scholarly journals A study of feto maternal outcome in primary caesarean section

2021 ◽  
Vol 11 (1) ◽  
pp. 183
Author(s):  
Maitry Mandaliya ◽  
Arti Patel ◽  
Devanshi Shah
Keyword(s):  
Decision Making ◽  
Caesarean Section ◽  
Caesarean Delivery ◽  
Caesarean Section Rate ◽  
Normal Vaginal Delivery ◽  
Previous Caesarean Section ◽  
Common Indication ◽  
Medical College ◽  
Multiparous Women ◽  
A Prospective Study

Background: Primary caesarean section is defined as caesarean section to be performed in women who have not had previous caesarean delivery. The increase in the rates of primary caesarean section is not only due to increased caesarean section in nulligravida but also due to upward rise in caesarean section rates in parous women. Through this study we aimed to examine the frequency and the indications of primary caesarean section in nulliparous and multiparous women.Methods: A prospective study was carried out in the OBGY department of smt. SCL Hospital, NHL municipal medical college from April 2020 to April 2021. All multiparous women with previous normal vaginal delivery who underwent caesarean section this time were included in this study. Patients with previous caesarean section <28 weeks of gestation, patients who did not give consent were excluded from the study.Results: 92% were 20-30 years and are gravida 2 or 3 patients. 85% patients were booked patients. Most common indication of primary caesarean section in parous women was MSL+FD (31%). Difficulty in delivery of the baby was encountered in 45% of cases. Major cause of admission in NICU was MAS.Conclusions: Primary caesarean section has become a major driver of overall caesarean section rate. Decision making on primary caesarean section should be carefully scrutinized, introducing a diagnostic second opinion for all primary caesarean section. Primary caesarean section in both multigravida and primigravida becomes mandatory in many cases to prevent maternal and feta morbidity.

scholarly journals Changing trends in the indication of caesarean delivery in multigravida- experience from a referral center in Eastern India: a prospective study

2020 ◽  
Vol 9 (8) ◽  
pp. 3367
Author(s):  
Nikhil Sebastian ◽  
Anup Pradhan ◽  
Pesona Grace Lucksom
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Clinical Laboratory ◽  
Medical Science ◽  
Normal Vaginal Delivery ◽  
Maternal Request ◽  
Intraoperative Complication ◽  
Multiparous Women ◽  
A Prospective Study ◽  
Pro Forma

Background: Caesarean delivery is one of the commonly performed surgical procedures in obstetrics in today's practice. The objective of this study was to estimate the overall incidence and indications of primary caesarean delivery among multiparous women and to study the immediate maternal and perinatal outcome.Methods: It was a prospective observational study done in Sikkim Manipal Institute of Medical Science, Sikkim, India. It included all pregnant women after 28 weeks of gestation who had normal vaginal delivery in previous pregnancy but underwent caesarean delivery during current pregnancy (n=120) from January 2016 to December 2016. Authors collected data using a pro forma. Relevant history including demographic details, relevant clinical, laboratory and radiological examination, indication for caesarean delivery, details of delivery and neonate, and duration of hospital stay were noted. Data was described using descriptive data like mean and percentages.Results: Out of 1646 deliveries conducted, 49% were by caesarean section. It included 7.29% primary caesarean delivery in multigravida.  Majority of women (27%) were in the age group 25-29. Maternal request was the commonest indication for caesarean delivery (21.66%). Atonic PPH was the commonest intraoperative complication (2.5%). Surgical site infection was the commonest post-operative morbidity (3.33%). There were 51 perinatal morbidity and 2 perinatal mortality. There was no maternal mortality.Conclusions: Caesarean section rates in this study was higher than WHO recommendation (15% versus 49.69%). This shift in trend can be attributed to higher number of maternal request for caesarean delivery which can be avoided by good analgesic facility and good counselling.

scholarly journals A sonographic assessment of previous caesarean section scar: is a reliable safeguard for trial of labour?

2020 ◽  
Vol 9 (4) ◽  
pp. 1520
Author(s):  
Vandana Dhama ◽  
Sonam Gupta ◽  
Rachna Chaudhary ◽  
Shakun Singh
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Prospective Observational Study ◽  
Previous Caesarean Section ◽  
Practical Application ◽  
Singleton Pregnancy ◽  
Common Indication ◽  
Sonographic Assessment ◽  
Previous Cesarean ◽  
Caesarean Delivery Rate

Background: Over the time the caesarean delivery rate has significantly increase worldwide from 18.2% in 2002 to 30.3% in 2012. In parous women, previous caesarean section has been found to be the most common indication for caesarean delivery in as high as 67% cases. Unsecure prediction of the integrity of the scarred LUS during labor appears to be one of the reasons for high repeat caesarean rates. The purpose of this study was to assess the usefulness of sonographic measurement of the lower uterine segment scar before labour for deciding whether it is a reliable safeguard for trial of labour or not in a woman having previous one caesarean delivery.Methods: This study was a prospective observational study, carried out on 108 pregnant women having previous one CS, gestational age >37, singleton pregnancy, cephalic presentation. Trans-abdominal USG was done to measure scar thickness. Trial of labour was given to each patient irrespective of scar thickness. Pregnancy outcome were noted in terms of successful VBAC or emergency LSCS and compared with scar thickness. Correlation between sonographic and intra-operative finding of scar were noted.Results: Result shows strong correlation between scar thickness and successful trial of labour. Scar thickness increases chances of successful vaginal deliveries.Conclusions: Sonographic assessment of previous scar has a practical application to predict the thickness and thinness of previous scar and can be taken as a reliable safeguard for trial of labour after previous cesarean but cut off value above which vaginal delivery could be considered safe is yet to be identified.

scholarly journals Study of the indications for caesarean sections between 20 and 28 weeks of gestation

2017 ◽  
Vol 6 (3) ◽  
pp. 787
Author(s):  
Sudha R. ◽  
Anjali R.
Keyword(s):  
Caesarean Section ◽  
Gestational Age ◽  
Caesarean Delivery ◽  
Caesarean Section Rate ◽  
Scientific Information ◽  
Major Change ◽  
Progressive Increase ◽  
Past Century ◽  
Previous Caesarean Section ◽  
The Common

Background: Major change in the practice of obstetrics over the past century is progressive increase in the frequency of caesarean delivery and recent scientific information show improved survival or decreased morbidity for the neonate when caesarean delivery is performed for extreme prematurity. This study was done to determine the caesarean section rate for sections done between 20 and 28 weeks of gestation and to analyze the indications for such sections.Methods: Institutional based retrospective observational study done in the Obstetrics and Gynaecology Department, Cheluvamba Hospital, MMC&RI, Mysore, Karnataka, India. Caesarean sections done over 5 years from January 1st 2010 till December 31st 2014 are considered for the study. The total number of Caesarean sections done for gestational age between 20 and 28 weeks are noted. The data obtained is analyzed for the indications at the respective gestational ages.Results: Frequency of caesarean section at gestational age between 20 and 28 weeks is seen to be <1%. Out of total 15,906 LSCS cases, 97 (0.6%) patients under went caesarean section between 20 and 28 weeks of gestation. Of the 97 cases, 54 cases (55.67%) were operated at 28 weeks, 17 cases (17.52%) at 26 weeks, 20 cases (20.61%) at 24 weeks, 4 cases (4.12%) at 22 weeks and 2 cases (2.06%) at 20 weeks of gestation. APH in 33 (34.0%), pre-ecclampsia and ecclampsia in 30 (30.9%) cases are found to be the indications for delivery in 61 cases (64.9%). The indications for caesarean sections in 44 (45.3%) cases were previous caesarean section associated with or without pre-ecclampsia and APH as contributory factors.Conclusions: Caesarean section rate for gestational age between 20 and 28 weeks’ gestational age is <1% and there is decreasing trend. Previous caesarean section, APH, ecclampsia and pre-ecclampsia with their complications are the common indications for such sections. The decision to perform first caesarean section and the indication for it is of prime importance.

scholarly journals Outcome of Mode of Delivery in Nulliparous and Multiparous Women Presenting with Early and Late Cervical Dilatation

2019 ◽  
Vol 7 (1) ◽  
pp. 16-20
Author(s):  
Ferdous Ara Shuchi ◽  
Salma Lovereen ◽  
Mst Nazumnnaher Mina
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Cervical Dilatation ◽  
Normal Vaginal Delivery ◽  
Medical College ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
Dilatation Group ◽  
Spontaneous Onset

Background: Knowledge of the patterns of normal and abnormal labour, and of women’s behavior, is fundamental to the formulation of mode of delivery. It is observed that women admitted to hospital early have a higher frequency of obstetric interventions in labour than those admitted later. Objective: To study the outcome of spontaneous onset of labour in nulliparous and multiparous patients. Materials and method: During the study period of 1st July 2008 to 31st Dec 2008, 568 pregnant women admitted in Kumudini Women’s Medical College were included in this study. Mothers were observed since admission with spontaneous onset of labour and followed up till they were released from the hospital. Labour outcome was measured and mode of delivery was compared among nulliparous and multiparous women. Results: Among the nulliparous women, normal vaginal delivery occurred in 71 (23%) patients presented with early cervical dilatation (0-3 cm) and in 142 (46%) patients presented with late cervical dilatation (>4 cm). In nulliparous women caesarean section were needed in 60 (45.8%) patients in early cervical dilatation group and in 35 (19.8%) patients in late cervical dilatation group. In multiparous women, normal vaginal delivery occurred in 66 (25%) patients presented with early cervical dilatation and in 133 (51%) patients presented with late cervical dilatation whereas cesarean section were done in 35 (34.7%) patients and in 25 (15.8%) patients in the two groups respectively. Duration of labour between nulliparous and multiparous was significantly different (8 hours vs. 6 hours). Indication of caesarean section were, 61 (40%) patients due to prolong labour, 48 (34%) due to foetal distress and 44 (26%) due to cephalopelvic disproportion. Conclusion: Normal vaginal delivery occurred more and duration of labour was shorter in patients admitted with advanced labour (cervical dilatation >4cm). Delta Med Col J. Jan 2019 7(1): 16-20

scholarly journals A case study of caesarean sections in referred cases

2021 ◽  
Vol 11 (1) ◽  
pp. 148
Author(s):  
Devanshi Shah ◽  
Arti Patel ◽  
Maitry Mandaliya
Keyword(s):  
Caesarean Section ◽  
Tertiary Care ◽  
Community Health Center ◽  
Normal Vaginal Delivery ◽  
Tertiary Care Centre ◽  
Fetal Head ◽  
Medical College ◽  
Pregnancy And Childbirth ◽  
High Level ◽  
A Prospective Study

Background: Referral is a coordinated movement of healthcare seekers through the health system to reach a high level of care in a small and often fatal window of time. Even physiological processes like pregnancy and childbirth are not free of complications. The purpose of this study is to understand maternal and foetal outcome in caesarean sections in referred cases.Methods: A prospective study was carried out in the OBGY department of SMT.SCL HOSPITAL, NHL Municipal medical college from April 2020 to April 2021. All referred antenatal and intranatal patients to our tertiary care centre with >20 weeks of gestation who underwent caesarean section with referral note.Results: A total 64% patients were referred from community health center. 63.5% patients were referred due to lack of high-risk management services. 211 patients underwent caesarean section while 69 patients had normal vaginal delivery. Difficulty in delivery of the baby was encountered in 53% of cases due to deep engagement of the fetal head. Major cause of admission in NICU was sepsis (38.6%) followed by prematurity (23.8%).Conclusions: Cesarean section is one of the quickest and most efficient method in the delivery of the baby and thus should in considered in patients in critical situations .The millennium development goals defined by united nation includes one goal (MDG 5) towards improving maternal health which still remains a challenge. Thus, improving knowledge of women regarding good antenatal care and strengthening referral services will play a big role in this.

scholarly journals Frequency of Caesarean Delivery on maternal request in a private teaching hospital

2020 ◽  
Vol 24 (2) ◽  
pp. 139-143
Author(s):  
Fozia Umber Quraishi ◽  
Saima Jabeen ◽  
Wajiha Alvi
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Teaching Hospital ◽  
Caesarean Delivery ◽  
Caesarean Section Rate ◽  
Normal Vaginal Delivery ◽  
Maternal Request ◽  
Normal Delivery ◽  
Vaginal Deliveries ◽  
Private Teaching

Introduction: Caesarean section rates are increasing worldwide. There are many reasons for this increasing caesarean section rate one of them is increasing requests by women for caesarean section in the absence of medical indications. Most women think that elective caesarean section is safe both for women and babies. Some clinician also considered caesarean section safe. An increasing rate of caesarean section is alarming in developed as well as underdeveloped countries. Objective: To investigate the frequency of caesarean section on maternal request and factors leading to it in a private teaching hospital. Materials and Methods: This was a cross-sectional descriptive study carried out at Shalamar hospital from 1st May 2018 to 30th April 2019. Women of all ages who were pregnant and were going to have caesarean delivery during the study period at Shalamar hospital. Results: There were 3438 total births during the study period. There were 2380(69%) caesarean section and 1058(31%) were normal vaginal deliveries. Caesarean section rate was 69%. Caesarean sections performed on maternal request were 167(7%) out of 2380 caesarean. Out of these 167 Seventy-two, 43.1% of women were those who already have a previous caesarean section for different non-recurrent indications and now they don’t want the trial of labour and requested for caesarean section. Forty, 24% of women requested for a caesarean section because of fear of labour pains and eighteen, 10.8% were those who had a bad experience of the previous child-birth. Twelve, 7.2% of women had fear of failed vaginal delivery and eight women had fear of trauma to baby and three, 1.8% had fear of perineal trauma during the trial of normal vaginal delivery. Six, 3.6% of women had some social reasons for caesarean section and six, 3.6% had some bad experience of normal delivery of their relatives or friends and two, 1.2% were those who were requesting caesarean section because of their family members preferences. Conclusion: Most of the women requesting for caesarean section were those who had previously trial of labour. We can control the caesarean section rate by proper counselling of pregnant women.

scholarly journals On demand caesarean section: What’s women’s attitude?

1970 ◽  
Vol 2 (2) ◽  
pp. 12-15
Author(s):  
Nira S Shrestha ◽  
Sumita Pradhan
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
University Teaching ◽  
Normal Vaginal Delivery ◽  
On Demand ◽  
Assisted Delivery ◽  
The Right

Objectives: To evaluate the knowledge and attitude of Nepalese women towards mode of delivery and caesarean on demand. Study design: Hospital based cross sectional descriptive study where 200 pregnant women after 37 completed weeks of gestation were recruited randomly and interviewed, and their answers were analyzed. Results: Of the 200 interviewed pregnant women, all of them knew about normal vaginal delivery and caesarean delivery, but only 30% knew about instrumentally assisted delivery and 9% had heard about painless labour. Vaginal delivery was the preferred mode in 93% and 7% preferred caesarean delivery. Only 35% of the interviewed women believed that women should have the right to demand a caesarean section Conclusion: Knowledge assessment of two hundred women regarding the mode of delivery clearly indicates the need for strengthening counseling aspect of antenatal care and awareness program regarding mode of delivery. In Nepal on demand caesarean section is not provided in the University Teaching Hospital. However one third of women still felt that women should have the right to choose caesarean section on demand. Key words: Attitude, mode of delivery, Caesarean on demand. doi:10.3126/njog.v2i2.1448 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 12 - 15

scholarly journals Trial of scar in post caesarean pregnancies

2018 ◽  
Vol 7 (3) ◽  
pp. 1173
Author(s):  
G. Kuppulakshmi ◽  
S. Saranya
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Uterine Wall ◽  
Perinatal Morbidity ◽  
Surgical Incision ◽  
Medical College ◽  
Caesarean Birth ◽  
Obstetric Management ◽  
One Year ◽  
Present Pregnancy

Background: The term caesarean delivery used to describe the delivery of a fetus through a surgical incision of the intact anterior uterine wall. The objective of this study was to analyse the maternal and perinatal morbidity between successful VBAC and failed vaginal delivery in cases selected for trial of labour.Methods: Prospective study conducted in Government RSRM Lying In Hospital, Government Stanley Medical College, Chennai over a period of one year from January 2017 to December 2017.Results: Trial of labour in previous caesarean section was more successful when the interval between previous caesarean and present pregnancy was between two to four years 86.40%. Conclusions: Most patients with a prior caesarean birth are candidates for VBAC. In properly selected women, a trial of labour after one previous low transverse caesarean section constitutes the best and safest form of obstetric management.

scholarly journals Caesarean delivery rate and indications at a secondary healthcare facility in Ibadan, South Western Nigeria: a five-year review

2021 ◽  
Vol 21 (1) ◽  
pp. 320-6
Author(s):  
Waheed O Ismail ◽  
Ibrahim S Bello ◽  
Samuel A Olowookere ◽  
Azeez O Ibrahim ◽  
Tosin A Agbesanwa ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Care Setting ◽  
Primary Care Setting ◽  
Caesarean Section Rate ◽  
Healthcare Facility ◽  
Surgical Skill ◽  
Maternal Morbidity And Mortality ◽  
Study Population ◽  
Caesarean Delivery Rate

Background: Caesarean delivery is an essential surgical skill within the primary care setting aimed at reducing maternal morbidity and mortality. Objectives: To determine the rate and indications for caesarean deliveries with a view to improving on the service delivery in the study area. Methods: A retrospective review of all caesarean deliveries over a five-year period, January 1st, 2012 to December 31st, 2016. Results: A total of 2321 deliveries were recorded during the study duration and 481 of them were through caesarean sec- tion (CS) giving a caesarean section rate of 20.4%. The rate was higher in the multigravida 255 (53.1%). The commonest indication for caesarean section was previous caesarean section 131 (27.2%). Emergency caesarean delivery accounted for 278 (57.8%). Only 16 (3.3%) stayed more than five days postoperatively while the rest, 465 (96.7%), stayed less than five days. There was a gradual yearly increase in rate from 12.1% in 2012 to 19.5% in 2016. Conclusion: The rate of CS in this study has shown a gradual yearly increase with emergency CS having a higher percentage. Early diagnosis and referral of high-risk pregnancies from peripheral hospitals could reduce emergency CS among the study population. Keywords: Caesarean section; rate; secondary healthcare; Nigeria.

CLINICAL STUDY OF PRIMARY CESAREAN SECTION IN MULTIPAROUS WOMEN AT OBSTETRICS AND GYNAECOLOGY DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

2021 ◽  
pp. 7-8
Author(s):  
Kumari Nisha ◽  
Renu Jha ◽  
Kumudini Jha ◽  
Debarshi Jana
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Placenta Previa ◽  
Fetal Distress ◽  
Normal Vaginal Delivery ◽  
Major Surgery ◽  
Obstetrics And Gynaecology ◽  
Emergency Cesarean ◽  
Study Results ◽  
Multiparous Women

Background: Caesarean section is the most commonly performed major surgery among women. The aims and objective of this study was to know the incidence of primary Caesarean section in multigravidas, its indications and to know the maternal and foetal outcome among these patients. Methodology: This was an observational study conducted at Department of Obstetrics and Gynaecology of Darbhanga Medical College and Hospital, Laheriasarai, Bihar. Aim of the study was to study the indication, maternal and fetal outcome in primary cesarean in multiparous women. All multiparous women admitted for delivery were included in the study Results: The total number of deliveries were 3064 and cesarean section were 1026 (33%).The total number of primary cesarean section in multiparous women were 84 constituting 2.7%. In this study, majority of women were Gravida 2. 91.6% of the cases were underwent emergency cesarean section and anesthesia was spinal. Majority of patients were between age group of 22 to 27 yrs (70%). Indications for cesarean section in our study were severe oligohydroamnios (22%), fetal distress (15.4%), and breech presentation (14%), premature rupture of membrane (12%).Intra operative ndings were meconium stained liquor, post partum hemorrhage, thinned out lower segment and extension of incision. Out of 84 cases, 48 cases needed intra operative or immediate post operative blood transfusion. The post operative morbidity was present in 6 cases i.e paralytic ileus, puerperal fever, urinary tract infection and wound gaping. Majority of babies, weighed in the range of 2-3kgs (55%).Out of 84 cases 7 were causes were placenta previa, obstructed labor and fetal distress. Conclusion: Many unforeseen complications occur in women who previously had a normal vaginal delivery. It is recommended that all antenatal patients must be booked and receive proper and regular antenatal care. Also 100% deliveries in multigravida should be institutional deliveries in order to reduce maternal and perinatal morbidity and mortality.

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