scholarly journals Changing trends in the indication of caesarean delivery in multigravida- experience from a referral center in Eastern India: a prospective study

2020 ◽  
Vol 9 (8) ◽  
pp. 3367
Author(s):  
Nikhil Sebastian ◽  
Anup Pradhan ◽  
Pesona Grace Lucksom
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Clinical Laboratory ◽  
Medical Science ◽  
Normal Vaginal Delivery ◽  
Maternal Request ◽  
Intraoperative Complication ◽  
Multiparous Women ◽  
A Prospective Study ◽  
Pro Forma

Background: Caesarean delivery is one of the commonly performed surgical procedures in obstetrics in today's practice. The objective of this study was to estimate the overall incidence and indications of primary caesarean delivery among multiparous women and to study the immediate maternal and perinatal outcome.Methods: It was a prospective observational study done in Sikkim Manipal Institute of Medical Science, Sikkim, India. It included all pregnant women after 28 weeks of gestation who had normal vaginal delivery in previous pregnancy but underwent caesarean delivery during current pregnancy (n=120) from January 2016 to December 2016. Authors collected data using a pro forma. Relevant history including demographic details, relevant clinical, laboratory and radiological examination, indication for caesarean delivery, details of delivery and neonate, and duration of hospital stay were noted. Data was described using descriptive data like mean and percentages.Results: Out of 1646 deliveries conducted, 49% were by caesarean section. It included 7.29% primary caesarean delivery in multigravida.  Majority of women (27%) were in the age group 25-29. Maternal request was the commonest indication for caesarean delivery (21.66%). Atonic PPH was the commonest intraoperative complication (2.5%). Surgical site infection was the commonest post-operative morbidity (3.33%). There were 51 perinatal morbidity and 2 perinatal mortality. There was no maternal mortality.Conclusions: Caesarean section rates in this study was higher than WHO recommendation (15% versus 49.69%). This shift in trend can be attributed to higher number of maternal request for caesarean delivery which can be avoided by good analgesic facility and good counselling.

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 Frequency of Caesarean Delivery on maternal request in a private teaching hospital

2020 ◽  
Vol 24 (2) ◽  
pp. 139-143
Author(s):  
Fozia Umber Quraishi ◽  
Saima Jabeen ◽  
Wajiha Alvi
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Teaching Hospital ◽  
Caesarean Delivery ◽  
Caesarean Section Rate ◽  
Normal Vaginal Delivery ◽  
Maternal Request ◽  
Normal Delivery ◽  
Vaginal Deliveries ◽  
Private Teaching

Introduction: Caesarean section rates are increasing worldwide. There are many reasons for this increasing caesarean section rate one of them is increasing requests by women for caesarean section in the absence of medical indications. Most women think that elective caesarean section is safe both for women and babies. Some clinician also considered caesarean section safe. An increasing rate of caesarean section is alarming in developed as well as underdeveloped countries. Objective: To investigate the frequency of caesarean section on maternal request and factors leading to it in a private teaching hospital. Materials and Methods: This was a cross-sectional descriptive study carried out at Shalamar hospital from 1st May 2018 to 30th April 2019. Women of all ages who were pregnant and were going to have caesarean delivery during the study period at Shalamar hospital. Results: There were 3438 total births during the study period. There were 2380(69%) caesarean section and 1058(31%) were normal vaginal deliveries. Caesarean section rate was 69%. Caesarean sections performed on maternal request were 167(7%) out of 2380 caesarean. Out of these 167 Seventy-two, 43.1% of women were those who already have a previous caesarean section for different non-recurrent indications and now they don’t want the trial of labour and requested for caesarean section. Forty, 24% of women requested for a caesarean section because of fear of labour pains and eighteen, 10.8% were those who had a bad experience of the previous child-birth. Twelve, 7.2% of women had fear of failed vaginal delivery and eight women had fear of trauma to baby and three, 1.8% had fear of perineal trauma during the trial of normal vaginal delivery. Six, 3.6% of women had some social reasons for caesarean section and six, 3.6% had some bad experience of normal delivery of their relatives or friends and two, 1.2% were those who were requesting caesarean section because of their family members preferences. Conclusion: Most of the women requesting for caesarean section were those who had previously trial of labour. We can control the caesarean section rate by proper counselling of pregnant women.

scholarly journals On demand caesarean section: What’s women’s attitude?

1970 ◽  
Vol 2 (2) ◽  
pp. 12-15
Author(s):  
Nira S Shrestha ◽  
Sumita Pradhan
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
University Teaching ◽  
Normal Vaginal Delivery ◽  
On Demand ◽  
Assisted Delivery ◽  
The Right

Objectives: To evaluate the knowledge and attitude of Nepalese women towards mode of delivery and caesarean on demand. Study design: Hospital based cross sectional descriptive study where 200 pregnant women after 37 completed weeks of gestation were recruited randomly and interviewed, and their answers were analyzed. Results: Of the 200 interviewed pregnant women, all of them knew about normal vaginal delivery and caesarean delivery, but only 30% knew about instrumentally assisted delivery and 9% had heard about painless labour. Vaginal delivery was the preferred mode in 93% and 7% preferred caesarean delivery. Only 35% of the interviewed women believed that women should have the right to demand a caesarean section Conclusion: Knowledge assessment of two hundred women regarding the mode of delivery clearly indicates the need for strengthening counseling aspect of antenatal care and awareness program regarding mode of delivery. In Nepal on demand caesarean section is not provided in the University Teaching Hospital. However one third of women still felt that women should have the right to choose caesarean section on demand. Key words: Attitude, mode of delivery, Caesarean on demand. doi:10.3126/njog.v2i2.1448 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 12 - 15

CLINICAL STUDY OF PRIMARY CESAREAN SECTION IN MULTIPAROUS WOMEN AT OBSTETRICS AND GYNAECOLOGY DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

2021 ◽  
pp. 7-8
Author(s):  
Kumari Nisha ◽  
Renu Jha ◽  
Kumudini Jha ◽  
Debarshi Jana
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Placenta Previa ◽  
Fetal Distress ◽  
Normal Vaginal Delivery ◽  
Major Surgery ◽  
Obstetrics And Gynaecology ◽  
Emergency Cesarean ◽  
Study Results ◽  
Multiparous Women

Background: Caesarean section is the most commonly performed major surgery among women. The aims and objective of this study was to know the incidence of primary Caesarean section in multigravidas, its indications and to know the maternal and foetal outcome among these patients. Methodology: This was an observational study conducted at Department of Obstetrics and Gynaecology of Darbhanga Medical College and Hospital, Laheriasarai, Bihar. Aim of the study was to study the indication, maternal and fetal outcome in primary cesarean in multiparous women. All multiparous women admitted for delivery were included in the study Results: The total number of deliveries were 3064 and cesarean section were 1026 (33%).The total number of primary cesarean section in multiparous women were 84 constituting 2.7%. In this study, majority of women were Gravida 2. 91.6% of the cases were underwent emergency cesarean section and anesthesia was spinal. Majority of patients were between age group of 22 to 27 yrs (70%). Indications for cesarean section in our study were severe oligohydroamnios (22%), fetal distress (15.4%), and breech presentation (14%), premature rupture of membrane (12%).Intra operative ndings were meconium stained liquor, post partum hemorrhage, thinned out lower segment and extension of incision. Out of 84 cases, 48 cases needed intra operative or immediate post operative blood transfusion. The post operative morbidity was present in 6 cases i.e paralytic ileus, puerperal fever, urinary tract infection and wound gaping. Majority of babies, weighed in the range of 2-3kgs (55%).Out of 84 cases 7 were causes were placenta previa, obstructed labor and fetal distress. Conclusion: Many unforeseen complications occur in women who previously had a normal vaginal delivery. It is recommended that all antenatal patients must be booked and receive proper and regular antenatal care. Also 100% deliveries in multigravida should be institutional deliveries in order to reduce maternal and perinatal morbidity and mortality.

scholarly journals Caesarean delivery on maternal request (CDMR): clinical and ethical dilemma

2017 ◽  
Vol 6 (7) ◽  
pp. 3201
Author(s):  
Ankita Mann ◽  
Sumita Mehta ◽  
Anshul Grover
Keyword(s):  
Developing Countries ◽  
Caesarean Section ◽  
Ethical Dilemma ◽  
Maternity Care ◽  
Patient Autonomy ◽  
Caesarean Delivery ◽  
Caesarean Section Rate ◽  
Maternal Request ◽  
Research Education ◽  
Bioethical Debate

Now a days, in developing countries like India, one of the most common contributing factor for increasing caesarean section rate is CDMR (Caesarean delivery on maternal request). Incidence of CDMR reached upto 18 percent of total caesarean deliveries worldwide. The issue of CDMR is ongoing bioethical debate which highlights the struggle to balance patient autonomy with duty of obstetrician to uphold the principle of beneficence, non maleficence and justice. Our mission should be to promote safe, effective and satisfying maternity care for all women and their families through research, education, expertise and advocacy.

scholarly journals Sublingual misoprostol to reduce blood loss at caesarean delivery

2021 ◽  
Vol 11 (1) ◽  
pp. 95
Author(s):  
Shonali N. Agarwal ◽  
Nidhi D. Thakkar
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Caesarean Delivery ◽  
Operating Time ◽  
Normal Vaginal Delivery ◽  
Prospective Clinical Study ◽  
Reduce Blood Loss ◽  
Lower Segment Caesarean Section ◽  
Hospitalization Period ◽  
Sublingual Misoprostol

Background: Caesarean section is the most common obstetrical procedure performed worldwide. Sometimes oxytocin alone is not sufficient to prevent postpartum haemorrhage and additional uterotonics may be required. We attempted an additional uterotonic misoprostol by sublingual route to evaluate the role of it to reduce blood loss at caesarean delivery.Methods: This prospective clinical study was done on patients of S. S. G. Hospital, Baroda; 138 patients who underwent lower segment caesarean section (elective or emergency). The primary outcome was less intra/peri operative blood loss, need for additional uterotonic agents and perioperative haemoglobin (Hb) fall. The secondary outcomes studied were incidence of shivering, pyrexia, nausea, vomiting, operating time, blood transfusion, endomyometritis and hospitalization period. Average blood loss after normal vaginal delivery is 500 ml and after caesarean delivery is around 1000 ml.Results: Mean postoperative Hb was high with misoprostol group and perioperative Hb fall was less. Perioperative Hb fall of 1 g or more was lesser in this group.Conclusions: Sublingual misoprostol reduces intraoperative blood loss, perioperative blood loss and the need for additional uterotonic agents and blood transfusions at caesarean delivery. 

scholarly journals Incidence of Instrument Fall During Caesarean Section: An Enigma

2012 ◽  
Vol 11 (2) ◽  
pp. 87-90
Author(s):  
Chitra Joshi ◽  
Anil Kumar Joshi ◽  
Bhawani Pal ◽  
Zehra Mohsin ◽  
Rajyashri Sharma
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Medical Science ◽  
Operating Time ◽  
Training Programme ◽  
Emergency Caesarean Section ◽  
Medical Sciences ◽  
Emergency Caesarean ◽  
A Prospective Study ◽  
Operating Surgeon

Objective: The aim of the study was to analyse and compare statistically the incidence of accidental fall of instruments during elective and emergency caesarean section. Material and Methods: A prospective study was carried out at (V. C. S. G. G. Medical Sciences and Research Institute) Srinagar, Pauri Garhwal, India over a period of 24 months. The instrument fall during elective and emergency caesarean sections was observed. The observer counted the number of times an instrument fell during surgery. The personnel responsible were identified. A note of the nature of instrument falling was made. Results: We observed 362 surgeries which included 242 emergency caesarean sections and 120 elective caesarean sections. There were a total of 159 falls. Falls were classified as major and minor. There were 22 falls (18.33%) during elective caesarean sections and 137 falls (56.61%) during emergency caesarean sections. There were 53 major and 106 minor falls. Two or more falls were noted in 31 surgeries. In 96 instances (60.37%) the operating surgeon was responsible for the fall. In 37 cases (23.27%) assisting surgeon and in 17 cases (10.69%) the scrub nurse was responsible for the fall of the instruments. Nine falls (5.66%) were unaccountable. Most falls in elective caesarean section were in later half of the surgery while in emergency caesarean section, they were before and during the extraction of the baby. The surgeries were delayed, on an average by 5.7 minutes after a major fall of an instrument. Conclusions: Falling of instruments in the theatre is a common problem all over the world. This leads to increase in operating time, more resources and quality compromise. The operating surgeon was mainly responsible for the fall. Ashort training programme in instrument handling should be conducted for operating surgeons which may be helpful in preventing such avoidable falls. DOI: http://dx.doi.org/10.3329/bjms.v11i2.8957 Bangladesh Journal of Medical Science Vol. 11 No. 02 April 2012: 87-90

scholarly journals A comparative study of maternal and fetal outcome in trial of labour after caesarean delivery and elective repeat caesarean delivery

2019 ◽  
Vol 8 (3) ◽  
pp. 1171
Author(s):  
Asha Neravi ◽  
Namrata Kulkarni ◽  
M. Usha Brindhini ◽  
V. Udayashree
Keyword(s):  
Caesarean Section ◽  
Comparative Study ◽  
Caesarean Delivery ◽  
Medical Science ◽  
Study Groups ◽  
Fetal Outcome ◽  
Health Concern ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Mode Of Birth

Background: Globally, high rates of caesarean section (CS) are an issue of public health concern. For women who have had a previous caesarean, choices for mode of birth in their next pregnancy are either a trial of vaginal birth after caesarean (TOLAC) or an elective repeat caesarean delivery (ERCD). Both ERCD and TOLAC have benefits and risks associated.Methods: A prospective comparative study was conducted in the Department of Obstetrics and Gynecology at SDM college of medical science and hospital, Dharwad, Karnataka, India. The study included 80 women with one previous lower segment caesarean section over a period of 1 year. A 40 women underwent TOLAC and 40 women had a repeat caesarean section. The maternal and fetal outcomes in trial of labour after caesarean delivery and repeat caesarean delivery were compared.Results: In this study maternal morbidity was more common in ERCD group than in the TOLAC group. Neonatal outcome was the same in both the study groups. Conclusions: In our study the TOLAC success rate was 70-80%, pregnant woman with one previous lower segment Caesarean section should be given the option of TOLAC, unless contraindicated. 

scholarly journals Outcome of Mode of Delivery in Nulliparous and Multiparous Women Presenting with Early and Late Cervical Dilatation

2019 ◽  
Vol 7 (1) ◽  
pp. 16-20
Author(s):  
Ferdous Ara Shuchi ◽  
Salma Lovereen ◽  
Mst Nazumnnaher Mina
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Cervical Dilatation ◽  
Normal Vaginal Delivery ◽  
Medical College ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
Dilatation Group ◽  
Spontaneous Onset

Background: Knowledge of the patterns of normal and abnormal labour, and of women’s behavior, is fundamental to the formulation of mode of delivery. It is observed that women admitted to hospital early have a higher frequency of obstetric interventions in labour than those admitted later. Objective: To study the outcome of spontaneous onset of labour in nulliparous and multiparous patients. Materials and method: During the study period of 1st July 2008 to 31st Dec 2008, 568 pregnant women admitted in Kumudini Women’s Medical College were included in this study. Mothers were observed since admission with spontaneous onset of labour and followed up till they were released from the hospital. Labour outcome was measured and mode of delivery was compared among nulliparous and multiparous women. Results: Among the nulliparous women, normal vaginal delivery occurred in 71 (23%) patients presented with early cervical dilatation (0-3 cm) and in 142 (46%) patients presented with late cervical dilatation (>4 cm). In nulliparous women caesarean section were needed in 60 (45.8%) patients in early cervical dilatation group and in 35 (19.8%) patients in late cervical dilatation group. In multiparous women, normal vaginal delivery occurred in 66 (25%) patients presented with early cervical dilatation and in 133 (51%) patients presented with late cervical dilatation whereas cesarean section were done in 35 (34.7%) patients and in 25 (15.8%) patients in the two groups respectively. Duration of labour between nulliparous and multiparous was significantly different (8 hours vs. 6 hours). Indication of caesarean section were, 61 (40%) patients due to prolong labour, 48 (34%) due to foetal distress and 44 (26%) due to cephalopelvic disproportion. Conclusion: Normal vaginal delivery occurred more and duration of labour was shorter in patients admitted with advanced labour (cervical dilatation >4cm). Delta Med Col J. Jan 2019 7(1): 16-20

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