scholarly journals An audit of the decision to delivery interval in emergency caesarean section and its effect on neonatal outcome

2020 ◽  
Vol 9 (10) ◽  
pp. 4202
Author(s):  
Anuradha G. ◽  
Nirupama V. ◽  
Shirley George
Keyword(s):  
Caesarean Section ◽  
Neonatal Outcome ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Primary Objective ◽  
Emergency Caesarean Section ◽  
Care Hospital ◽  
College Hospital ◽  
Medical College ◽  
Emergency Caesarean

Background: Emergency caesarean section (CS) is divided into four categories based on the degree of urgency by RCOG and NICE guidelines. It is recommended that the decision to delivery interval (DDI) in emergency CS should be within 30 minutes in category 1 and within 75 minutes in category 2. Our Primary objective was to study the incidence and indications of emergency CS and audit the DDI in emergency CS at tertiary care hospital. Our secondary objective was to study the effect of DDI on neonatal outcome.Methods: Descriptive study was carried out among 409 women who underwent emergency CS from August 2018 to December 2018 at St. John's medical college hospital, Bangalore. Relevant data was collected by chart review. Emergency CS were categorised according to RCOG guidelines based on the degree of urgency and further classified based on DDI as <30 minutes, 30-75 minutes and >75 minutes.Results: We had 409 cases of emergency CS. Category 1 had 113 (27.63%) cases, category 2 had 126 (30.81%) cases and category 3 had 170 (41.56%) cases. DDI of <30 minutes was achieved in 19.5% in category 1, DDI of <75 minutes was achieved in 93.65% in category 2. Fetal distress was the leading cause of emergency CS in category 1 and 2. There was a high incidence of low APGAR in babies delivered in <30 minutes and lower APGAR was significantly associated with <30 minutes of DDI (p<0.0001).Conclusions: Fetal distress was the leading cause of emergency CS. DDI interval of <30 minutes was not always associated with good neonatal outcome; Category of CS has a significant effect on neonatal outcome.

scholarly journals Socio-demographic Factors Associated with Emergency Caesarean Section Cases admitted at Tertiary Care Hospital in Dhaka City

2018 ◽  
Vol 4 (1) ◽  
pp. 23-26
Author(s):  
Rifat Sultana ◽  
Dewan Shahida Banu ◽  
Mahmuda Khatun ◽  
Fatima Dolon ◽  
Mahmuda Nahar ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Intraoperative Complications ◽  
Tertiary Care ◽  
Demographic Factors ◽  
Emergency Caesarean Section ◽  
Care Hospital ◽  
College Hospital ◽  
Medical College ◽  
Emergency Caesarean ◽  
Socio Demographic Factors

Background: Socio-demographic factors are related with the need of emergency obstetric care.Objectives:  The purpose of the present study was to see the socio-demographic characteristics of emergency caesarean section.Methodology: This cross-sectional of study was conducted in the Department of Obstetrics and Gynaecology at Dhaka Medical College, Dhaka from the duration July 2006 to December 2006 for a period of six (6) months. The pregnant women underwent emergency caesarean section admitted at Dhaka Medical College Hospital during the mentioned period of the study were my study population. The cases were selected from the patients who got admitted at obstetrics ward of DMCH with an indication of emergency caesarean section with stable general condition at that moment. Every 10th patient was selected for the study. Data has been collected after taking written consent from the patients as per consent form. Then a thorough history, clinical examination was done and information were collected. Intraoperative complications such as haemorrhage, cardiac arrest were noted.Result: The study was performed on 100 cases of which 35(35.0%) emergency caesarean section cases belonged to the age group of 20 to 24 years and 56.0% were from lower socio economic class. Among them 42.0% of the cases of emergency caesarean section had education SSC and above level; furthermore 12.0% were illiterate. In addition 92.0% cases were house wife.Conclusion: In conclusion young house wives from lower socio economic status are mostly underwent emergency caesarean section.Journal of Current and Advance Medical Research 2017;4(1):23-26

scholarly journals Pregnancy with a Normal live Foetus and a Partial Molar Placenta - An Extremely Rare Condition

1970 ◽  
Vol 18 (1) ◽  
pp. 82-84 ◽  
Author(s):  
R Khanom ◽  
K Khatun ◽  
S Akter
Keyword(s):  
Caesarean Section ◽  
Rare Condition ◽  
Normal Karyotype ◽  
Emergency Caesarean Section ◽  
Molar Pregnancy ◽  
College Hospital ◽  
Medical College ◽  
Male Baby ◽  
Emergency Caesarean ◽  
Normal Foetus

The incidence of a normal live foetus along with a partial molar placenta is extremely rare. Although triploidy is the most frequent association, a foetus with normal karyotype can survive in cases of partial molar pregnancy. A case is reported in the Department of Obstetrics & Gynaecology, Dhaka Medical College Hospital, Dhaka that of partial molar placenta in which a live male baby was delivered at 34 weeks gestation by a 25 years old woman. At the 23rd week, ultrasonographic examination revealed a normal foetus with a huge, multicystic placenta. There were per vaginal bleeding up to the 34th gestational weeks. The patient underwent an emergency caesarean section and delivered a 1.6 kg male baby. The baby was admitted in SCABU. The foetus was normal and no complication was there. Key words: Live foetus with molar pregnancy; emergency caesarean section. DOI: 10.3329/jdmc.v18i1.6313 J Dhaka Med Coll. 2009; 18(1) : 82-84

scholarly journals Record based analysis of indications and complications of 500 cases of lower segment cesarean sections at a tertiary care hospital

2019 ◽  
Vol 8 (2) ◽  
pp. 393
Author(s):  
Vaishali Chaurasia ◽  
Sushruta Shrivastava
Keyword(s):  
Caesarean Section ◽  
Post Partum ◽  
Financial Burden ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Care Hospital ◽  
Lower Segment ◽  
Medical College ◽  
Lower Segment Cesarean Section ◽  
Evidenced Based

Background: The drastically increasing rate of caesarean section is a topic of constant worry and analysis throughout the world. In order to understand the degree to which caesarean section may be preventable, it is important to know why caesarean section are performed. This study is aimed to find out the rate of caesarean section at our institute, various indications of the procedure and complications related to them.Methods: This study was carried out retrospectively in the department of obstetrics and gynecology at Chirayu Medical College and Hospital, Bhopal. Study period was from January 2017 to December 2017. 500 cases of lower segment cesarean section were studied including both elective and emergency caesarean sections. Statistical analysis of age, parity, period of gestation, indications of LSCS and complications was done.Results: The rate of caesarean section came out to be 47.7%, which is far above recommended. Majority of patients (81.6%) were in 21-30 years age group; while the number of primary and repeat caesarean section were comparable (40.8% and 59.2%respectively). Commonest indication was previous LSCS (31.6%) followed by fetal distress (21.6%). Surgical site infection was present in 4.6% cases whereas, post-partum hemorrhage occurred in 5.8% cases. Three patients underwent obstetric hysterectomy and two cases of maternal mortality were reported among post LSCS patients.Conclusions: Increasing rates of caesarean section has contributed to maternal morbidity along with financial burden. Individualization of the indication and careful evaluation, following standardized guidelines, practice of evidenced-based obstetrics and audits in the institution, can help us limit rate of caesarean section.

scholarly journals Intraoperative findings in primary caesarean section for non-reassuring fetal status and its correlation with cardiotocography

2018 ◽  
Vol 7 (6) ◽  
pp. 2351
Author(s):  
Nisha Bhatia ◽  
Krishna Kumari M.
Keyword(s):  
Caesarean Section ◽  
Neonatal Outcome ◽  
Cost Effective ◽  
Fetal Distress ◽  
Emergency Caesarean Section ◽  
Obstetrics And Gynecology ◽  
Medical Sciences ◽  
Apgar Scores ◽  
Emergency Caesarean ◽  
Nuchal Cord

Background: Cardiotocography plays an important role in diagnosing nonreassuring fetal status during labour, which is a leading cause for caesarean section among primigravida. These abnormal cardiotocographic traces may or may not translate into intraoperative findings of meconium stained liquor or low APGAR at birth. Hence a study is warranted to understand their correlation, thereby demonstrating the utility of cardiotocography in diagnosing nonreassuring fetal status. The objective of the study was to assess the correlation of intraoperative findings and neonatal outcome in primigravida undergoing emergency caesarean section for nonreassuring fetal status with cardiotocography.Methods: A retrospective analysis of 104 case records of primigravida undergoing emergency caesarean section for fetal distress at Department of Obstetrics and Gynecology, Apollo Institute of Medical Sciences and Research, Hyderabad, was done. Their CTG traces were correlated with their intraoperative findings such as meconium stained liquor; nuchal cord and APGAR score at birth.Results: Out of these 104 primigravida who underwent emergency caesarean section for nonreassuring fetal status, 63.4% had CTG with decelerations-Non reactive, 28% had a CTG trace with persistent decreased variability while 7.6% had a reactive CTG with meconium stained liquor. Among patients with CTG trace showing decelerations 54.5% had meconium stained liquor, 28.7% had cord around the neck and 43.9% had low APGAR scores at birth. Among the group of patients with decreased variability 63.4% had meconium stained liquor, 30% had cord around the neck and 30% had low APGAR scores at birth. There were 8 patients who had reactive CTG with meconium stained liquor, among them only 3 had low APGAR scores.Conclusions: Cardiotocography positively correlates with meconium stained liquor and APGAR scores at birth, but not with the presence of nuchal cord. Hence, judicious interpretation of CTG and introduction of another noninvasive, cost effective and acceptable test to detect non reassuring fetal status is warranted to prevent unnecessary caesarean sections.

Chikungunya–dengue co-infection during pregnancy requiring preterm Caesarean section: first case report from Bangladesh

2017 ◽  
Vol 48 (3) ◽  
pp. 234-235 ◽  
Author(s):  
Muhammad Abdur Rahim ◽  
Shahana Zaman ◽  
Nasreen Sultana ◽  
Ariful Islam ◽  
Khwaja Nazim Uddin
Keyword(s):  
Case Report ◽  
Caesarean Section ◽  
Fetal Distress ◽  
Emergency Caesarean Section ◽  
Emergency Caesarean ◽  
First Case

We report the first case of chikungunya-dengue co-infection during pregnancy requiring emergency Caesarean section (CS) because of fetal distress in a Bangladeshi primigravida. Though previously unreported, this situation may become increasingly common.

Study on Maternal and Neonatal Outcome of women undergoing Caesarean Section using Nice Classification in a Tertiary Care Hospital in Rural Area of Central India - An Observational Prospective Study

2021 ◽  
Vol 17 ◽  
Author(s):  
Shuchi M. Jain ◽  
Ketki. Thool ◽  
Manish A. Jain ◽  
Poonam V. Shivkumar
Keyword(s):  
Caesarean Section ◽  
Prospective Study ◽  
Neonatal Outcome ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Central India ◽  
Neonatal Morbidity ◽  
Bladder Injury ◽  
Care Hospital ◽  
Chi Square

Background : Caesarean section is often perceived to be safer than vaginal delivery for mothers and neonates, and thus has become increasingly common around the globe. However, it may actually be detrimental to maternal and neonatal health while consuming valuable resources. Objective : The objective of this study was to categorize the caesarean sections performed in our rural institute into various categories using NICE classification and to study the maternal and neonatal outcome in them. Method : This was a prospective study of all women who underwent caesarean section over a period of 18 months. Data was retrieved from the files of women for morbiditiy and mortality in mothers and babies. Data was entered in MS excel sheet and analyzed with percentages and chi square test using SPSS ver.17. Results: Caesarean section rate (CSR) was 36.88%. All CS were classified into four categories based on urgency as per NICE guidelines. There were 22.62% women in Category I, 38.61% in category II, 28.37% in category III and 10.40% in Category IV. Adhesions, extension of angle, lacerations in lower segment, scar dehiscence, atonic PPH and bladder injury were noted in (12.83%), 11.81%, 6.83%, 4.08% , 1.53% and 0.08% CS respectively. Caesarean hysterectomy was done in 0.24% cases. Postoperative morbidity was febrile morbidity (11.93%), postdural puncture headache (13.85%), paralytic ileus (11.49%), wound infection (8.83%), ARDS (0.70%), sepsis (0.78%), pulmonary edema (0.47%) and pulmonary embolism (0.03%). Maternal mortality was 0.03%. Neonates born were 2577 (29 were twin deliveries). 82.46% neonates were healthy, 16.80% had morbidities and 0.74% were still born. Apgar score of less than 7 was in 10%. 16.80% neonates were admitted in NICU during their hospital stay. Neonatal mortality was 1.47%. Conclusion : Intraoperative and post-operative complication were more in caesarean sections of category I and II as compared to category III and category IV. Neonatal morbidity, mortality and admissions to NICU were more in caesarean sections of category I and II as compared to category III and category IV. Thus though caesarean section is an emergency lifesaving procedure for mother and baby it may prove detrimental to their health.

scholarly journals Profile of Caesarean Section at Kathmandu Medical College

2017 ◽  
Vol 15 (2) ◽  
pp. 110-113
Author(s):  
Apurwa Prasad ◽  
Garima Bhandari ◽  
Rachana Saha
Keyword(s):  
Caesarean Section ◽  
Demographic Data ◽  
Elective Caesarean Section ◽  
Emergency Caesarean Section ◽  
Medical College ◽  
Emergency Caesarean ◽  
Clinical Indications ◽  
Depth Study ◽  
Elective Procedure ◽  
Failed Induction

Background: There is a world-wide rise in caesarean section rateduring the last three decades and has been a cause of alarm and needs an in-depth study. The objective of this study was to determine the rate and clinical indications of Caesarean Section.Methods: A hospital based study was carried out from 15th June 2015 to 15th January 2016 in Department of Obstetrics and Gynecology at Kathmandu Medical College, Sinamangal, Nepal. Patients who delivered by caesarean section were included in the study. Basic demographic data and clinical indications were noted.

Results: A total of 1172 deliveries were carried out during the study period. Total number of caesarean section was 537 accounting to 45.81%. Most of the patients were of the age group of 25-29 years (42.8%). Most of the patients were primigravida (n=274; 51%). Emergency caesarean section was 411 (76.5%) and elective caesarean section was 126 (23.4%). Multigravida (71%) underwent more elective procedure than primigravida (25. 39%).The most frequent indication was fetal distress19.55% (n=105), failed induction 19.73%(n=106), and previous caesarean section 21.3% (n=115).Conclusions: The rate of cesarean section is quite high than that recommended by WHO which is (10-15%). Most of the caesarean sections were emergency caesarean section with previous caesarean being the leading cause.

scholarly journals VAGINAL DISCHARGE

2011 ◽  
Vol 18 (04) ◽  
pp. 598-603
Author(s):  
SHAHIDA SHAIKH ◽  
SALEEM AKHTER SHAIKH ◽  
INAYAT MAGSI
Keyword(s):  
Vaginal Discharge ◽  
Tertiary Care ◽  
Care Hospital ◽  
College Hospital ◽  
Internally Displaced ◽  
Syndromic Management ◽  
Sexually Transmitted ◽  
Medical College ◽  
Abnormal Growth ◽  
History Of

Objective: To observe the results of syndromic management in women living in IDPs camps complaining of chronic vaginal discharge. Design: Descriptive study. Setting: Medical Camps at Larkana set by Chandka Medical College Hospital for Internally Displaced Persons (IDPs) due to floods. Period: 1st September 2010 to 31st December 2010. Material and Methods: Total 200 symptomatic patients aged from 20 to 50 years suffering from chronic vaginal discharge having history of more than 6 months duration were included in the study. Asymptomatic as well as pregnant women and patients with abnormal cervix and having abnormal growth on cervix were excluded from the study. A detailed history and examination (including speculum and vaginal) was done and a proforma was filled. All these patients were given empirical treatment recommended by WHO as syndromic management consisting of stat doses of antifungal along with antibiotics, where no laboratory tests are required before treatment. Results: Next to vaginal discharge which was main symptom in all patients, the other symptoms like dusparunia, dysuria, itching ,lower abdomen pain and low backache was reported 9%, 16%, 20%, 24% and 31% respectively. Also 8% patients reported post coital bleeding. All patients were married and the mean age of the patients was 28+0.2 years and 15% of them were over 40 years. Mean parity was 4±1.Vaginal infection improved in 65% of the patients excellently with a first line single course of antibiotic and percentage raised up to 88% with second course. 19(9.5%) patients couldn’t be followed as they left that camp and 5(2.5%) patients who did not improve with two courses of antibiotics had big cervical erosions, referred to nearby tertiary care hospital for further management. Conclusions: IDPs live in poor conditions in camps without basic facilities and where it is difficult to perform bedside tests like microscopy, Potassium Hydroxide, wet mount films and tests for Sexually transmitted diseases like Chlamydia and gonorrhea are not available, syndromic management there is a rational way of treating cases of chronic vaginal discharge to get quicker response in such desperate women. 

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