scholarly journals Evaluation of Postoperative Analgesic Consumption After Emergency and Elective Cesarean Section

2018 ◽  
pp. 1
Author(s):  
Hakan Tapar ◽  
Serkan Karaman ◽  
Serkan Dogru ◽  
Tugba Karaman ◽  
Hatice Yilmaz Dogru
Keyword(s):  
Caesarean Section ◽  
General Anesthesia ◽  
Elective Caesarean Section ◽  
Pain Scale ◽  
Emergency Caesarean Section ◽  
Elective Cesarean Section ◽  
Analgesic Consumption ◽  
Emergency Caesarean ◽  
Post Operative Pain ◽  
Elective Cesarean

<p><strong>OBJECTIVE:</strong> This study compares post-operative pain and analgesic consumption among patients who have undergone either an emergent or elective caesarean section.</p><p><strong>STUDY DESIGN:</strong> A total of 115 patients, comprised of 48 emergency caesarean section and 67 elective caesarean section patients, were enrolled in this prospective study. Pain intensity was evaluated with a numeric pain scale in the 1st, 2nd, 6th, 12th and 24th post-operative hours and total post-operative tramadol consumption within 24 hours was recorded for each patient.</p><p><strong>RESULTS:</strong> Total tramadol consumption for emergency caesarean section patients under general anesthesia was 222.91±56.52 mg and for elective caesarean section patients under general anesthesia was 181.71±55.38 mg (p&lt;0.05). In patients under spinal anesthesia, total tramadol consumption was found to be 169.58±59.52 mg and 160.62±70.47 mg in emergency and elective cases respectively (p&gt;0.05).</p><p><strong>CONCLUSION:</strong> Analgesic consumption for emergency caesarean section patients under general anesthesia was observed to be high.<br /><br /></p>

scholarly journals BLOOD LOSS DURING EMERGENCY CAESAREAN SECTION OF PLACENTA PREVIA IS MORE AS COMPARED TO ELECTIVE CAESAREAN SECTION

2021 ◽  
Vol 31 (03) ◽  
pp. 146-150
Author(s):  
Sardar Muhammad Alfareed Zafar Zafar ◽  
Mehvish Ilyas ◽  
Saima Saeed Usmani ◽  
Maryam Javaid ◽  
Rizwana Tariq
Keyword(s):  
Caesarean Section ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Cesarean Section ◽  
Placenta Previa ◽  
Emergency Caesarean Section ◽  
Elective Cesarean Section ◽  
Emergency Caesarean ◽  
Elective Cesarean ◽  
The Mean

Background: Placenta Previa is one of the major obstetric complication. It is a serious condition that may lead to severe morbidity and mortality. The risk of cesarean and blood loss, particularly, in emergency cesarean section. Objective: To compare the mean blood loss and need for blood or blood products with emergency versus elective cesarean section in females with placenta previa. Study design: Cohort study. Settings: Department of Obstetrics & Gynaecology. Duration: 3 months (April to June 2020). Method: Sample size of 70 patients were enrolled in the study through Non Probability, Consecutive Sampling. Patients of age 20-40 years, presented >24 weeks of pregnancy, with diagnosis of placenta previa were included. Then females were booked and were followed-up in OPD till delivery. Emergency cesarean section was done if active labor and bleeding started while elective cesarean was done on given date for delivery. Intraoperative blood loss and need for blood or blood components transfusion was noted. Data was recorded on proforma and analyzed by using SPSS version 22. Results: The mean age of females in emergency group was 30.80 ± 4.36 years and mean age of females in elective group was 31.06 ± 3.76 years. The mean gestational age of females at delivery in emergency group was 35.74 ± 2.89 weeks and in elective group was37.54 ± 0.70 weeks. The average blood loss during emergency caesarean section was 1471.43 ± 891.65 ml while during elective cesarean section, average blood loss was 1042.86 ± 402.41 ml (p<0.05). In emergency caesarean group, 7 (20%) did not require blood transfusion while 28 (80%) required blood transfusion. In elective caesarean group, 21 (60%) did not require blood transfusion while 14 (40%) required blood transfusion (p<0.05). Conclusion: Though this study, we found significantly higher blood loss and need for blood transfusion in emergency caesarean section as compared to elective caesarean sections for placenta previa.

scholarly journals Profile of Caesarean Section at Kathmandu Medical College

2017 ◽  
Vol 15 (2) ◽  
pp. 110-113
Author(s):  
Apurwa Prasad ◽  
Garima Bhandari ◽  
Rachana Saha
Keyword(s):  
Caesarean Section ◽  
Demographic Data ◽  
Elective Caesarean Section ◽  
Emergency Caesarean Section ◽  
Medical College ◽  
Emergency Caesarean ◽  
Clinical Indications ◽  
Depth Study ◽  
Elective Procedure ◽  
Failed Induction

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.

scholarly journals Bupivacaine 0.5% vs. levobupivacaine 0.5% for epidural anaesthesia for caesarean section: a comparative study

2018 ◽  
Vol 7 (2) ◽  
pp. 343 ◽  
Author(s):  
Heena D. Pahuja ◽  
Megha P. Tajne ◽  
Anjali R. Bhure ◽  
Savita M. Chauhan
Keyword(s):  
Caesarean Section ◽  
Epidural Anaesthesia ◽  
Motor Block ◽  
Elective Caesarean Section ◽  
Sensory Block ◽  
Epidural Block ◽  
Elective Cesarean Section ◽  
Significant Difference ◽  
Elective Cesarean ◽  
Mean Time

Background: Levobupivacaine has been purported to be as efficacious as Bupivacaine for epidural anaesthesia in recent literature.Methods: With the intent to study the same in caesarean section cases in our set up, we observed various intra- and post-operative variables in two groups (Levobupivacaine and Bupivacaine) of 60 healthy parturients. Sixty parturients for elective caesarean section were allocated randomly to receive epidural block with 10-20 ml of either 0.5% Levobupivacaine with Fentanyl 25µg or 0.5% Bupivacaine with Fentanyl 25µg to reach T6 level.Results: Mean total volume in Bupivacaine group was 15.23ml and in Levobupivacaine group was 12.76 ml. The difference was statistically significant. There was significant difference between the groups in the sensory block. The onset of analgesia was earlier in Levobupivacaine group. Mean time was 6.20 minutes in Bupivacaine group and 4.36 minutes in Levobupivacaine group. The duration of motor block was significantly short in Levobupivacaine group. Mean Time for recovery from motor block in Bupivacaine group was 2.5 hours and in Levobupivacaine group 1.5 hours. Mean time to achieve T6 height was earlier in Levobupivacaine group i.e. 16.46 minutes in Bupivacaine group and 13.26 minutes in Levobupivacaine group. Duration of postoperative analgesia was similar. There was no significant difference in neonatal outcome.Conclusions: Levobupivacaine was found to fare better than Bupivacaine in the studied intra and post-operative parameters and is hence recommended over racemic Bupivacaine for epidural block in patients undergoing elective cesarean section.

scholarly journals Anaesthetic Management of a Morbidly Obese Parturient for Elective Caesarean Section

2016 ◽  
Vol 10 (2) ◽  
pp. 64-66
Author(s):  
R Pradhan ◽  
S Shrestha ◽  
T Gurung ◽  
AB Shrestha ◽  
KR Sharma
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Epidural Anaesthesia ◽  
Gestational Hypertension ◽  
Elective Caesarean Section ◽  
Anaesthetic Management ◽  
Elective Cesarean Section ◽  
Morbidly Obese ◽  
Elective Cesarean ◽  
Spinal Epidural

Anaesthesia for an obese parturient poses a challenge to anaesthesiologists. Here we report a case of 27 years obese primigravidae at 40 weeks of gestation with gestational hypertension who underwent elective cesarean section under combined spinal epidural anaesthesia. Her intraoperative and postoperative periods were uneventful. 

scholarly journals Maternal and foetal outcome in elective versus emergency caesarean sections

2017 ◽  
Vol 6 (4) ◽  
pp. 1222
Author(s):  
Amit A. Gurunule ◽  
Himangi S. Warke
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
Breech Presentation ◽  
Emergency Caesarean Section ◽  
Tertiary Care Centre ◽  
Emergency Caesarean ◽  
Significant Difference ◽  
Foetal Outcome ◽  
Tract Infections

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.

scholarly journals Elective versus emergency caesarean section: differences in maternal outcome

2019 ◽  
Vol 8 (8) ◽  
pp. 3207
Author(s):  
Anshu Sharma ◽  
Rajiv Acharya ◽  
Yashika Pehal ◽  
Bhawna Sharma
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Fetal Distress ◽  
Emergency Caesarean Section ◽  
Maternal Outcome ◽  
Common Indication ◽  
Emergency Caesarean ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Caesarean section is a life-saving surgical procedure when certain complications arise during pregnancy or labour. The use of CS worldwide has increased worldwide unprecedented levels although the gap between higher- and lower-resource settings remains. The present study evaluates the difference in maternal outcome in elective versus emergency caesarean sections in our institute.Methods: The study included first 65 cases of emergency caesarean section (group A) and during the study period, first 65 elective caesarean section (group B) if they fulfilled the inclusion criteria. Various intra operative and postoperative events were recorded which included intra operative complications, postpartum haemorrhage and transfusion indices.Results: The most common indication of caesarean section in group A was fetal distress (27.7%). In group B most caesarean sections were classified under 5 followed by class 6, the most common indication being previous caesarean section (27.6%). It was observed that pre-operative mean haemoglobin in group A was 10.6 g/dl and in group B was 11.2g/dl. A drop of 1.36 g/dl in group A and 1.10 g/dl in group B was observed in the post-op period. Cross match / transfusion ratio 1.5 in group A and  2 in group B, transfusion probability ratio was 60 % in group A and  66.7%  in group B and transfusion index was 1 in group A and  group B. There was significantly higher contraception acceptance in group B compared to group A.Conclusions: Elective caesarean section has more favourable maternal outcome as compared to emergency caesarean section as the former is done under controlled and planned circumstances.  However, there should be stringent audit to scrutinise indication of caesarean section, outcome of caesarean and blood transfusion practices.

scholarly journals Emergency Caesarean Section: Influences on the Decision-to-Delivery Interval

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Aiste Cerbinskaite ◽  
Sarah Malone ◽  
Jennifer McDermott ◽  
Andrew D. Loughney
Keyword(s):  
Caesarean Section ◽  
General Anesthesia ◽  
Emergency Caesarean Section ◽  
Transfer Time ◽  
Prospective Data ◽  
Nice Guidelines ◽  
Staffing Levels ◽  
Emergency Caesarean ◽  
Labour Ward ◽  
Fetal Compromise

RCOG/NICE guidelines recommend that, for fetal compromise in labour, delivery should be accomplished ideally within 30 minutes. In this study, we investigated the factors which affect the decision-to-delivery (DD) intervals for emergency caesareans. To achieve this, prospective data were collected for all grade 1 and 2 caesareans performed on a busy labour ward over 12 months. We found that the ratio of labouring women to midwives had a significant effect on the DD intervals, which were significantly prolonged when 1 : 1 care was not provided (). The observed effect resulted exclusively from a prolonged transfer time to theatre. General anesthesia use shortened the DD interval for grade 1 caesareans () and was more likely to be used during the day shift (). We conclude that midwifery staffing levels and the form of anaesthesia employed influence on DD intervals for the most urgent caesarean sections.

scholarly journals Post-operative Experience following Caesarean Section in a Nigerian Obstetric Population

2021 ◽  
Vol 2 (1) ◽  
pp. 60-65
Author(s):  
Jamila A Garba ◽  
Abubakar A Panti ◽  
Ahmed Yakubu ◽  
Eze A Ukwu ◽  
Ahmed T Burodo ◽  
...  
Keyword(s):  
Pain Relief ◽  
Caesarean Section ◽  
Outcome Measures ◽  
Elective Caesarean Section ◽  
Cross Sectional Study ◽  
Emergency Caesarean Section ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Patient’S Satisfaction ◽  
Emergency Caesarean

Background: Caesarean section is the most significant obstetrics operative intervention globally. Good postoperative experience after caesarean section is important because there is need for the mother to recover from surgery and take care of her baby. The aim of this study was to assess the experience of women that had caesarean section in the first 24 hours postoperatively. Materials/methods: This was a cross-sectional study conducted among women that had elective and emergency caesarean section. They were followed up to 24 hours post-operative. The primary outcome measures were pain score and satisfaction. Secondary outcome measures were time of mobilization, time of commencement of oral feeds and time of initiation of breastfeeding. Data analysis was carried out using Statistical Package for Social Sciences version 22. Results: The median pain scores among those that had emergency and elective caesarean section ranged between 2 and 3 at all points of pain assessment. The satisfaction was good among 66.1% that had emergency caesarean section and 71.2% among those that had elective caesarean section. However, the difference was not statistically significant (χ2 = 0.546, p = 0.761). More than 90% of the participants that had either emergency or elective caesarean section did not ambulate within the first 24 hours after caesarean section and there was no association between the time of ambulation and the type of caesarean section (χ2 = 0.005, p = 0.941). Conclusion: The participants had adequate pain relief and majority were satisfied with the pain relief. However, the optimum satisfaction was not achieved. The participants did not ambulate early and did not initiate breast-feeding early. Recommendation: Further research is recommended to assess other factors that affect patient's satisfaction and ambulation so as to improve on patient's postoperative care.

In pregnant bitches, is elective caesarean section more effective than vaginal delivery at improving puppy survival?

2020 ◽  
Vol 5 (3) ◽  
Author(s):  
Mullika Borisoot
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Research Question ◽  
Elective Caesarean Section ◽  
Emergency Caesarean Section ◽  
Clinical Expertise ◽  
Bottom Line ◽  
Safe Delivery ◽  
Definitive Answer ◽  
Emergency Caesarean

PICO question In pregnant bitches due to whelp, is elective caesarean section more effective than vaginal delivery to improve puppy survival?   Clinical bottom line Category of research question The category of the research question is regarding the incidence of puppy mortalities as a result of vaginal delivery, emergency caesarean section and elective caesarean section. The number and type of study designs reviewed Two retrospective articles were reviewed and critically appraised; one retrospective study with high single canine breed bias and one study on different canine breeds but limited support in directly answering the PICO question. Strength of evidence The studies selected both had strong uses of experimental designs but together provided weak evidence to determine a definitive answer to the PICO question. Outcomes reported The outcomes from both retrospective studies suggests that the mortality rates of newborn puppies can be reduced if pregnant bitches are scheduled ahead for elective caesareans, in comparison to undergoing an emergency caesarean section when complications develop, particularly in breeds with higher risks of dystocia. Therefore, there is some evidence to support that it may be advantageous to consider the breed, age and overall health of the bitch during pregnancy to determine whether elective caesarean sections, for the safe delivery of puppies, should be considered. Conclusion There are currently insufficient studies, literatures and evidence in veterinary medicine for caesarean sections to become a routine procedure in first opinion practices. Future prospective studies should be conducted and include the optimum anaesthetic protocols with the lowest associated risks for the pregnant bitch and puppies.   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

scholarly journals Maternal and Fetal Outcome in Emergency versus Elective Caesarean Section

2020 ◽  
Vol 18 (2) ◽  
pp. 186-189
Author(s):  
Naveen Darnal ◽  
Ganesh Dangal
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Elective Caesarean Section ◽  
Fetal Outcome ◽  
Emergency Caesarean Section ◽  
P Value ◽  
Age Group ◽  
Common Indication ◽  
Emergency Caesarean ◽  
Emergency Cesarean

Background: Caesarean section is one of the most performed surgical procedures all over the world. It is associated with high morbidity and mortality as compared to vaginal delivery. The present study was carried out to evaluate the maternal and neonatal outcome and complications in two groups of pregnant women who underwent elective and emergency cesarean section, so that measures can be taken to reduce morbidity and mortality in near future.Methods: It was hospital based descriptive cross-sectional study carried out at Paropakar Maternity and Women’s Hospital from October to December 2018. There were 340 patients enrolled in the study 170 in elective and 170 in emergency caesareans selected randomly. Ethical approval was obtained from the Institutional Review Board and informed consent was taken from the patients and patients’ guardians. Data were collected daily from the Operation Theater. Results: The rate of caesarean section in the hospital was 30.7%. Proportion of emergency caesarean section was 1324 (74.4%) and elective caesarean section was 456 (25.6%). Emergency Caesarean section was more common in younger age group and in primigravida while elective Caesarean section was more common in advanced age group and in multigravida. The most common indication for emergency Caesarean section was Fetal Distress and the most common indication for elective Caesarean section was previous cesarean with refused vaginal delivery after cesarean section. The maternal outcome in terms of post-operative wound infection, (post-partum hemorrhage, urinary tract infection need for blood transfusion, fever and need for maternal intensive care unit admission was significantly (p- value <0.05) higher in emergency Caesarean section than in elective Caesarean section .The fetal outcome in terms of birth asphyxia, meconium stained liquor and need for Neonatal ICU admission were significantly (p – value <0.05) higher in emergency Caesarean section than in elective Caesarean section. Conclusions: Maternal and fetal complications were significantly higher in the emergency caesarean section as compared to elective caesarean section group.Keywords: Fetal outcome; emergency cesarean section; elective cesarean section; maternal outcome.

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