Exploring caesarean delivery in the second stage of labour at a tertiary care hospital: a retrospective study

Background: Caesarean section (CS) performed in the second stage of labour has many implications for maternal and neonatal morbidity as well as for subsequent pregnancies. The objectives of this study were to determine the rates of CS at full dilatation, their indications, associated maternal and neonatal complications.Methods: This retrospective study assessed all the women with a singleton fetus in cephalic presentation at term (≥37 weeks) who underwent CS in the second stage of labor between 1 August 2019 and 31 March 2020 at a tertiary care hospital. Maternal demographics, labour and delivery details as well as neonatal outcomes were collected.Results: During the study period, 2124 (36%) babies were born by CS. Of these, 49 (2.3%) were performed in the second stage of labour at ≥37 weeks of gestation. The most common indication of CS was non-descent of head in 38 (77.55%) of cases. The majority of women 38 (77.55%) delivered by CS in the second stage of labor were primiparous. The 27 (55.10%) women were in the age group of 20-25 years. Most common intraoperative complication was blood-stained urine in 20 (40.81%) women. Overall transfusion rate was 18.36%. Maximum number of babies born 44 (89.79%) were having birth weight between 2.5-3.5 kg. Out of 65 babies born, 17 (34.69%) were admitted to neonatal intensive care unit.Conclusions: Formulation of an institutional protocol and training and supervision of trainees to improve the skill of operative vaginal delivery and second stage cesarean is needed.

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Maternal and neonatal outcomes in vacuum assisted births in the government tertiary care hospital in Mandya: a retrospective record-based study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20200569 ◽

2020 ◽

Vol 9 (3) ◽

pp. 965

Author(s):

Shwetha M. ◽

Shilpa M. N.

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Neonatal Morbidity ◽

Vacuum Extraction ◽

Care Hospital ◽

Second Stage ◽

Second Stage Of Labour ◽

Vaginal Deliveries ◽

Assisted Delivery ◽

The Government

Background: Vacuum extraction and forceps are the two options when an instrument is needed to facilitate a vaginal birth. Vacuum extraction has recently gained popularity because of new designs of vacuum cups with reduced risk of injury to the neonate. Vacuum extraction is one of the evidence-based interventions that can prevent complications by shortening the second stage of labour. The present study has been carried out to evaluate the maternal and neonatal morbidity, mortality and failure associated with vacuum assisted vaginal deliveries, at a Government tertiary care hospital in Mandya, Karnataka, India.Methods: The study was a record-based study including a total of 207 women who underwent vaginal assisted delivery in the form of vacuum assisted deliveries in a period of 6 months from January 2019 to June 2019 at the Government tertiary care hospital in Mandya, Karnataka, India. Records of women who had vacuum assisted deliveries and records of their newborn children were accessed.Results: In our study 41.5% of the subjects were in the age group of 21-25 years. Nearly 3/4th (74.4%) of the subjects were primigravida. More than half (54.1%) of the study subjects had to be put under vacuum assisted techniques for delivery because of the prolonged second stage of labour, failure rate was 0.4%. Out of 207 vacuum assisted deliveries maternal complication rate was 8.21%, 17.3% neonates had NICU admission and 14.97% had perinatal complications.Conclusions: Vacuum assisted vaginal delivery is comparatively a better choice in preventing the complications caused due to prolonged second stage of labour thus reducing the cesareans rate. It is a safe alternative to cesareans delivery in rightly chosen case. Vacuum assisted delivery by a skilled person and a proper technique is associated with lesser maternal and neonatal morbidity.

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Upright kneeling position during second stage of labor: a pilot study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175930 ◽

2018 ◽

Vol 7 (2) ◽

pp. 401 ◽

Cited By ~ 1

Author(s):

Anjali Dabral ◽

Pallavi Pawar ◽

Rekha Bharti ◽

Archana Kumari ◽

Achla Batra ◽

...

Keyword(s):

Tertiary Care ◽

Mode Of Delivery ◽

Admission Rate ◽

North India ◽

Care Hospital ◽

Apgar Scores ◽

Second Stage Of Labor ◽

Second Stage ◽

Perineal Tears ◽

Second Stage Of Labour

Background: Women delivering in upright position have shorter labour due to efficient and stronger contractions with faster descent of foetal head. The present study aimed to find out effect of upright kneeling position in the second stage of labour on maternal and foetal outcome and assess patients’ satisfaction.Methods: The study was carried out in a tertiary care hospital of North India from October 2012 to February 2014. Low risk women admitted in early labour were divided into two groups, women delivering in kneeling position and in supine position. The outcome measures studied were, duration of second stage of labour, mode of delivery, 2nd degree perineal tears, Apgar scores at 5 minutes, NICU admission rate and patient satisfaction.Results: The mean duration of second stage of labour in kneeling group was shorter by 14.901 minutes. The rate of vaginal delivery was comparable for both primigravidas and multigravida in kneeling and supine groups, RR: 2.275, 95% CI (0.7872-6.5831) and RR: 1.633, 95% CI (0.393-6.775). Primigravidas had more 2nd degree perineal tears in kneeling group as compared to supine, RR 4.191, 95% CI (1.54 to 11.41). No difference in Apgar scores >7 at 5 minutes was observed in both groups, however, significantly lesser babies in kneeling group were admitted in NICU, RR 0.246, 95% CI (0.079 to 0.761). There was no difference on comparing satisfaction scores of primigravidas and multigravida in both supine and kneeling position.Conclusions: Kneeling position reduces the duration of second stage of labour and NICU admissions.

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Complications of caesarean section during second stage of labor in a tertiary care hospital

International Journal of Clinical Obstetrics and Gynaecology ◽

10.33545/gynae.2020.v4.i3a.573 ◽

2020 ◽

Vol 4 (3) ◽

pp. 33-34

Author(s):

Dr. Nabnita Patnaik

Keyword(s):

Caesarean Section ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Second Stage Of Labor ◽

Second Stage

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Caesarean Delivery in the Second Stage of Labour at a Tertiary Care Hospital

The Journal of Obstetrics and Gynecology of India ◽

10.1007/s13224-018-1179-4 ◽

2018 ◽

Vol 69 (6) ◽

pp. 558-560

Author(s):

Smriti Bhargava ◽

Nupur Hooja ◽

Manisha Kala ◽

Premlata Mital ◽

Kritika Tulani ◽

...

Keyword(s):

Caesarean Delivery ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Second Stage ◽

Second Stage Of Labour

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FETO-MATERNAL OUTCOME OF CAESAREAN SECTION DURING SECOND STAGE OF LABOR IN A TERTIARY CARE HOSPITAL: AN OBSERVATIONAL STUDY

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i11.1514 ◽

2020 ◽

Vol 4 (11) ◽

Author(s):

Ruby Kumari

Keyword(s):

Caesarean Section ◽

Observational Study ◽

Tertiary Care ◽

Neonatal Morbidity ◽

Cervical Dilatation ◽

Care Hospital ◽

Maternal Complications ◽

Second Stage ◽

Second Stage Of Labour ◽

The Mean

Aim: To highlights the maternal and neonatal outcome of caesarean section in second stage of labour. Methods: This prospective observational study was carried out in the Department of Obstetrics and Gynecology at Government Medical College and Hospital Bettiah, Bihar, India from December 2017 to December 2018. total of 24600 women delivered by caesarean section, 16800 emergency and 7800 elective cases. Of these 400 were at full cervical dilatation, >37 weeks gestation with a singleton fetus in cephalic presentation. All caesarean sections performed at full cervical dilatation over the time period of 1 year at a government hospital were included. Results: Among the 400 patient’s majority of them were in the age group of 20-30 years (72.5%). about 75.5% of the patients were primigravidae and only the remaining 24.5% were multigravida. The commonest indications for doing caesarean section in the second stage of labour were cephalo pelvic disproportion, fetal distress and obstructed labour. Incidence of PPH is 48 out of 400 cases (12%). Post-operative wound infection was seen in 23(5.75%) and Post-operative fever was seen in 70(17.5%) out of 400 cases. There were no cases of maternal deaths reported. The mean operative time was 52.9 min .The mean length of hospital stays was 6.6 days. Mean weight of the babies of the second stage caesarean section was 3.2 kg. Conclusions: Caesarean sections done in second stage of labour are associated with several intra-operative maternal complications and neonatal morbidity. Keywords: Caesarean complications; emergency caesarean section; maternal morbidity; neonatal morbidity

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