scholarly journals Comparison of caesarean section rate and maternal complications in elective induction versus spontaneous labor

Author(s):  
Salma Kousar Beigh ◽  
Samar Mukhtar ◽  
Nighat Firdous ◽  
Fariha Amaan

Background: Elective induction of labor is defined as an initiation of labor, either by mechanical or pharmacological means at a time earlier than nature regardless of a medical or obstetric indication. Objectives were to estimate the proportion of caesarean sections and vaginal deliveries and magnitude of maternal complications following elective induction and spontaneous labor.Methods: The study entitled “comparison of caesarean section rate and maternal complications in elective induction versus spontaneous labor in LD Hospital, Kashmir” was a hospital based observational study, conducted in the Postgraduate Department of Obstetrics and Gynaecology, LallaDed Hospital of Government Medical College, Srinagar over a period of one and a half years.Results: Women in induced labor group had slightly increased risk of caesarean section than those in spontaneous group. Fetal distress was the most common indication for caesarean section in both the groups. There was no difference in both groups regarding maternal complications such as perineal lacerations; postpartum hemorrhage (PPH); need for blood transfusions and post partum hospital stay.Conclusions: Though induction of labor is associated with a slight increased risk of caesarean delivery, it is not related to other maternal complications. Therefore inductions are safe in hands of safe obstetricians.

2018 ◽  
Vol 16 (1) ◽  
pp. 84-88 ◽  
Author(s):  
Keshar Bahadur Dhakal ◽  
Sulochana Dhakal ◽  
Saroj Bhandari

Background: Rising rate of caesarean section since few decades has been a global public health issue.This study is aimed to determine the rate of caesarean section plus examine the indications and complications of caesarean section.Methods: A retrospective cross-sectional study was conducted using secondary data sources at Mid-Western Regional Hospital in Surkhet, Nepal. Data were collected from patients’records ofthe hospital dating from 16 July 2016 to 15 July 2017. All patients who had delivered their baby by caesarean section were included in this study. Data were analyzed by help of SPSS version 21.Ethical approval was obtained from the hospital authority prior to the study.Results: During the study, out of total 3,694 deliveries, 695 (18.8%) were caesarean section. Most of the caesarean section were emergency than elective (83.0% vs 17.0%). Among all women who underwent caesarean section, majority were from 37 to 42 weeks pregnancy (88.5%), age group between 20 and 24 (42.9%) and multiparous (53.5%).Fetal distress (20.1%) was most common among all major indications of caesarean section. Maternal complications due to caesarean section was low (3.7%). Among all complications, Post-partum hemorrhage (30.5%) was the major maternal complication of caesarean section. Most of newborn babies had APGAR score six or more at one minute (94.5%) and five minutes (97.9%).Conclusions: In our study, caesarean section rate was 18.8%, which is higher than WHO recommendation (10 – 15%). Main indication for caesarean section was fetal distress. Maternal and fetal complications were low.


Author(s):  
Shanmugapriya Kumaresan ◽  
Malarvizhi Loganathan

Background: There is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. With this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlights includes the rate of caesarean deliveries in the second stage of labour, the indications for delivery and the associated maternal morbidity in this cohort of women.  Methods: This was a prospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between July, 2016 and December 31, 2017 at government medical college hospital Dharmapuri. The main outcome measures were second stage caesarean section, indications and its maternal morbidity.Results: 250 women underwent caesarean delivery in the advanced labor. Among the 250 patient’s majority of them were in the age group of 21-30 yrs. about 76% of the patients were primigravidae and only the remaining 24% were multigravida. The commonest indications for doing caesarean section in the second stage of labor was cephalo pelvic disproportion and non-reassuring fetal heart rate patterns. The difficult task was delivery of the deeply engaged head, the increased likelihood of intraoperative and post-operative complications.Conclusions: Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and morbidity.


Author(s):  
Joyita Bhowmik ◽  
Amit Kyal ◽  
Indrani Das ◽  
Vidhika Berwal ◽  
Pijush Kanti Das ◽  
...  

Background: The Caesarean section epidemic is a reason for immediate concern and deserves serious international attention. The purpose of this study was to evaluate adverse maternal and fetal complications associated with pregnancies with history of previous caesarean section.Methods: A cross-sectional, observational study carried out over a period of 1 year from 1st June 2016 to 31st July 2017 in Medical College Kolkata. 200 antenatal patients with previous history of 1 or more caesarean sections were included. In all cases thorough history, complete physical and obstetrical examination, routine and case specific investigations were carried out and patients were followed till delivery and for 7 days thereafter. All adverse maternal and fetal complications were noted.Results: Out of 200 women, 30 candidates were tried for VBAC, of them 20 (66.66%) had successful outcome. Most common antenatal complication was APH (5.5%) due to placenta praevia followed by scar dehiscence. There were 12 cases (6.66%) of PPH and 6 cases (3.33%) of scar dehiscence in the study group. 3 cases required urgent hysterectomy due to placenta accreta. 42 out of 196 babies required management in SNCU immediately or later after birth.Conclusions: Women with a prior cesarean are at increased risk for repeat cesarean section. Vigilance with respect to indication at primary cesarean delivery, proper counselling for trial of labor and proper antepartum and intrapartum monitoring of patients are key to reducing the cesarean section rates and maternal complications.


Author(s):  
Bhabani Pegu ◽  
Manju Mehrotra ◽  
Anita Yadav ◽  
Pinky S. K. Sahoo

Background: Intrahepatic cholestasis of pregnancy (IHCP) is one of the commonest pregnancy related liver disorder. Although the maternal course is usually benign, there is an increased risk of spontaneous preterm delivery, fetal compromise, meconium stained amniotic fluid and even intrauterine fetal demise. The objective of this study was to study the incidence of IHCP and its impact on maternal and perinatal outcome.Methods: A prospective study carried out in 68 number of IHCP cases. Diagnosis was done on the basis of clinical and laboratory parameters. All the cases were followed up to the puerperium to find out maternal and perinatal outcome.Results: The incidence of cholestasis of pregnancy was 2.73%. Most (88%) of the cases were presented with generalized pruritus, relived with ursodeoxycholic acid and complete recovery was observed after delivery. The rate of instrumental delivery was 8.82% and caesarean section rate was 30.88%. Most common indication of caesarean section was fetal distress and non-progress of labour. There was one stillbirth at 35 weeks however none of the mother had complication during labour or puerperal period.Conclusions: Increased level of liver enzymes in patients of IHCP associated with poor perinatal outcome. Therefore, careful monitoring during antenatal period and termination of pregnancy at term will result in favourable outcome of both mother and baby.


Author(s):  
Dolly Chavda ◽  
Kamal Goswam ◽  
Kavita Dudhrejiya

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.


Author(s):  
Arabinda Nepak ◽  
Surendra Nath Soren ◽  
Ashish Kumar Karjee

Background: With changing socio-demographic landscape of India, teenage pregnancy has become an important public health issue. The present study was conducted to assess the incidence of teenage pregnancy in Berhampur, Odisha and various maternal and neonatal outcomes of these pregnancies.Methods: This observational study was conducted on 564 antenatal mothers aged 16 to 19 years, who from October 2018 to September 2020. Demographic information of the mothers was noted. Maternal complications during antenatal, intrapartum and postpartum period were noted. Neonatal outcomes, mode of delivery, complications and need for intensive care unit admission was noted. The data collected was described in tabulated form.Results: The incidence of teenage pregnancy at our centre was 4%. Of the 564 teenage pregnancies, 214 were anaemic, pregnancy induced hypertension in 74 and 129 had preterm labour. The caesarean section rate was performed in 51.9%, and the most common indications for caesarean section were fetal distress and cephalopelvic disproportion. Of the 553 live births, 1.04% of them weighed <1.5 kg, 29.16% weighed 1.5 till 2.5 kg, 65.5% weighed between 2.5 to 3.5 kg and 5.2% weighed >3.5 kg. NICU admission was required for 26.9% of the neonates and the most common complication was neonatal jaundice, which was observed in 14.3%.Conclusions: Teenage pregnancies represent a high-risk. The present study demonstrated the various maternal as well as neonatal complications in teenage pregnancies. Those who experience teenage pregnancy should be given extra attention and care.


2017 ◽  
Vol 15 (2) ◽  
pp. 178-181 ◽  
Author(s):  
Padma Gurung ◽  
Sameer Malla ◽  
Sushma Lama ◽  
Anagha Malla ◽  
Alka Singh

Background: There is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. Within this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlight the feto-maternal outcome of caesarean section in second stage of labour.Methods: This was a retrospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between April 1, 2013 and March 30, 2017 at Patan Academy of Health Sciences. The main outcome measures were second stage caesarean section, indications and its maternal and fetal morbidity.Results: During the study period, there were 40,860 deliveries. A total of 18,011 (44%) babies were born by caesarean section, 10484 emergency and 7527 elective. Out of the emergency caesarean section, 200 (1.9 %) were performed in second stage of labor. In this study, the most common indication was cephalopelvic disproportion. (92.4%) were delivered without a trial of instrumental delivery. In terms of maternal complications, atonic post partum haemorrhage uterine incision extension 18 (12.5%), postoperative fever 27(18.8%), wound infection 7 (4.8%) were observed. In perinatal complications, meconium stained amniotic fluid 49(34.2%), neonatal hyperbilirubinemia 14(9.7%) and increased nursery admission 2(15.3%) and 2(1.3%) perinatal mortality were seen.Conclusions: Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and neonatal morbidity.


Author(s):  
Vaishali Chaurasia ◽  
Sushruta Shrivastava

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.


Author(s):  
Rajib Roy ◽  
Manisha Vernekar

Background: Grand multiparity has been considered as obstetric hazards both to the mother and foetus and thus, viewed with great caution. In present set up grand multiparity is associated with increased likelihood of feto-maternal complications.Methods: The study was conducted to determine the feto-maternal outcome in grand multipara pregnancy.Results: In present study, the prevalence of grand multipara was 0.72% out of 15196 deliveries in the period from September 2010 to august 2012. 79.1% of the grand multipara women belonged to the age group of 31-40 years. A majority of the women were in Para 5. Most of the women had no antenatal care attendance. The highest prevalence of grand multipara women was seen among Muslim community (1.65%). A majority (59.1%) of the women were anemic. Caesarean section rate was 30.0% in our study. Post-partum hemorrhage was the most common complication encountered. 7.0% were macrosomic babies, whereas 8.7% were LBW babies. There were 10 perinatal deaths, birth asphyxia being the most important cause for the perinatal mortality. There were no maternal deaths.Conclusions: Our study demonstrates that, there is increase in antenatal and intra-partum maternal complications like anaemia, hypertensive disorder, preterm labour, increase in the rate of caesarean section, PPH etc., leading to severe maternal morbidity. So, the study concludes that in grand multipara pregnancy, both the woman and the fetus are at a greater risk during pregnancy and labour. This risk can be effectively reduced with good antenatal care and delivery by trained personnel.


Author(s):  
Vijay L. Badge ◽  
Sumit Suresh Aggarwal ◽  
Deepti D. Ambalkar ◽  
Arun Humne ◽  
Neethika Raghuwanshi

Background: Caesarean section is one of the commonly performed surgical procedures in obstetrics and is certainly one of the oldest operations in surgery. One of the most dramatic features of modern obstetrics is the increase in the caesarean section rate. The present study was conducted to estimate proportion of various indications of LSCS and also to assess socio demographic profile of mothers undergoing caesarean section in a tertiary care centre. Methods: The present cross sectional observational study was conducted at Government Medical College & Hospital, Akola in the post natal ward (PNC). Non probability convenient sampling method was used. All patients admitted to PNC ward after LSCS were included in study. For data collection paper based pre tested, semi –structured questionnaire was used. Results: Previous LSCS was indication for LSCS in 32% cases. Eclampsia, preeclampsia and Anaemia were the indications for LSCS in 19.3%, 8.6% and 5.3% cases respectively. Other common indications includes CPD, meconium stained liquor, fetal distress, breech presentations, twin pregnancy and preterm labour. Conclusions: The proportion of LSCS is more than WHO recommended proportion of LSCS. It may be due to present institute acts as tertiary care center. Still this proportion is high, so encouragement should be given to trial of labour in selected low risk cases and in Primi patients whenever possible. 


Sign in / Sign up

Export Citation Format

Share Document