scholarly journals INDICATIONS OF PRIMARY CAESAREAN SECTIONS AMONG IRAQI WOMEN IN KARBALA CITY DURING 2018

Author(s):  
EMAN MAHDI MOHAMMAD ◽  
SAAD IBRAHIM AL-GHABBAN ◽  
MOUSA MOHSIN AL-ALAK

Objective: To study the different indications of primary caesarean sections for women attending Karbala Maternity Teaching Hospital and Al-kafeel Super Specialty hospital. Methods: This was cross-sectional study, the sample was 330 women. Over the period from 1st January 2018 to [30]th June 2018. Questionnaire was filled by direct interviews. A pilot study was done; the subjects of the pilot including 20 women with previous PCS, and some modifications were occurred done accordingly. The sample of study was convenient sample including all women for whom PCS was done in the first time, it was 330 women. Then data was entered and analyzed by SPSS program version 22. Results: The commonest age group in this study was (25-29) year, which represent 32.1%. Majority of the study sample (49.7%) were primigravida. The percentage of indications of Caesarean section include fetal distress 22.1%, prolonged labor18.5%, malpresentation 17.3% and amniotic fluid leakage 16.4%. Emergency CS had 43.6%, and maternal request had 21.5%. Conclusion: Largest number of participant were primigravidarum which read big and serious problem for women life in future. Most women had taken regular antenatal care. Fetal distress and prolonged labor were the most common indications for caesarean section. Fetal outcome was good that reflect good antenatal care and perinatal care.

Author(s):  
Daniel W. A. Leno ◽  
Mamoudou E. Bah ◽  
Jerry C. Moumbagna ◽  
Tamba M. Millimouno ◽  
David Lamah ◽  
...  

Background: The frequency of caesarean sections (CS) increased dramatically in the world over the last twenty years. The objective of this study was to evaluate caesarean section practices based on Robson classification in an urban referral hospital in Conakry, GuineaMethods: We conducted a cross-sectional study of 2,266 birthing records collected at the maternity ward of the Coronthie Communal Medical Center in Conakry, from January 1st to December 31st 2016. We included in the study all women who had a caesarean section and whose medical records were complete. Robson's classification was used to classify women into 10 groups based on maternal and fetal characteristics. The relative size of each group, its gross caesarean section rate as well as its contribution to overall caesarean section rate and the main caesarean section indications were calculated.Results: In 2016, 769 caesarean sections were performed out of 2,266 deliveries, corresponding to a hospital section rate of 33.9%. Groups 5 (11.0%), 1 (4.8%), and 3 (4.3%) of the Robson classification were the most contributors to registered hospital caesarean section rate. The main indications for caesarean section were uterine scar in group 5 and acute fetal distress in groups 1 and 3.Conclusions: The systematic reference to the Robson classification could help to identify and avoid the relative indications of the caesarean section in urban Guinea. Besides, increasing induction of labor and strengthening providers’ capacities in emergency obstetric and newborn care services could contribute to reduce caesarean section rates in Guinea.


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.


2018 ◽  
Vol 25 (10) ◽  
pp. 1537-1545
Author(s):  
Muhammad Ikram ◽  
Amna Javed ◽  
Shafqat Mukhtar

Introduction: The cardiotocography (CTG) is more commonly knows aselectronic fetal monitoring (EFM). A cardiotocography measures the fetal heart and the frequencyof uterine contractions. Using two separate disc shaped transducers. Objectives: The objectiveof this study is to co-relate the intrapartum cardiotocography monitoring with fetomaternaloutcome. Study Design: Cross sectional analytical study. Setting: Department of Obstetricsand Gynaecology, Shaikh Zayed Hospital, Lahore, Pakistan. Period: From September 2012 toMarch 2013 (Six Months). Patient & Method: Total 60 patients (pregnant females) fulfilling theinclusion criteria were selected for this study, who were admitted in labour room in early andactive labour. In group A normal CTG monitoring and in Group B women with abnormal CTGmonitoring. Maternal outcomes in terms of mode of delivery and fetal outcome (APGAR Score,neonatal seizures, admission to nursery and time of neonatal discharge were seen). Result: Themean age in group A was 26.13+3.90 years and in group B was 26.53+4.17 years. The meangestational age in group A was 38.40+1.50 weeks and in group B was 36.60+1.59 weeks. Ingroup A, 25 (83.3%) woman were delivered through spontaneous vaginal birth and 4(13.4%)women, who were delivered by caesarean section (for all indication except fetal distress), 1(3.3%) woman by assisted vaginal birth (for all other indications). In group B there were 7(23.8%)women who delivered through spontaneous vaginal birth. 3(10%) women by assisted vaginalbirth (for abnormal CTG monitoring) and 20(66.7%) women by caesarean section (for abnormalCTG). In group A, there were 7(23.3%) neonates who were admitted in nursery, while in groupB, there were 19(63.3%) neonates, who were admitted in nursery. Conclusion: Intrapartumexternal fetal cardiotocography is not a single indicator of fetal distress. An increased caesareansection rate in babies with a pathological cardiotocography stresses on the need for additionaltests to differentiate hypoxic fetuses from non-hypoxic.


2020 ◽  
Vol 19 (2) ◽  
pp. 23-27
Author(s):  
Monira Jamal ◽  
Rajat Kumar Biswas

Background: The leading cause of perinatal morbidity and mortality is prematurity in developed and underdeveloped countries. In one third of the patients with preterm labour, there is associated premature rupture of membranes. The study was conducted to evaluate the clinical presentation of Pre-labour Rupture of Membrane (PROM) in pregnancy and obstetric outcome. Materials and methods: This is a cross sectional study carried out in the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University, Dhaka, between September 2013 to February 2014. About 50 women having PROM with more than 32 weeks gestational age who admitted in the above department for delivery were enrolled in this study. Results: The mean age was found 27.4 ± 4.42 years with range from 17 to 41 years. Forty eight percent of PROM patient were primi and 52.0 percent of patients were multigravida. Six percent patients were illiterate. Almost two third patients were housewives. More than half (54.0%) of the patients were came from poor class income group family. Majority (64.0%) patients had term PROM (>37 weeks) gestational age and the mean gestational age was 38.1 ± 2.7 weeks with range from 32- 40 weeks. More than half (54.0%) didn't received any antenatal checkup. A total of (56.0%) patients had associated disease, out of which anaemia was more common. Twelve percent had diabetes mellitus and 8.0% had UTI infection. Almost two third (64.0%) was vaginal delivery and 18(36.0%) were caesarean section and common indication for caesarean section was fetal distress (38.9%). Two third patients were healthy and 17 patients had morbidities, wound infection is highest (29.4%). The mean birth weight was found 2.74 ± 0.7 kg. APGAR score >7 at 1 minute was found (92.0%) and (94.0%) at 5 minutes of birth of baby after birth. Fetal outcome take home alive (98.0%) and neonatal death 2.0%. Among 50 foetus morbidity develop in 26 cases. Among them respiratory insufficiency is highest (38.5%). Conclusion: Motivation of the patients, health education, improvement of nutritional status of mother, neonatal care service, early diagnosis, treatment, overall institutional delivery is needed for reduction of neonatal morbidity and mortality, as well as maternal morbidity. Chatt Maa Shi Hosp Med Coll J; Vol.19 (2); July 2020; Page 23-27


2020 ◽  
Author(s):  
Lilian Nuwabaine ◽  
Amperiize Mathius ◽  
Patience Annet Nakalega

Abstract Background: Globally, overall prevalence of caesarean section (CS) is estimated at 18.6%, with 27% in high-income countries and 6% in low- and middle-income countries. There is an increase in trends of CS in Uganda from 8.5% in 2012 to 11% in 2016. There have been no studies done to account for the high rates of CS in a rural hospital in Uganda. This study determined the proportion and factors associated with CS delivery at a rural hospital in south western Uganda.Methods: This was a cross sectional study of 321 immediate postnatal women in a rural hospital in south western Uganda. A structured questionnaire and data abstract forms were used to collect information on proportion and factors associated with CS. Eligible participants were enrolled consecutively. Logistic regression analysis was done to identify the factors associated with CS taking into account potential confounders.Results: This study recruited 321 women with mean age of 25.8 ±6.086 years, mean parity 2.6 ±1.673 and mean antenatal care visits of 4.27 ±1.197. The proportion of CS in this study was 38.3% (123/321). Of these, 110 (89.4%) were emergencies and 27(10.6%) electives. Only 8.4% of the respondents were referrals. The commonest indications of CS were fetal distress (28.5%), history of previous CS (18.7%) and poor progress of labour (11.4%). No factors were significantly associated with CS in this study.Conclusion: There is a high proportion of CS in a rural hospital in Uganda and this is three times higher than the WHO recommended CS rates. Majority of CS are emergencies due to fetal distress and poor progress of labour. There is a need for additional studies exploring the reasons for the much higher than expected CS rates.


2013 ◽  
Vol 26 (2) ◽  
pp. 77-80 ◽  
Author(s):  
Rowshan Akhtar ◽  
Afroza Ferdous ◽  
Syeda Nurjahan Bhuiyan

Objective: To study on clinical profile & maternal - fetal outcome of eclamptic patient.Methods: A prospective cross sectional study was done in the department of Obstetrics & Gynaecology in Chittagong Medical College and Hospital from January to December 2010. All patients with eclampsia were included in the study, it was 416. Patients came with convulsion  other than eclampsia e.g. epilepsy, malaria, septicemia, meningitis, encephalitis, cerebral haemorrage, high fever, hepatic coma were excluded.Main outcome measures: Incidence of eclampsia, sociodemographic status, ante natal  care, time interval between attack and admission, level of consciousness was assessed by AVPU(Alert, response to voice, response to pain stimuli, Unconsciousness) score, types of eclampsia patients (antepartum,intrapartum,postpartum), number of convulsion, gestational age distribution of the patients, mode of delivery , maternal and fetal outcome.Results: Total number of deliveries during this period was 13,635. The incidence of eclampsia in this study was 3.05 %. Among 416 patients with eclampsia most of the patients were between 20-25 years (77%), a large number were primi para (72.5%), most of them comes from rural area (76%), most of them belongs to poor socioeconomic condition (72%), 49% patients were illiterate, 60 % patients had no antenatal check up, 52 % patients came after 6 hours of beginning of convulsion, 18 patients (4%) were unconscious, most of the patients had antepartum eclampsia (64%) , number of convulsion was between 5-9 in about 58% case , 63% were delivered by LSCS, 23% mother showed complications of eclampsia, of them pulmonary oedema (7.45%)  and renal failure(6.49%) were common, 35 (8%) mothers were died. Among perinatal mortality 18% baby were stillbirth and 9% were early neonatal death.Conclusion: Eclampsia is still a major killer disease in Bangladesh. It is a preventable  disease if preeclampsia is diagnosed by antenatal care. By giving quality antenatal care, mass awareness regarding the importance of antenatal care, emergency obstetric service in  the upazilla health complex we can prevent eclampsia. Female education, employment,  empowerment is urgently needed to reduce the incidence of this killer diseases. DOI: http://dx.doi.org/10.3329/bjog.v26i2.13784 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(2) : 77-80  


2020 ◽  
pp. 1-2
Author(s):  
Saila Khatri ◽  
Megha S. Patel ◽  
Pankti Jaiswal ◽  
Prakruti Patel

Background: Oligohydramnios is defined as amniotic fluid index <5cm sonographically.5 Various complications to fetus like meconium stained liquor, IUGR, cord around neck, fetal distress, congenital anomaly, low birth weight, low Apgar score which leads to increase NICU admissions are seen. Increase rate of caeserian section compared to vaginal birth exposes mother to further operation related complications.6,7 Methodology: A cross sectional study was carried out among 124 patients who presented with oligohydraminos and got admitted in obstetric ward. Result: Oligohydraminos seen more in gestational age from 36.1 to 42 weeks(51%) and less from 28.1 to 32 weeks(15%). 62% AFI is between 3-5cm and 38% <3cm. Complications like meconium stained liquor(19%), IUGR(18%), cord around neck(15%), fetal distress(21%) also checked in form of low Apgar score (23%),congenital anomaly(4%), NICU admission(62%), increased rate of LSCS(76%) than vaginal delivery(24%) seen.


Author(s):  
Sujata Swain

Background: Gestational diabetes mellitus, most of which progress to type-2 diabetes mellitus is increasing worldwide. Identification of gestational diabetes and control of glucose can reduce such complications and improve maternal and neonatal health.Methods: A hospital based cross sectional study was conducted to find out maternal and fetal outcome of gestational diabetes from January 2014 to September 2015. Data were collected from 500 antenatal women screened out of which 25 had gestational diabetes and 35 women had intermediate hypergylcaemia attending Sriram Chandra Medical College and Hospital Cuttack for delivery.Results: In our study out of 500 patients, 25 mothers were diagnosed as GDM; its prevalence is 5% in our hospital. In GDM group 10 patients out of 25 had history of risk factors, which constitutes 40 % of the patients. The age group at risk of getting gestational diabetes in this study was between 20-35 years in 98.5%of cases. All the mothers with gestational diabetes were of low parity. In this study, nearly 56% of mothers with gestational diabetes had a body mass index of greater than 25. Significant numbers of cases were detected by rescreening at 32 to 36 weeks who are screen negative during the initial screening procedure (i.e. 10% in GDM group). Caesarean section rate was more in GDM group, mostly due to obstructed labour, fetal distress, hypertension, big baby. Complications like trauma to the baby, congenital anomaly, still birth of the baby were infrequent in this study.Conclusions: Pregnancy thought to be the most vulnerable stage of women's life and protecting her health along with her fetus during this period yields a positive impact on the health of future generation. Particular attention should be given during antenatal period to initiate screening programme and treatment protocol for gestational diabetic mothers.


2021 ◽  
Author(s):  
Loyce Kusasira ◽  
David Mukunya ◽  
Obakiro Samuel ◽  
Kiyimba Kenedy ◽  
Nekaka Rebecca ◽  
...  

Abstract BackgroundThe rates for the delayed initiation of breastfeeding in Uganda remain unacceptably high and reasons for this are not well understood. We aimed to determine the prevalence and predictors for the delayed initiation of breastfeeding in Eastern Uganda. MethodsThis study employed a cross-sectional study design. A total of 404 mother-infant pairs were enrolled onto the study between July and November, 2020 at Mbale regional referral hospital (MRRH). They were interviewed on socio-demographic related, infant-related, labour and delivery characteristics using a structured questionnaire. We estimated adjusted odds ratios using multivariable logistic regression models.Results. The rate of delayed initiation of breastfeeding was 70% (n=283/404, 95% CI: 65.3% – 74.4%). The factors that were associated with delayed initiation of breastfeeding were maternal charateristics including: being single (AOR=0.37; 95%CI: 0.19 – 0.74), receiving antenatal care for less than 3 times while pregnant (AOR=1.85, 95%CI: 1.07 – 3.19) undergoing a caesarean section (AOR= 2.07; 95%CI: 1.3 – 3.19) and having a difficult labour (AOR=2.05; 95%CI: 1.25 – 3.35). Infant characteristics included: having a health issue at birth (AOR=9.8; 95%CI: 2.94 – 32.98).Conclusions:The proportion of infants that do not achieve early initiation of breastfeeding in this setting remains high. Women at high risk of delaying the initiation of breastfeeding include those who: deliver by caesarean section, do not receive antenatal care and have labour difficulties. Infants at risk of not achieving early initiation of breastfeeding include those that have a health issue at birth. We recommend increased support for women who undergo caesarean section in the early initiation of breastfeeding. Breastfeeding support can be initiated in the recovery room after caesarean delivery or in the operating theatre. The importance of antenatal care attendance should be emphasized during health education classes.


Author(s):  
Jishma Jose ◽  
Sendhil Coumary Arumugam ◽  
Syed Habeebullah

Background: Caesarean section (CS) rates are rising worldwide and is a major public health concern. There is lack of evidence supporting the maternal and neonatal benefits with the increasing CS rates. Robson’s ten group classification system serves as an initial structure with which caesarean section rates can be analysed. RTGCS helps us to analyse and allow us to bring changes in our practice.Methods: This was a hospital based cross sectional study conducted over a period of 10 months during the year 2018, which involved 1478 pregnant women, out of which 693 underwent CS, those who underwent CS were grouped according to Robson’s Ten group classification system and the data was collected and analyzed.Results: 693 women underwent CS and the overall section rate was 46.88%. Group 5 (previous LSCS) and Group 2 (nulliparous, >37 weeks, induced) contributed the maximum to the overall CS rates (33.9% and 26.3% respectively). The most common indication for caesarean section was previous LSCS (38%), fetal distress (19.2%) and meconium stained liquor (13.7%).Conclusions: Robson’s ten group classification system helps us in auditing the caesarean section rates. Group 5 and 2 contributes the maximum for caesarean section rates. Encouraging and adequate counselling for VBAC, proper training of obstetricians in CTG interpretation would reduce the caesarean section rates.


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