroud ◽  
Raga A. Elzahaf ◽  
Fawzia A. G. Arhaiam
Keyword(s):  
Decision Making ◽  
Caesarean Section ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Vaginal Birth ◽  
Previous Caesarean Section ◽  
Trial Of Labor ◽  
High Chance ◽  
Vaginal Birth After Caesarean

Background: Vaginal birth after caesarean section is one strategy that has been developed to decrease the rate of caesarean section.Methods: The prospective observational study was carried out over a period of 01 January 2017 to 31 December 2018 years. VBAC was routinely offered at Al-Wahda hospital Derna to women fulfilling the criteria for trial of scar, according to the hospital protocol.Results: A total of 5018 deliveries took place in the study duration, there were 1039 (20.7%) had previous one caesarean section, out of which 319 (30.7%) were the number of underwent repeat caesarean section and 720 (69.3%) were the number of VBAC. The indications for emergency repeat caesarean section at Al-Wahda hospital was (29.3%) malpresentation, (24.45%) FD, (13.47) postdate, (11.59) obstracted lab and abruptiopl (5.95%). Anemia and difficult intubation were observed in repeated caesarean section.Conclusions: This study concluded that there is a high chance of success in a trial of labor. These findings might help clinicians and women in the decision-making for the mode of delivery when it comes to pregnancy with a previous caesarean section. Women are explained about the option of trial of scar and told about the risk associated with a repeat CS, so many CSs can be avoided.  

scholarly journals Obstetrical outcome in post caesarean pregnancy

2018 ◽  
Vol 7 (11) ◽  
pp. 4561
Author(s):  
Anitha Aldur Manjappa ◽  
Soundara Raghavan Subrahmanian
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Clinical Situation ◽  
Labour Induction ◽  
Previous Caesarean Section ◽  
Success Rates ◽  
Vaginal Deliveries ◽  
History Of ◽  
Obstetrical Outcome

Background: Rates of caesarean delivery have increased over past 40 years. The increase has been attributed to liberalization of indications for caesarean sections. Repeat caesarean section is a major contributor to caesarean rates; Vaginal Birth After Caesarean (VBAC) is one of the methods to contain increasing caesarean rates. Success rates of 60-80% have been reported.Methods: This was a descriptive study involving 1000 pregnancies of period of gestation more than 28 weeks with history of one previous caesarean section. The women under study were subjected to either trial vaginal delivery or elective repeat caesarean delivery depending upon the clinical situation. The percentage of successful vaginal deliveries, factors responsible for failure of vaginal delivery and differences in outcome between successful vaginal delivery and caesarean delivery group were analyzed.Results: Out of the 1000 women, 423 underwent elective repeat caesarean delivery, of the remaining 577, 403 (69.8%) had successful vaginal delivery. Age of the woman and onset of labour were the only factors influencing the success of vaginal delivery. Women aged 35 years or more and women who needed labour induction had lower success of vaginal delivery. Maternal and perinatal outcome were worse in failed vaginal delivery group when compared to elective repeat caesarean delivery or successful vaginal delivery groups.Conclusions: Factors which are usually thought to influence the decision about trial vaginal delivery like prior vaginal delivery, indication for previous caesarean section and interpregnancy interval are not absolute in determining the decision or the outcome. Labour induction should be resorted with great caution in women with post caesarean pregnancy.

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