scholarly journals A study on pattern of placentation in post caesarean pregnancy

2020 ◽  
Vol 9 (7) ◽  
pp. 2797
Author(s):  
Deepthi P. S. ◽  
Neena Devasia
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Comparison Group ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Previous History ◽  
Previous Caesarean Section ◽  
Normal Delivery ◽  
Adherent Placenta ◽  
Increased Risk

Background: It appears that the rate of caesarean delivery has been increasing over the past two decades. Various western studies have shown that with previous caesarean section, increased risk of placenta previa, adherent placenta, and greater incidence of antepartum haemorrhage. Nonetheless, the extent to which previous caesarean delivery predisposes women to the development of placenta previa is unclear from earlier studies. Also, there are not many Indian studies regarding the association of placenta previa and previous caesarean section. This study aims to find the association between prior caesarean delivery and subsequent development of placenta previa and adherent placenta.Methods: A descriptive study was conducted on 600 antenatal women with post cesarean pregnancy in a tertiary care centre. Similar number of women with previous normal delivery was included in comparison group and placental location was studied. Those patients with previous caesarean were further divided into those with placenta previa and without previa to study the determinants of previa in those with previous caesarean section.Results: Placenta previa was found in 2.8% of the study group compared to 1.2% of comparison group. Adherent placenta was found only in post caesarean group. In the post caesarean group, the incidence of anterior previa was 41.2% compared to posterior previa (29.3%). In those with post cesarean pregnancy, determinants of placenta previa found were multiparity (35.3%), previous history of abortions (35%), multiple previous caesarean sections (29.4%), interpregnancy interval <2 years (35.29%).Conclusions: In post cesarean pregnancy, the risk of placenta previa is 2 times compared to those with a previous normal delivery. Anterior previa occurred with sufficient frequency in post-caesarean pregnancy to warrant ultrasonic placentography prior to surgical entry into lower segment. When the combination of previous caesarean and placenta previa occurs the risk of adherent placenta is 17.6%.

scholarly journals Study of fetomaternal outcome in cases of placenta previa at tertiary care hospital

2020 ◽  
Vol 9 (8) ◽  
pp. 3326
Author(s):  
Parul T. Shah ◽  
Fiza Z. Saiyed ◽  
Kruti J. Deliwala ◽  
Priya Dhameliya
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Maternal Mortality ◽  
Perinatal Outcome ◽  
Tertiary Care Hospital ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Previous History ◽  
Care Hospital ◽  
Normal Delivery

Background: Placenta previa is defined as placenta implanted partially or completely in the lower uterine segment. It contributes upto 30% of the cases the antepartum hemorrhage. This catastrophic complication not only poses a risk to the fetus but also endangers the mother’s life. The objective of the study was to determine the incidence and risk factors, obstetric management, maternal mortality and morbidity and perinatal outcome in women presenting with placenta previa.Methods: It is the prospective study of 50 cases carried out to study the maternal and perinatal outcome in cases of placenta previa in tertiary care hospital. This study included antenatal patient diagnosed as placenta previa by ultrasound >28 weeks to full term pregnancy. This data was compiled and analyzed for maternal and neonatal outcome.Results: In the present study, the incidence of placenta previa is 0.8% among which 42% of cases having age group of 25-29 years and 72% cases are multigravida. In this study 60% cases have major degree of placenta previa and 66% cases have previous history of caesarean section. Out of total cases 96% cases delivered by caesarean section and 4% had Normal delivery. NICU admission in the study is 28 babies i.e. 56%. There is no maternal mortality seen in the present study.Conclusions: Risk factors that increase the cases of placenta previa are multiparity, previous caesarean section, previous abortion. Placenta previa is major risk factor for adverse maternal and perinatal outcome. Good antenatal care, availability of emergency obstetrics services with senior obstetricians, blood bank facility, ICU care and NICU services can improve maternal and neonatal outcome in high risk cases.

scholarly journals Uterine Leiomyoma and Pregnancy Outcome: An Experience at Tertiary Care Setup

2021 ◽  
Vol 15 (6) ◽  
pp. 1682-1684
Author(s):  
Farha Naz Chohan ◽  
Shaista Memon ◽  
Sabreena Abbas ◽  
Syeda Hira Ali Shah ◽  
Aliya Shamim ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Uterine Fibroids ◽  
Breech Presentation ◽  
Study Data ◽  
Health Science ◽  
Increased Risk ◽  
The Impact

Objective: To determine the impact of leiomyoma in pregnant women a tertiary care set up in Hyderabad. Methods: This prospective observational study conducted at OPD of Gynecology unit-III, Liaquat University of Medical and Health Science Hyderabad, from June 2018 to December 2018. A total of 18,402 pregnant women of age 20-45 years were attended, out of which 195 had leiomyoma and they were asked to take part in study. Data regarding demographic characteristics including complications during pregnancy, and indications of caesarean section was collected via study proforma. Results: Total 186 out of 195 females were studied, their mean age was 31.23+3.12 years, average gestational age was 33.12+3.15 weeks and average size of Leiomyoma was 3.12+2.15cm. The most common complications were PPH among 28.49% of cases, blood transfusion was required in 39.25% of the cases, miscarriage occurred in 6.45% of the cases, cord prolapse was seen in 24.3% cases, placental abruption in 5.91% cases, placenta previa in 11.32% cases and retained placenta was observed among 1.61% of the cases. Preterm labour occurred in 5.38% of the cases and IUGR was seen in 10.22% of the cases. Out of all cases, 10 females underwent preterm delivery, while 12 underwent fetus delivery before 24 weeks (miscarriage). Among all term pregnancies, 78.66% underwent C-Section due to failure in progress, cord prolapsed, fibroid in lower segment, breech presentation and low-lying placenta. Conclusion: Fibroid complicates pregnancy itself and also the outcome. Rural area dwelling women are at more risk, which include increase in caesarean section and a multifold increased risk of PPH and associated hysterectomy in these cases. Keywords: Leiomyoma, Uterine Fibroids, Pregnancy, complications.

scholarly journals Outcome of Women with Previous Cesaerian Section At A Tertiary Care Hospital in Eastern Nepal

2015 ◽  
Vol 12 (1) ◽  
pp. 18-23
Author(s):  
Ajay Agrawal ◽  
S Chhetri ◽  
A Thakur ◽  
S Agrawal ◽  
P Basnet
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Caesarean Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Vaginal Birth ◽  
Care Hospital ◽  
Previous Caesarean Section ◽  
Vaginal Birth After Caesarean

Background: Pregnant women with previous caesarean section are increasing due to the liberal use of caesarean section in first pregnancy due to multifactorial reason. The risks, benefits, and relative safety of vaginal birth after caesarean (VBAC) have been subject of interest for well over 100 years. Thus mutual understanding between the treating obstetrician and patient herself is a core towards achieving good maternal and perinatal outcome considering all the risk and benefit in women with previous caesarean section. Objective: The aim was to analyze the maternal and perinatal outcome in pregnant women with previous caesarean section. Methods: In this prospective observational study, 300 women with singleton pregnancy in cephalic presentation with previous one lower segment caesarean section (LSCS) having inter pregnancy interval ≥ 18 months presenting at ≥ 37-41 week period of gestation admitted for delivery were enrolled and various maternal and perinatal outcome were noted. Results: Caesarean delivery rate during the study period was 26.95%. Eighty percent of eligible women opted for trial of labor. Successful vaginal birth after caesarean section was 29%. Elective repeat caesarean delivery was 19.66%. The rate of failed VBAC was 51%. Failed VBAC increased with increasing weight of baby. There was no difference in mean birth weight among patient who had successful VBAC, who refused VBAC and who had failed VBAC. Mode of delivery had no significant effect on the number of neonatal intensive care unit admission and number of still births.  DOI: http://dx.doi.org/10.3126/hren.v12i1.11980Health Renaissance 2014;12(1):18-23

scholarly journals LOWER SEGMENT CESAREAN SECTION (LSCS);

2013 ◽  
Vol 20 (06) ◽  
pp. 916-923
Author(s):  
NAZIA MUSSARAT ◽  
SAIMA QURASHI ◽  
MAHNAZ ROOHI
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Placenta Previa ◽  
Caesarean Section Rate ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
University Hospital ◽  
Breech Delivery ◽  
Lower Segment Cesarean Section ◽  
Increased Risk

Introduction: Caesarean section is one of the commonly performed surgical procedures in obstetric and is certainly one ofthe oldest operations in surgery. Recently there has been a dramatic rise in the caesarean section rate world wide especially in thedeveloped countries. As primary caesarean deliveries contributed most to the overall caesarean section rate (CSR). So this is clear thatprimary caesarean section is an important target for reduction because it leads to an increased risk for repeat caesarean delivery.Objectives: To have an overview of fetomaternal indications for LSCS at a teaching hospital And to review intra-operative and postoperativecomplications of LSCS at tertiary care centre. Material And Methods: All caesarean sections performed at Obstetrics andGynecology Unit Independent University Hospital Faisalabad from January 2009 to December 2010 were reviewed. Information wasobtained from operation theater and labor ward records. Results: During the study period 100 patients undergone caesarean section. Outof 100 patients, 58(58%) had emergency and 42(42%) had elective caesarean section. The leading maternal indications were previouscaesarean section 34 (34%), severe pre- eclampsia 6(6%),post date& failed induction of labor6 (6%), placenta previa 6(6%), and failureof progression of labor 5(5%), PROM3(3%), Pre-PROM3(3%)and cephalopelvic disproportion2 (2%).Major fetal indications include fetaldistress9 (9%), malpresentation 6(6%), cord prolapse 3(3%),IUGR 5(5%) and pregnancy complicated by multiple fetuses 7 (7%). Intraoperativesurgical and anesthetic complications were observed in very few patients. Nine babies had perinatal deaths in this study, 8belonged to emergency and only one baby died in elective group due to aspiration pneumonia. Conclusions: Majority of cesarean sectionare done in emergency situations and previous CS is the most frequent indication of cesarean section. The most effective mean to controlCS is the prevention of first caesarean section which could be achieved by adopting the policy of trial of vaginal birth after previous Csection,selective vaginal breech delivery and regular audit of C-section as well as early detection of at risk cases and proper referral intime is the key factor in decreasing the cesarean section rate and complications.

scholarly journals Frequency, risk factors and materno-foetal outcomes among cases of Placenta previa at a tertiary care hospital: a two year study

2019 ◽  
Vol 8 (6) ◽  
pp. 2240
Author(s):  
Pamulaparthi Bindu Reddy ◽  
Gurram Swetha Reddy
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care Hospital ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Previous History ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Early Date

Background: Placenta previa refers to the presence of placental tissue that extends over the internal cervical os.  Placenta previa is linked to maternal hypovolemia, anaemia, and long hospital stay and with prematurity, low birth weight, low APGAR score in newborn. So it is very important to identify the condition at an early date to warn the condition thereby reducing the maternal and foetal morbidity and mortality. The present study was aimed to estimate the prevalence of PP, its associated predisposing risk factors and maternal morbidity, mortality and the perinatal outcome.Methods: A prospective observational study for two years was conducted at a tertiary care hospital. Pregnant mothers with >28 weeks of age with H/o ante partum haemorrhage were screened for placenta previa, confirmed by ultra sonography and included in the study. Clinical history, obstetric examination was done and followed up till the delivery. Maternal and foetal outcomes were recorded. Data analyzed by using SPSS version 20.Results: 1.4% incidence of PP was noted, mean age of group was 29.17±1.6 years. Age group of 21-30 years, multiparity Gravida 2-4, previous history of caesarean section and less number of ante natal checkups were significant risk factors and LSCS was most common outcome. Prematurity, low birth weight and APGAR <7 score for 1 minute was common foetal outcomes.Conclusions: Our study strongly suggests foetal surveillance programmes in cases of placenta previa. Measures should be made to bring awareness about PP, in urban slums and to increase medical checkups regularly. Making USG mandatory during every ANC and referral of cases of PP to tertiary care centres would definitely reduce the chances of morbidity and mortality.

scholarly journals Obstetric Anal Sphincter Injuries – Maternal, Foetal and Sociodemographic Risk Factors: A Retrospective Register-Based Study

2021 ◽  
Author(s):  
Kristin André ◽  
Andrea Stuart ◽  
Kärin Kallén
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Caesarean Section ◽  
Anal Sphincter ◽  
Maternal Education ◽  
Vacuum Extraction ◽  
High Birth Weight ◽  
Previous Caesarean Section ◽  
Obstetric Anal Sphincter Injuries ◽  
Increased Risk

Objective. To determine risk and protective factors of obstetric anal sphincter injuries (OASIS). Design. A retrospective register-based observational study. Setting. Sweden. Population. A cohort of 988, 988 singleton term deliveries 2005-2016 were included. Methods. Data from the Swedish Medical Birth Registry and Statistics Sweden were extracted to identify cases of OASIS and maternal and foetal characteristics. Modified Poisson Regression analyses were performed to assess risk factors. Main outcome measures. Risk ratios for OASIS with 95% confidence interval associated with maternal and foetal risk factors were calculated. Results. The rate of OASIS was 3.5% (n=34, 583). Primiparity (aRR 3.13 95% CI 3.05–3.21), vacuum extraction (aRR 2.79 95% CI 2.73–2.86), forceps (aRR 4.27 95% CI 3.86–4.72) and high birth weight (aRR 2.61 95% CI 2.50–2.72) were associated with a significantly increased risk of OASIS. Increasing maternal age and decreasing maternal height increased the risk of OASIS. Smoking (aRR 0.74 95% CI 0.70–0.79) and low maternal education (aRR 0.87 95% CI 0.83–0.92) were associated with a decreased frequency of reported OASIS. Obesity decreased the risk of OASIS (aRR 0.90 95% CI 0.87–0.94), but only after adjusting for foetal birth weight. Previous caesarean section increased the risk of OASIS (aRR 1.41; 95% CI 1.36–1.47). Conclusion. Primiparity, instrumental delivery and high birth weight increased the risk of OASIS. Risk factors including BMI, height, age, smoking, maternal education, ethnicity and previous caesarean section also contribute to the overall risk of OASIS. Keywords. Obstetric sphincter injuries, risk factors, pregnancy.

scholarly journals Emergency Peripartum Hysterectomy as Postpartum Hemorrhage Treatment: Incidence, Risk factors, and Complications

2014 ◽  
Vol 52 (193) ◽  
pp. 668-676 ◽  
Author(s):  
Meena Pradhan ◽  
Yong Shao
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Blood Loss ◽  
Postpartum Hemorrhage ◽  
Placenta Previa ◽  
Uterine Atony ◽  
Previous Caesarean Section ◽  
Peripartum Hysterectomy ◽  
Incidence Risk ◽  
Emergency Peripartum Hysterectomy

Introduction: The aim of the research was to investigate incidence, risk factors, and complications associated with emergency peripartum hysterectomy, the ultimate treatment method for intractable postpartum hemorrhage.Methods: This is a single center case-control study conducted in Chongqing city in central China from 1st January 2007 to 31st December 2012 for emergency peripartum hysterectomy performed as a treatment of postpartum hemorrhage both in caesarean and vaginal delivery cases. While the study group included emergency peripartum hysterectomy (n=61) due to intractable postpartum hemorrhage, the control group included no hysterectomy (n=333) during the same study period.Results: We found 61 cases recorded for emergency peripartum hysterectomy for intractable postpartum hemorrhage. Incidence of peripartum hysterectomy was 2.2 per 1000 deliveries. Emergency peripartum hysterectomy as treatment of intractable postpartum hemorrhage include the followings: (i) blood loss 1000-2000 ml, crude odd ratio (OR) =18.48 (95% CI 5.1-65.7), adjusted odd ratio (AOR) = 9.1 (95% CI 2.2-37.7); (ii) blood loss >2000 ml, OR = 152 (95% CI 43.7-528.4), AOR = 45.3 (95% CI 11.6-176.9); (iii) previous caesarean section, OR = 5.5 (95% CI 2.9-9.7), AOR = 3.7(95% CI 1.4-9.9); (iv) uterine atony, OR = 11.9 (95% CI 5.8-24.6), AOR = 7.5 (95% CI 1.8-30.2); (v) placenta previa, OR = 2.04 (95% CI 1.1-3.5), AOR = none. Conclusions: Emergency peripartum hysterectomy is the last resort as treatment of intractable severe postpartum hemorrhage. Our study depicts that severe post partum hemorrhage, further dreaded complex events for emergency peripartum hysterectomy, has significant association with placental factors, previous caesarean section, and uterine atony. Pathologically, placenta accreta remained the most leading cause of hysterectomy.Keywords: caesarean section; hemorrhage; peripartum hysterectomy; placenta previa.

scholarly journals Pregnancy outcome in patient who had first trimester bleeding in previous pregnancy: a prospective study

2020 ◽  
Vol 9 (4) ◽  
pp. 1559
Author(s):  
Faswila M. ◽  
Ramya N. R.
Keyword(s):  
Pregnancy Outcome ◽  
Preterm Delivery ◽  
Spontaneous Abortion ◽  
Adverse Pregnancy Outcome ◽  
Placenta Previa ◽  
Previous History ◽  
Fetal Loss ◽  
Previous Pregnancy ◽  
Increased Risk ◽  
History Of

Background: Patient who had history of spontaneous abortion in her previous pregnancy is associated with adverse outcome in her present pregnancy.Methods: A total 63 pregnant women attending OPD and admitted in department of obstetrics and gynecology, Yenepoya Medical College, from April 2017 to September 2017, considered and outcome were studied.Results: Out of 63 patient’s majority (57.1%) of patients belong to the age group 21-29 year. Anemia was found to be very severe in 4.3%, severe in 10% and moderate in 30% patients. Maximum patients (45.7%) were with history of previous one abortion followed by previous two abortions (38.6%). The final outcomes were term livebirth 47 (74.3%), abortion 9 (14.3%), preterm delivery 5 (8.6%), and stillbirth 2 (2.8%) caesarean section (23.3%) for various indications. 19.23% had term PROM, 9.09% had PPROM, 5.76% had term IUGR, 3.84% term IUD, preterm IUD accounts for 9.09% and still birth accounted for about 1.92% which was term, pre-eclampsia accounted for 4.76%, malpresentation for 7.93%, total 3 cases of antepartum hemorrhage out of which  placenta previa accounts for about 3.1% and abruption for 1.58%, manual removal of placenta 4.7% and low birth weight 7.6%.Conclusions: Previous history of spontaneous abortion is associated with adverse pregnancy outcome. There is increased risk of abortion, preterm delivery, need for caesarean sections and fetal loss which can be reduced by booking and giving antenatal care.

scholarly journals Trends of caesarean section: an analytical overview of indications

2019 ◽  
Vol 9 (1) ◽  
pp. 288
Author(s):  
Shruti A. Gavhane ◽  
Shilpa N. Chaudhari
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Graphical Representation ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
High Rate ◽  
Care Hospital ◽  
Chi Square ◽  
Chi Square Test ◽  
Evidenced Based

Background: Caesarean section is one of the commonly performed surgical procedures in obstetrics. An increasing trend has been observed in both primary and repeat caesarean sections. The reasons for its increase are multifaceted. So, this study was carried out to compare the rates of caesarean delivery and to analyse various indications contributing to it.Methods: This retrospective study was conducted over a period of three year from 1st January 2016 to 31st December 2018 at the department of obstetrics and gynaecology, tertiary care hospital Pune, Maharashtra, India. All caesarean delivery (primary and repeat) taken place during the study period. The rate and indications of caesarean section was calculated over the study period to find out the trends in caesarean delivery. The data so collected was presented with graphical representation. Statistical analysis was performed with SPSS software and t-test was used for continuous data and pearson chi square test for discrete data.Results: There were a total of 12373 deliveries during the study period out of which, 3701 had delivered via Caesarean Section. So, the rate of caesarean section in the study was found to be 29.91%.Conclusions: Being a tertiary care hospital, a high rate of caesarean deliveries was observed, Individualization of the indication and careful evaluation, following standardized guidelines, practice of evidenced-based obstetrics and audits in the institution, can help us limit caesarean section rates.

scholarly journals Pregnancy with previous caesarean section: an overview of adverse fetomaternal sequelae

2018 ◽  
Vol 7 (5) ◽  
pp. 1817 ◽  
Author(s):  
Joyita Bhowmik ◽  
Amit Kyal ◽  
Indrani Das ◽  
Vidhika Berwal ◽  
Pijush Kanti Das ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Previous History ◽  
Successful Outcome ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Medical College ◽  
Increased Risk ◽  
Fetal Complications ◽  
History Of

Background: The Caesarean section epidemic is a reason for immediate concern and deserves serious international attention. The purpose of this study was to evaluate adverse maternal and fetal complications associated with pregnancies with history of previous caesarean section.Methods: A cross-sectional, observational study carried out over a period of 1 year from 1st June 2016 to 31st July 2017 in Medical College Kolkata. 200 antenatal patients with previous history of 1 or more caesarean sections were included. In all cases thorough history, complete physical and obstetrical examination, routine and case specific investigations were carried out and patients were followed till delivery and for 7 days thereafter. All adverse maternal and fetal complications were noted.Results: Out of 200 women, 30 candidates were tried for VBAC, of them 20 (66.66%) had successful outcome. Most common antenatal complication was APH (5.5%) due to placenta praevia followed by scar dehiscence. There were 12 cases (6.66%) of PPH and 6 cases (3.33%) of scar dehiscence in the study group. 3 cases required urgent hysterectomy due to placenta accreta. 42 out of 196 babies required management in SNCU immediately or later after birth.Conclusions: Women with a prior cesarean are at increased risk for repeat cesarean section. Vigilance with respect to indication at primary cesarean delivery, proper counselling for trial of labor and proper antepartum and intrapartum monitoring of patients are key to reducing the cesarean section rates and maternal complications.

Sign in / Sign up

Export Citation Format

Share Document