scholarly journals Puerperal complications in elective versus emergency caesarean deliveries

Author(s):  
Ashka Joshi ◽  
Maulesh Modi ◽  
Ami Shah ◽  
Kanupriya Singh ◽  
Haresh Doshi

Background: The aim of current study was to compare puerperal complications in elective vs emergency caesarean section. Though similar complications occur in elective and emergency caesarean sections, this study aims to find out which complications are more common in either of them.Methods: A prospective case comparative study was conducted at GCS Medical College and Hospital, Department of Obstetrics and Gynecology, Ahmedabad from 01 December 2020 to 01 June 2021.Results: The emergency caesarean section (CS) rates (36) were more common in the age group of 21-25 years than the elective CS (32). Emergency CS was most common in primipara women (69). The most common risk factor is previous known history of hypothyroidism and most common indication is known history of previous lower segment caesarean section (LSCS). 10 patients in elective CS and 8 patients in emergency CS had previous LSCS. Body mass index (BMI) of 26 patients in elective CS was ranging between 24.9-29.9 kg/m2 when compared to 28 patients with similar BMI in emergency CS. Overweight patients underwent more emergency CS when compared to elective CS. Most common intra-operative complication was adhesions between rectus sheath and muscle and second most common was dense adhesion. Most common post op complication was breast engorgement and mastitis.Conclusions: There is a significant difference between the number of patients in elective and emergency CS group when common indications are seen (p<0.05). Similarly, statistically significant is observed between the 2 groups when post-operative complications are observed (p<0.05).

2021 ◽  
pp. 57-60
Author(s):  
Dipak S. Kolate ◽  
Meenal M. Patvekar ◽  
Shriraj Katakdhond ◽  
Yogesh Thawal ◽  
Kale DhanaLaxmi ◽  
...  

Background:Acomprehensive study of maternal morbidity and mortality with perinatal outcome in patients with prior LSCS undergoing elective or emergency caesarean section was carried out. With the sky rocketing caesarean section rates worldwide an increasing number of women face the issue of mode of delivery in their current pregnancy. There are conicting reports regarding the safety of a trial for vaginal birth after caesarean delivery (VBAC) in terms of uterine rupture, maternal and perinatal morbidity. The purpose of this study was to evaluate the obstetric and fetal outcomes of patients presenting at term with a history of previous one or more LSCS. Methods:Asix months prospective, observational study was conducted where all patients who had a term pregnancy with a history of previous one or more LSCS were included after obtaining their consent for participation. The obstetric and fetal outcomes of these patients with elective or emergency LSCS in the present pregnancy were noted and tabulated. Adescriptive analysis of these outcomes was carried out. Results: 100 Patients at term, with a history of previous one or more LSCS were studied. 38 patients underwent an elective repeat caesarean delivery and 62 in emergency.Scar dehiscence was seen in 35.5 % of the patients who were presented in emergency with uterine contractions or lower abdominal pain and those were not candidate for a trial for VBAC.All of the complications were signicantly higher in emergency group in terms of both maternal (83.9 % Vs 31.6%) and perinatal outcome (6.5% Vs 0 %). Conclusion:With an increase in the proportion of patients with a history of previous LSCS, it is essential for health care institutions to have proper antenatal counseling regarding plan of delivery and vigilance while operating patients with prior history of LSCS , especially in emergency situation. There should be a well dened management protocol in an effort to decrease the number of complications and bring down the overall maternal morbidity & mortality .


2017 ◽  
Vol 15 (2) ◽  
pp. 110-113
Author(s):  
Apurwa Prasad ◽  
Garima Bhandari ◽  
Rachana Saha

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.


Author(s):  
Amit A. Gurunule ◽  
Himangi S. Warke

Background: Caesarean delivery is defined as the birth of the foetus through an incision in the abdominal wall (i.e. laparotomy) and the uterine wall (hysterotomy). The purpose was to analyze the maternal and foetal outcome in elective versus emergency caesarean sections retrospectively in a tertiary care centre and to analyze the indications of elective versus emergency caesarean sections.Methods: A retrospective observational study of the cases undergoing caesarean sections in KEM hospital, Mumbai, India was carried out during the period of September 2013 to September 2015. Maternal and foetal outcome was studied. The data was collected and analyzed from the maternal medical records. The neonatology records were also examined.Results: Out of the 600 selected patients, 300 patients in each group of elective and emergency caesarean section were studied. The usual indications of emergency caesarean sections were foetal distress, followed by meconium stained amniotic fluid (MSAF) and cephalopelvic disproportion (CPD). The most frequent indicator for elective lower segment caesarean section (LSCS) was patient with previous LSCS not willing for vaginal birth, followed by breech presentation and previous multiple LSCS. There was a significant difference seen in the occurrence of fever, urinary tract infections and wound infections in the two groups. These were more common in the emergency caesarean section group. Significant difference was also seen in the incidence of postpartum haemorrhage in the two groups, which was more in the elective caesarean section group.Conclusions: The maternal morbidity, intra operative and postoperative complications were more in the emergency LSCS group as compared to patients who underwent elective LSCS.


Author(s):  
Pragya Verma ◽  
Dolly Chawla ◽  
Rashmi Khatri ◽  
Preeti Verma

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.


2018 ◽  
Vol 4 (1) ◽  
pp. 23-26
Author(s):  
Rifat Sultana ◽  
Dewan Shahida Banu ◽  
Mahmuda Khatun ◽  
Fatima Dolon ◽  
Mahmuda Nahar ◽  
...  

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


1970 ◽  
Vol 18 (1) ◽  
pp. 82-84 ◽  
Author(s):  
R Khanom ◽  
K Khatun ◽  
S Akter

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


Author(s):  
Osvaldo Reyes

<p>Paciente femenina de 22 años con gestación de 38 semanas. Acude con historia de salida espontánea de líquido transvaginal en su casa, asociado a contracciones uterinas de 6 horas de evolución. Al llegar al hospital, con 3 centímetros de dilatación, 80% de borramiento, cefálico, membranas ovulares rotas, líquido meconial. Monitoreo fetal realizado en el cuarto de urgencias (figura 1) evidencia desaceleraciones profundas de tipología variable, variabilidad disminuida y taquicardia fetal hacia el final del trazo (más de diez minutos). Se realizó cesárea de urgencia, obteniéndose un producto de sexo masculino, APGAR 6/8, de 3200g, con triple circular de cordón al cuello. Evolución satisfactoria post parto.</p><p>22-year-old female patient with a 38-week gestation. She comes with history of spontaneous leakage of transvaginal fluid at home, associated with uterine contractions of 6 hours of evolution. On arrival at the hospital, with 3 centimeters of dilation, 80% effacement, cephalic, ruptured ovular membranes, meconial fluid. Fetal monitoring performed in the emergency room (Figure 1) shows deep decelerations of variable typology, decreased variability and fetal tachycardia towards the end of the line (more than ten minutes). An emergency caesarean section was performed, obtaining a male product, APGAR 6/8, of 3200g, with a triple circular cord around the neck. Satisfactory postpartum evolution.</p>


Author(s):  
Neelam Sharma ◽  
Anshul Jhanwar

Background: Lower Segment Caesarean section (LSCS) is recommended when vaginal delivery might pose a risk to the mother or baby. Worldwide rise in LSCS rate during the last three decades, has been the cause of alarm and needs an in-depth study.Methods: It was a retrospective, observational study conducted in Obstetrics and Gynecology department of Jhalawar medical college, Jhalawar. Data were obtained from medical record database of patients admitted for deliveries from October 2017 to March 2018 over period of six months. The total number of patients delivered and the number of LSCS done were counted to find the incidence of LSCS in our hospital. Age, parity and gestational age of the patients who underwent LSCS were tabulated.Results: In present study the incidence of LSCS was 31.1%. Of these cases 91% belonged to age group 20 -29 yrs. Emergency LSCS (72.1%) and primary LSCS (66.5%) were more common. The commonest indication of LSCS was previous LSCS in 35% followed by foetal distress, breech presentation, severe oligohydrominos and pre-eclampsia.Conclusions: In present study LSCS rate was high as compared to the WHO standard. The scheme like Janani Suraksha Yojana (JSY) may have a great impact on accepting institutional deliveries by poor women which may be a reason of the increase of LSCS in India. Utilization of antenatal care, better doctor patient communication, doctor’s commitment to reduce the rate of LSCS, may help to reduce the increasing rate of caesarean delivery.


Author(s):  
Awosusi, Babatope Lanre ◽  
Adegoke, Omolade Oluwafadekemi ◽  
Nwanji, Ifeanyichukwu Dupe ◽  
Oni, Fola

Aim: To present the case report of an incidental finding of disseminated peritoneal leiomyomatosis (DPL) found during an emergency caesarean section in a young Nigerian woman who presented with slow progress in labour and maternal exhaustion. Presentation of Case: We present the case of a 35-year-old unbooked primigravida with previous myomectomy who presented with maternal exhaustion and slow progress in labour and subsequently had an emergency lower segment caesarean section. At surgery, multiple firm to hard nodules of varying sizes were seen scattered throughout the peritoneum. Histological examination and immunohistochemical analysis of the nodules showed features consistent with disseminated peritoneal leiomyomatosis. Clinical and radiological follow-up for 1 year was uneventful. Discussion: DPL is a rare benign smooth muscle tumour that clinically and macroscopically simulates disseminated intra-abdominal or pelvic malignancy. It occurs predominantly in women of child bearing age and is mostly discovered incidentally. The occurrence of DPL in association with pregnancy and uterine leiomyomas was also corroborated in this index case as pedunculated and intramural uterine nodules were also seen during surgery. Conclusion: Disseminated peritoneal leiomyomatosis is a rare benign disease which may be misdiagnosed as disseminated or metastatic intra-abdominal malignancy. Therefore, a high index of suspicion is required for accurate diagnosis and proper management.


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