scholarly journals Changing trends in uterine rupture audit, from the Institute of obstetrics and gynecology, modern government maternity hospital, Osmania medical college

2020 ◽  
Vol 9 (9) ◽  
pp. 3631
Author(s):  
Pratibha Devabhaktuni ◽  
Padmaja Allani ◽  
Maheen F.
Keyword(s):  
Caesarean Section ◽  
Uterine Rupture ◽  
Maternity Hospital ◽  
Fetal Outcome ◽  
Bladder Rupture ◽  
Obstetrics And Gynecology ◽  
Medical College ◽  
Lower Segment Caesarean Section ◽  
Trial Of Labor ◽  
Insight Into

Background: Between January 2001 to September 2003, 46,171 deliveries were recorded, the number of caesarean deliveries during this period of two years and nine months were 16,182 (35.04%).  Methods: An Audit from the Institute of obstetrics and gynecology, of uterine ruptures.Results: Total 81 cases of uterine rupture were managed at the Institute. Total number of scar ruptures managed were, 48/81 uterine ruptures. Five women had previous classical upper segment caesarean, and in previous lower segment caesarean section (LSCS), there were 43 cases of rupture uterus. In two cases following forceps delivery, traumatic uterine ruptures were recorded. Spontaneous ruptures were 31 during the study period. Bladder rupture occurred in 13 cases, 16.04% of uterine ruptures.  The fetal outcome in uterine ruptures 81 cases, live births were 19-23.45%. The number of vaginal births after caesarean section were 261, 215, 186 in the years 2001, 2002 and 2003 at the Institute of obstetrics and gynecology. The number of scar ruptures were 7/261, 9/215, 2/186 in the respective years. Hysterectomy was done in 43/81=53.08%. Rent repair of the uterine rupture was done in 38/81.Conclusions: An Audit from the Institute of obstetrics and gynecology, of uterine ruptures has provided the following data that gives an insight into the practice of obstetrics during the decade 2000 to 2010 in the teaching Institute.  Caesarean deliveries accounted for 35.04% of the total deliveries.  Repeat caesarean sections were 7105, 43.9%. The number of vaginal births after caesarean section (VBAC) were 662. Scar ruptures in VBAC were 18 /662-2.71%. The maternal mortality in MGMH study was 3/81 uterine ruptures-3.7%. Scar ruptures constituted, 48/81-59.25% of uterine ruptures. Trial of labor after caesarean (TOLAC) and VBAC are practiced in the teaching Institute.

COMPARISON OF OUTCOME OF SUTURE MATERIALS POYGLACTIN 910 & POLYAMIDE MONOFILAMENT AS SUBCUTICULAR STITCHES IN CAESAREAN SECTION.

2021 ◽  
pp. 77-79
Author(s):  
Hari Charan Ray ◽  
Himadri Nayek ◽  
Jonge Lollen ◽  
Sankar Nath Mitra ◽  
Debarshi Jana
Keyword(s):  
Caesarean Section ◽  
Family Health ◽  
Wound Dehiscence ◽  
Population Level ◽  
Obstetrics And Gynecology ◽  
P Value ◽  
Suture Materials ◽  
Eligibility Criteria ◽  
Medical College ◽  
The Usa

INTRODUCTION:Caesarean delivery rate rose from 4.5 percent in 1970 to 32.9 percent in 2009. And then the rate has trended slightly downward, and it was 32 percent in 2015 in the USA. More than 85 percent of these operations are performed only for four reasons- prior caesarean delivery, dystocia, fetal jeopardy, or abnormal fetal presentation. As per the latest data (National Family Health Survey 2015-16 (NFHS-4), the caesarean rates at population level in India seems to be 17.2%. In 1985 WHO stated: ―There is no justication for any region to have Caesarean section rates higher than 10-15%. AIMS AND OBJECTIVES:The efcacy of two suture materials polyglactin 910 (Vicryl 2.0) and polyamide monolament (Ethilon 2.0) in terms of pain, tenderness, swelling, induration, discharge, cosmesis and wound healing, suture materials with least complications. MATERIALS AND METHODS:This was a prospective, observational, comparative study conducted in the Department of Obstetrics and Gynecology, in a tertiary medical college in Paschim Medinipur, for 18 months after getting approval from the Institutional Ethical Committee. 18 months; 1st April 2019 to 30th September 2020. Randomly selected term pregnant women admitted in the Department Of Obstetrics and Gynecology, Midnapore Medical College and Hospital during the study period and fullling the eligibility criteria (according to inclusion and exclusion criteria). RESULTS AND ANALYSIS:It is clear that the parameters, pain and tenderness (p value = 0.3710), swelling and induration (p value = 1) and wound dehiscence (p value =0) in both the groups are statistically insignicant and the other parameters are signicant in both the groups; discomfort (p value = 0.0114) and wound dehiscence (p value = 0.0254347). SUMMARY & CONCLUSION: Multilament sutures also induce a more intense inammatory response and contribute to larger knot volumes than monolaments of equal sizes. Multilament sutures demonstrate enhanced capillarity with a resultant increase in the transport and spread of microorganisms. There are multiple factors which cause surgical site complications that have not been analyzed in this study and need an additional evaluation in further studies and there is lack of previous research studies on the same topi

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 Perinatal Outcome of Deliveries after One Previous Caesarean Section

2015 ◽  
Vol 3 (1) ◽  
pp. 19
Author(s):  
Narinder Kaur ◽  
Sushila Jain
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Previous Caesarean Section ◽  
Lower Segment Caesarean Section ◽  
History Of ◽  
Live Fetus ◽  
The Right ◽  
A Prospective Study

Introduction: Contrary to the WHO recommended caesarean section (CS) rate of 15%, there is an alarming trend of increasing caesarean section rates. An important reason for this is repeat caesarean section (RCS). Vaginal birth after caesarean (VBAC) is one of the methods of reducing CS rates in women with history of previous CS. This study was done with the aim to see the maternal and fetal outcome among parturient with history of single previous caesarean section and to determine the rate of VBAC at Lumbini Medical College, Nepal. Methods: This is a prospective study done for a period of ten months. Seventy parturient fulfilling inclusion criteria of term pregnancy with single live fetus and history of one Lower Segment Caesarean Section (LSCS) were enrolled in the study. Patients meeting the criteria for VBAC were given trial of labour and others were taken for elective repeat CS. This cohort was analyzed further, with respect to age, parity, period of gestation, mode of delivery, indication for CS, maternal and fetal complications and outcomes. Results: VBAC was successful in 27.14% of patients (n=19) while the rest 51 (72.85%) underwent RCS . Indications for RCS was mainly scar tenderness 7 (13.7%), fetal distress 6 (11.7%), non progress of labour 6 (11.7%), meconium stained liquor 6 (11.7%) and post-dated pregnancy 6 (11.7%). Maternal morbidity was comparable in women undergoing RCS or VBAC. There was one still birth and one early neonatal death in each group due to complications of meconium aspiration. Conclusion: Patients with previous CS are at high risk of RCS. If trial of labor is allowed under careful patient selection and supervision, the rate of vaginal delivery after caesarean section can be increased safely. As there is no added perinatal morbidity and mortality in cases of VBAC as compared to RCS, VBAC shows the right way forward to decrease the rate of caesarean section.

scholarly journals Incidence of post-operative (caesarean section) infectious morbidities in cleansing and non-cleansing group after povidone iodine vaginal cleaning

2021 ◽  
Vol 10 (9) ◽  
pp. 3393
Author(s):  
Pragya Verma ◽  
Dolly Chawla ◽  
Rashmi Khatri ◽  
Preeti Verma
Keyword(s):  
Caesarean Section ◽  
Povidone Iodine ◽  
Medical College ◽  
Lower Segment Caesarean Section ◽  
Significant Difference ◽  
Maternal Morbidity And Mortality ◽  
Group A ◽  
Randomized Control ◽  
Group B ◽  
Control Study

Background: Despite of wide spread use of prophylactic antibiotics and various antiseptic measures, post-operative infection remains one of the significant and serious complication of caesarean delivery contributing to high maternal morbidity and mortality. Objective was to study the incidence of post-operative infectious morbidities in patients with/without povidone iodine vaginal cleansing done prior to caesarean section.Methods: A prospective randomized control study was done in the department of obstetrics and gynecology of Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi.Results: Mean age of participants in group A is 26.22±2.47 years and in group B is 26.48±2.3 years. Majority women (84.0%) underwent emergency lower segment caesarean section (LSCS). (6.4%) women developed post-operative endometritis, out of which maximum (4.6%) belong to no vaginal cleansing group (B) compared to 1.8% in povidone iodine vaginal cleansing group(A), which is statistically significant (p=0.01). Over all (13%) women had post-operative fever, with significant difference among the two groups i.e. (8.6%) were in group B versus (4.4%) in group A (p=0.005).Conclusions: Povidone iodine vaginal cleansing prior to caesarean section is significantly effective in reducing post-operative infectious morbidities.

scholarly journals Anaesthetic Challenge in Undiagnosed Mitral Valvular Disease in Emergency Lower Segment Caesarean Section in a Secondary Level Hospital – A Case Report

2014 ◽  
Vol 9 (1) ◽  
pp. 118-121
Author(s):  
ME Karim ◽  
S Akhter ◽  
MM Yasin
Keyword(s):  
Case Report ◽  
Caesarean Section ◽  
Heart Diseases ◽  
Indian Subcontinent ◽  
Secondary Level ◽  
Armed Forces ◽  
Lower Segment ◽  
Medical College ◽  
Lower Segment Caesarean Section ◽  
Level Hospital

Although the incidence of Rheumatic Mitral Stenosis is grossly reduced in Indian subcontinent, it occupies a greater segment among heart diseases complicating pregnancy. A 25 years old lady, who was not known as a case of valvular heart disease, was admitted in a secondary level hospital for emergency lower segment caesarean section. The patient developed severe pulmonary oedema during operation which was managed successfully. DOI: http://dx.doi.org/10.3329/jafmc.v9i1.18741 Journal of Armed Forces Medical College Bangladesh Vol.9(1) 2013: 118-121

scholarly journals A study of cases of rupture uterus in a tertiary medical college of Jharkhand, India

2017 ◽  
Vol 6 (6) ◽  
pp. 2553
Author(s):  
Samarina Kamal ◽  
Shashibala Singh
Keyword(s):  
Caesarean Section ◽  
Health Care Providers ◽  
Uterine Rupture ◽  
Anterior Wall ◽  
Traumatic Rupture ◽  
Care Providers ◽  
Lower Segment ◽  
Obstructed Labor ◽  
Lower Segment Caesarean Section ◽  
Gynecology And Obstetrics

Background: Uterine rupture is a grave condition which is almost fatal for fetus. The most common risk factor for the uterine rupture is previous uterine surgery. Other major factors are obstructed labor, multiparity, use of uterotonic drugs, placenta percreta and rarely intrauterine manipulations such as internal podalic version and breech extraction.Methods: This study was conducted over a period from March 2014 to September 2015, in the Department of Gynecology and Obstetrics, RIMS Ranchi, Jharkhand. All cases of rupture uterus, who were either admitted with or who developed this complication in the hospital, were included in the study.Results: There were 80 cases of rupture uterus out of 10474 deliveries. The incidence of rupture uterus was more (97.5%) in cases who had no previous antenatal checkup at all. Most of cases of previous caesarean section scar rupture during labour was lower segment caesarean section scar (94.11%). The most common causes of traumatic rupture were injudicious use of oxytocics (75%). Majority of cases of rupture uterus were of complete type (96.25%). The most frequent site of rupture was in the anterior wall of lower segment in 68.75% of cases. The maternal mortality rate cases of rupture uterus were 3.75%.Conclusions: Proper antenatal care and updated training courses of health care providers should be stressed to prevent this catastrophic but avoidable complication.

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