scholarly journals Intra-operative difficulties in repeat caesarean section-in a tertiary care hospital

2021 ◽  
Author(s):  
Neelima Singh ◽  
Sreedevi . ◽  
Bolle Lavanya
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Intraoperative Complications ◽  
Tertiary Care ◽  
Surgical Techniques ◽  
Cesarean Section Rate ◽  
Care Hospital ◽  
Cross Sectional ◽  
Number Of Factors ◽  
Reasonable Limit

Background: Caesarean section is associated with risks of postoperative adhesions, incisional hernias (which may require surgical correction) and wound infections. The risk of the surgery may be increased due to a number of factors. The aim of the study was to study the effects of repeated caesarean sections and intra surgical difficulties.Methods: A cross sectional, observational, hospital-based study was done for all patients with repeat caesarean section for a period of 8 months. 190 women who have undergone one or more caesarean section of term gestation with a live foetus irrespective of amniotic fluid colour and amount with cephalic, breech, or transverse presentation elective and emergency caesarean sections and singleton or multiple pregnancies were selected for study.Results: In the present study the highest prevalence of previous C-section was seen in age group 20-29 years, which accounted for (88.5%). Complications are present in 42.1% patients in which adhesions was the most found complication. Adhesion between Parietal peritoneum and anterior surface of uterus is present in 26.3% patients, omentum and uterus is present in 25.8% patients, adhesiolysis was done in 28.9% patients. 80% complications were present in patients with one previous CS. The association was found to be statistically significant.Conclusions: Women undergoing repeated cesarean sections have a risk of increased morbidity due to increased intraoperative complications. To avoid this one should keep the cesarean section rate at reasonable limit with appropriate surgical techniques and to limit primary cesarean section rate.

scholarly journals Robson’s Group 2 Criteria among Total Caesarean Sections in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (243) ◽  
pp. 1098-1101
Author(s):  
Pratigyan Gautam ◽  
Chanda Karki ◽  
Asmita Adhikari
Keyword(s):  
Caesarean Section ◽  
Confidence Interval ◽  
Cesarean Section ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Group 2

Introduction: Globally, there is a dramatic rise in cesarean section rate which has increased the maternal morbidity and adverse effects in a subsequent pregnancy. Robson’s classification will aid in the optimization of the cesarean section use, assessment of the strategies aimed to decrease the cesarean section rate and thus improve the clinical practices and quality of care in various health care facilities. The main aim of this study is to find out the prevalence of caesarean section for Robson’s group 2 among total caesarean sections done in a tertiary care hospital. Methods: A descriptive cross-sectional study was carried out at a tertiary care centre in Nepal from August 2020 to January 2021. Ethical approval was taken from the institutional review committee (reference number: 1607202003) and data were entered using Robson’s criteria. The convenient sampling technique was used. Data was analyzed using Microsoft Excel. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: According to Robson’s group 10 classification, among 380 caesarean sections, 110 (28.94%) (24.38-33.50 at 95% Confidence Interval) cases were in Robson’s group number 2. Conclusions: This study showed that the prevalence of caesarean section which lies in Robson’s group 2 in our study is higher than the standard of World Health Organization. It showed that Robson’s group 2 was one of the significant contributors to the greater caesarean section rate. Improved case selection, standardization, and protocol for induction of labour as well as regular audit could also reduce caesarean section rates.

scholarly journals Caesarean Section Rate and Frequencies of Indications Using Robson–Ten Classifications

2021 ◽  
Vol 8 (4) ◽  
pp. 43-47
Author(s):  
Sadia Ali ◽  
Shazia Khattak ◽  
Rabeea Sadaf ◽  
Shamshad Begum ◽  
Nasreen Kishwar
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Cesarean Section ◽  
Tertiary Care Hospital ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Cesarean Section Rate ◽  
Obstetrics And Gynecology ◽  
Care Hospital ◽  
Hospital Records

OBJECTIVES: To determine the caesarean section rate (CSR) and frequency of different indications of caesarean section (CS) in a tertiary care hospital. METHODOLOGY: A retrospective study done in the Department of Obstetrics and Gynecology Hayatabad Medical Complex Hospital Peshawar, a tertiary care hospital, from a period of 1st January 2019 till 31st December 2019. The required data was collected from the patient’s hospital records (clinical charts) with the consent of the hospital ethical committee. RESULTS: The total number of deliveries over the study period was 5611. Out of these 1258 patients were delivered through caesarean section (CS), giving a CSR of 22%. The main contributing groups in our study were Robson Groups R5 (multiparous with prior CS, singleton, cephalic and >37 weeks), R1 (nulliparous, cephalic, singleton >37 weeks in spontaneous labor or CS) and R6 (all nulliparous breeches) with percentages of 21.1%, 17.5% and 12.9% respectively. CONCLUSION: Our study showed Robson Groups 5, 2 and 6 as the major contributors, focusing on these groups could have an impact on decreasing the cesarean section rate in future. Limiting the primary cesarean section rate can affect the overall cesarean section rate (CSR).

scholarly journals Indication and complication of caesarean section at tertiary care hospital: a retrospective study

2019 ◽  
Vol 8 (4) ◽  
pp. 1646
Author(s):  
Bilal Ur Rehman ◽  
Hiba Gul
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Cesarean Delivery ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Bladder Injury ◽  
Care Hospital ◽  
Cross Sectional ◽  
Risk Pregnancy ◽  
Repeat Cesarean Section

Background: The incidence of cesarean section is steadily rising. Cesarean delivery has played a major role in lowering both maternal and perinatal morbidity and mortality rates.  There are various factors involved in the rise of rate of cesarean section like rising incidence of primary cesarean delivery, identification of high-risk pregnancy, wider use of repeat cesarean section, rising rates of induction of labor and failure of induction, no reassuring fetal status etc.Methods: A retrospective cross-sectional study was conducted. Data was collected from patient records of the hospital during 1st January 2018 to 30th June 2018. All patients (N= 602) who had delivered their baby by caesarean section were included in the study. Data were analyzed by help of SPSS version 21 after proper compilation.Results: Among all women who underwent cesarean section, majority were age group between 21 and 30 years (67.1%). Repeat cesarean section (48.5%), followed by fetal distress (18.9%), oligohydramnias (6.6%) and cephalopelvic disproportion (6.5%) were most common among all major indication of cesarean section. Intrapartum complication (2.0%) includes postpartum hemorrhage (1.2%), CS hysterectomy (0.5%), bladder injury (0.3%) and postpartum complication (2.3%) including UTI (0.8), wound infection (0.5%), sepsis (0.5%), lactation failure (0.5%) were major maternal complication of cesarean section.Conclusions: Reduction of number of primary cesarean section, successful VBAC, individualization of the indication and careful evaluation, following standardized guidelines can help to keep rate of cesarean section to the possible minimum level.

scholarly journals A clinical study on the analysis of caesarean section rates using Robson’s ten group classification in a tertiary care hospital

2019 ◽  
Vol 8 (2) ◽  
pp. 488
Author(s):  
Priya Shankar ◽  
Madhu J. ◽  
Vinay Raju
Keyword(s):  
Clinical Study ◽  
Caesarean Section ◽  
Cesarean Section ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Group Classification ◽  
Cesarean Section Rate ◽  
Care Hospital ◽  
Group 5 ◽  
Group 2

Background: Auditing c section rates can be done using Robson’s classification which in turn helps achieve a uniform basis for comparison across centers and across various countries.Methods: A retrospective analysis was done in a tertiary care hospital in north Karnataka KIMS, over a period of 6 months May 2017 to October 2017. All cases of LSCS done during this period were classified according to Robson’s classification and analyzed.Results: Out of 5080 overall deliveries 1876 delivered by cesarean section attributing to 36.76% cesarean section rate. Highest contribution was from group 5 (36%) and group 2 (19.24%).Conclusions: Robson’s classification helps to identify and analyze the group that contribute to the most to overall cesarean section rate and this helps us to modify strategies and interventions to optimize cesarean section rate.

scholarly journals Drug utilization of antibiotics in post-operative cesarean section inpatients in tertiary care hospital: a prospective observational study

2020 ◽  
Vol 9 (6) ◽  
pp. 859
Author(s):  
Srinivasa B. ◽  
Basavaraj C. Kotinatot
Keyword(s):  
Caesarean Section ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Essential Medicines ◽  
Care Hospital ◽  
Cross Sectional ◽  
Institutional Ethics ◽  
National Model ◽  
Rational Use Of Antibiotics

Background: The aim of this study is to evaluate the pattern and rational use of antibiotics in post-operative caesarean section (CS) inpatients in tertiary care teaching hospital, BIMS Belagavi.Methods: This cross sectional prospective observational study was conducted from December 2019 to February 2020, prior permission from institutional ethics committee was taken. Detailed data of post-operative caesarean section (CS) inpatients including age, diagnosis, line of management, complications and any adverse effects if occurred during the study was collected and entered in a specially designed proforma and MS word excel and analyzed by descriptive statistics like percentage.Results: Total 100 post-operative caesarean section inpatients were involved in the study. Most common indication for C-section was cephalopelvic disproportion. Average no of antibiotics per prescription was 3.32. Most commonly prescribed antibiotic was cefotaxime (27.71%) followed by gentamycin (25.90%) and metronidazole (24.59%). Majority (90%) of patients who admitted for ≤3 days (66%) had received combination antibiotic i.e., cefotaxime, metronidazole and gentamycin. IV fluids (21.21%) and analgesics (13.13%) were most frequently prescribed concomitant drugs. Majority (97.8%) of patients received parenteral preparation. 306 antibiotics (92.17%) used were from national model list of essential medicines (NLEM) and 332 antibiotics (100%). used were by generic name. Polypharmacy was 7.92.Conclusions: Cefotaxime was the most frequently prescribed antibiotic. Most of the antibiotics prescribed was rationally from NLEM and were by generic name.

scholarly journals Survival outcomes of trachea esophageal fistula in infant

2019 ◽  
Vol 6 (4) ◽  
pp. 1680
Author(s):  
S. Prabkaran ◽  
K. Kasthuri Thilagam
Keyword(s):  
Tertiary Care ◽  
Surgical Techniques ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Esophageal Fistula ◽  
Chi Square ◽  
Cross Sectional ◽  
Cardiovascular Defects ◽  
Chi Square Test ◽  
Type 3

Background: Tracheo-esophageal fistula (TEF) is a rare congenital abnormality often associated with several other anomalies including renal, vertebral column, gastrointestinal or cardiovascular defects. This study was carried out to evaluate the outcome of trachea esophageal fistula among patients who underwent various surgeries for the anastomosis of trachea esophageal fistula.Methods: This study was conducted as a record based cross sectional study among 88 patients who were diagnosed and treated for trachea-esophageal fistula in tertiary care hospital between 2015 and 2018. Data regarding the type of anomaly, presence of associated anomalies, type of surgery and outcomes were documented. Findings of echocardiography and ultrasonography were also documented. Data was analyzed using SPSS software. Chi square test was used to evaluate the outcome of the surgical procedures for management of TEF.Results: Majority of the participants in our study belong to <1 month of age and were males (56.8%). Type 3 tracheo esophageal fistula (80.7%) was the most common type. Associated cardiovascular anomalies were present in 50% of the participants. Thoracotomy with TEF repair was most preferred surgery (76%). Present study demonstrated that surgical techniques improve the physical and physiological outcome of the patients (p <0.05).Conclusions: Trachea esophageal fistula needs to be corrected with surgical procedure. Modern techniques like thorocoscopic anastomosis, thorocosopic techniques to achieve an anastomosis can also be explored. Future studies may be directed in detecting congenital anomalies during the pre-natal period with the help of genetic techniques.

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 Study of indications and post-operative complications of primary caesarean section in tertiary care hospital in Nepal

2018 ◽  
Vol 7 (3) ◽  
pp. 835 ◽  
Author(s):  
Sanyukta Rajbhanadary ◽  
Veena Rani Shrivastava
Keyword(s):  
Caesarean Section ◽  
Post Partum ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
College Teaching ◽  
Care Hospital ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Continuous Increase ◽  
Fetal Complications

Background: Caesarean section performed for appropriate obstetric or medical indications are life saving for both mother and new born. But its advantage does not justify its continuous increase as it is a major surgical procedure associated with maternal and fetal complications. The main objective of this study was to study the indications of primary caesarean section and its maternal and fetal complications in Nepal medical college teaching hospital (NMCTH).Methods: This is a hospital based cross sectional study carried out for a period of one year from 1st October 20113 to 30th September 2014 in department of obstetrics and gynecology in NMCTH Nepal. The study included 183 primary caesarean cases enrolled as per the inclusion criteria. The indications for caesarean section, associated maternal and fetal complications were noted.Results: The rate of caesarean section during the study period was 21.40%. The study included 183 patients who underwent primary caesarean section, 162 (88.5%) cases were emergency cases and 21 (11.5%). Cases were elective cases. The most common indications were fetal distress (n-74, 40.4%) followed by cephalo pelvic disproportion (n-27, 14.8%). The maternal complications seen were urinary tract infection (n-34, 68%), wound infection (n-12, 24%), post-partum hemorrhage (n-3, 6%). The common fetal complications noted were apgar score of less than 7 (n-7, 31.8%), transient tachypnea of newborn (n-6, 27.27%) and meconium aspiration syndrome (n-4, 18.18%).Conclusions: Emergency primary caesarean section was proportionally higher than elective caesarean section. It was also associated with more maternal and fetal complications.

scholarly journals ROBSON’S CLASSIFICATION OF CAESAREAN SECTION CONDUCTED AT A TERTIARY CARE WOMEN’S HOSPITAL

2020 ◽  
Vol 4 (9) ◽  
Author(s):  
Nishtha Agrawal ◽  
Neha Agrawal
Keyword(s):  
Cesarean Section ◽  
Tertiary Care ◽  
Total Duration ◽  
Primary Source ◽  
World Health ◽  
Care Hospital ◽  
Cross Sectional ◽  
Vaginal Deliveries ◽  
The World ◽  
Primiparous Women

Background: Despite the World Health Organization’s recommendation and caution the cesarean section rates are continuously rising across the world. This despite the evidence indicating that this increase in c-section rate is not leading to a decline in the maternal and child mortality rates. The objective of this study was to classify and categories all the primary c-section conducted among multi-parous women delivering at a tertiary care hospital.  Material and Methods: An observational, cross-sectional, single centre study was conducted at the Sultania Zanana Hospital affiliated to Gandhi Medical College, Bhopal. The total duration of the study was one year from April 2013 to March 2014.  The study population comprised of the multi-parous women coming or referred to SHZ.  The primary source of the data for this study where the patient’s interview, treatment records and operation theatre delivery register.  Results: During the period between April 2013 to March 2014, a total of 10,271 deliveries were conducted at SZH; of these 7,570 were normal vaginal deliveries and 3,151 were c-section. The prevalence of primary cesarean section in multipara in the present study is 5.6 %.  Most (62.0%) women were categorized as belonging to the III group while only 2.1% of women were categorized in the VIII group. Discussion:  A large number of primary c-section among primiparous women can be prevented. In comparison to primiparous women, the prevalence of primary c-section was less among multiparous women.

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