scholarly journals Perinatal Outcome of Deliveries after One Previous Caesarean Section

2015 ◽  
Vol 3 (1) ◽  
pp. 19
Author(s):  
Narinder Kaur ◽  
Sushila Jain
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Previous Caesarean Section ◽  
Lower Segment Caesarean Section ◽  
History Of ◽  
Live Fetus ◽  
The Right ◽  
A Prospective Study

Introduction: Contrary to the WHO recommended caesarean section (CS) rate of 15%, there is an alarming trend of increasing caesarean section rates. An important reason for this is repeat caesarean section (RCS). Vaginal birth after caesarean (VBAC) is one of the methods of reducing CS rates in women with history of previous CS. This study was done with the aim to see the maternal and fetal outcome among parturient with history of single previous caesarean section and to determine the rate of VBAC at Lumbini Medical College, Nepal. Methods: This is a prospective study done for a period of ten months. Seventy parturient fulfilling inclusion criteria of term pregnancy with single live fetus and history of one Lower Segment Caesarean Section (LSCS) were enrolled in the study. Patients meeting the criteria for VBAC were given trial of labour and others were taken for elective repeat CS. This cohort was analyzed further, with respect to age, parity, period of gestation, mode of delivery, indication for CS, maternal and fetal complications and outcomes. Results: VBAC was successful in 27.14% of patients (n=19) while the rest 51 (72.85%) underwent RCS . Indications for RCS was mainly scar tenderness 7 (13.7%), fetal distress 6 (11.7%), non progress of labour 6 (11.7%), meconium stained liquor 6 (11.7%) and post-dated pregnancy 6 (11.7%). Maternal morbidity was comparable in women undergoing RCS or VBAC. There was one still birth and one early neonatal death in each group due to complications of meconium aspiration. Conclusion: Patients with previous CS are at high risk of RCS. If trial of labor is allowed under careful patient selection and supervision, the rate of vaginal delivery after caesarean section can be increased safely. As there is no added perinatal morbidity and mortality in cases of VBAC as compared to RCS, VBAC shows the right way forward to decrease the rate of caesarean section.

scholarly journals FETAL BIOPHYSICAL PROFILE

2010 ◽  
Vol 17 (04) ◽  
pp. 670-675
Author(s):  
BUSHRA BANO ◽  
UZMA HUSSAIN ◽  
BUSHRA ZAHID
Keyword(s):  
Caesarean Section ◽  
Apgar Score ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Fetal Hypoxia ◽  
Effective Technique ◽  
Biophysical Profile ◽  
Fetal Movements ◽  
History Of ◽  
One Year

To evaluate fetal Biophysical Profile as an effective technique for the assessment of fetal condition and to improve fetal outcome by early detection of fetal hypoxia. Design: Co relational study: Place and Duration of Study: The study was carried out for a period of one year from Oct 2004-Oct 2005 at Obstetrics and Gynecology Department of Fatima memorial hospital Lahore. Patients and Methods: All patientswith history of sluggish fetal movements and clinical suspicion of IUGR, were underwent BPP from 32-42weeks. 100 patients were selected and their BPP score was recorded and were followed till delivery. Those who went into spontaneous labor and who were induced monitored during labor and at any sign of fetal distress immediate caesarean section performed. APGAR score of newborn was noted at one and five minutes and those having poor APGAR score were resuscitated and were followed till one week after delivery. APGAR score was compared with BPP score. Results: During this study 100 BPP were performed. 34patients were primigravidas and 66 were multigravidas. Among 100 patients 73had a BPP score of 9-10/10, 21 patients had a score of 7-8/10 and 6 patients had 4-6/10.In 2 patients with 4/10score emergency caesarean section led to the delivery of neonates with APGAR score of 8 at 5 minutes. Majority of patients with normal BPS of 8-9/10 had good APGAR score of 7- 8/10.Only 8 patients having BPP of 9-10/10 had poor APGAR score 6/10 or <6/10. Conclusion: The fetal BPP appears to be an effective technique for assessment of fetal condition.

scholarly journals CARDIOTOCOGRAPHY

2018 ◽  
Vol 25 (10) ◽  
pp. 1537-1545
Author(s):  
Muhammad Ikram ◽  
Amna Javed ◽  
Shafqat Mukhtar
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Vaginal Birth ◽  
Cross Sectional ◽  
Group A ◽  
Group B ◽  
Labour Room

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.

scholarly journals The maternal and fetal outcome of repeat previous one caesarean section

2021 ◽  
Author(s):  
Uma Jain ◽  
Deepali Jain ◽  
Shaily Sengar ◽  
Preeti Gupta
Keyword(s):  
Caesarean Section ◽  
Placenta Previa ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Bladder Injury ◽  
History Of ◽  
Caesarean Hysterectomy ◽  
Placenta Accrete

Background: The rates of adverse maternal and neonatal outcomes have increased significantly in the last decade. Patients with repeated caesarean deliveries also have a greater risk of placenta previa, placenta accrete, uterine rupture, bowel and bladder injury, and unplanned hysterectomy.Methods: This retrospective study was performed between 01 April 2017 to 31 March 2021, at a private hospital to know about the surgical difficulties and maternal and neonatal complications encountered in cases of repeated LSCS. The outcome of 1028 women admitted with a history of previous LSCS was studied.Results: The 613 patients were given a trial of labour. 40.07% of patients delivered normally. The most common indication for repeat LSCS was CPD in 20.94% and fetal distress 20.12%. The most common complication observed was adhesion in 37.65%. Scar dehiscence in 8.92 %, scar rupture in 0.64%, uterine atony in 4.8%, placenta previa in 3.57%, placenta accrete in 0.64%, injury to the bladder was seen in 0.97%, caesarean hysterectomy was done in only 2 cases and gaped wound was found in 1.13% of cases. 19.15% of neonates were admitted to NICU. Apgar score <7 at 5 minutes in 14.77%. premature neonates were 8.44% RDS was found in 7.62%, birth asphyxia was found in 2.92% cases and neonatal sepsis was found in 1.13%.Conclusions: The dramatic increase in caesarean section rates over the past three decades has been associated with a corresponding increase in maternal morbidity but there a continuous decrease in neonatal morbidity and mortality rates because of advances in neonatal medicine.

scholarly journals Incidence and indications of LSCS among Doctors Community of Chattogram

2021 ◽  
Vol 20 (2) ◽  
pp. 37-40
Author(s):  
Adiba Malik ◽  
Kamrun Nessa ◽  
Yasmin Ara Begum ◽  
M Jalal Uddin ◽  
Aklima Sultana ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Placenta Previa ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Left Ventricular ◽  
Subsequent Pregnancy ◽  
Cross Sectional ◽  
Lower Segment Caesarean Section

Background: Lower segment caesarean section (LSCS) is a surgical intervention, which is carried out to ensure the safety of mother and baby when vaginal delivery is not possible or when danger to mother and baby would be greater with vaginal delivery. This study is designed to identify indication of LSCS and detect complications if any among the respondents. Materials and methods: Cross sectional descriptive study where 95 female doctors of Chattogram were selected by convenient sampling without knowing their mode of delivery and if it is LSCS then indication of LSCS , maternal and neonatal complications were noted. Results: Age of the respondents at the time of interview were noted and most of them were between 31- 40 years 52 (55%), regarding income most of them between 100000 -200000 42(44%) most of the delivery occurred in the private clinics 92 (70%) regarding mode of delivery, LSCS was 92 (70%) vaginal delivery 40 (30%) regarding indications of LSCS most common was repeat caesarean section 27 (29%) and second common was LSCS due to maternal interest 18 (20%) and others were severe preeclampsia 10 (11%) fetal distress 08(09%) placenta previa, Diabetes with big baby, cephalopelvic disproportion, PROM with non progression of labour. PPH was the most common complication 05 (63%), next was paralytic ileus 02 (25%) and left ventricular failure 01 (12%). Common neonatal comoplications were low birth weight baby 904 (40%), prematurity 03 (30%) and birth asphyxia 03 (03%). Conclusion: LSCS is a major surgical procedure for delivery. Inspite of its low maternal morbidity and mortality due to improved surgical technique, modern aneasthetic skill and availability of blood and blood products, still it carries a slightly greater risk in subsequent pregnancy, so we should be rational in doing primary caesarean section. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 37-40

scholarly journals FETAL OUTCOME;

2017 ◽  
Vol 24 (03) ◽  
pp. 462-465
Author(s):  
Afsheen Memon ◽  
Aisha Abdullah Sheikh ◽  
Anisa Kamal
Keyword(s):  
Caesarean Section ◽  
Apgar Score ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
High Rate ◽  
P Value ◽  
Study Group ◽  
Nuchal Cord ◽  
Nicu Admission

Objectives: To compare the effect of nuchal cord versus without cord aroundthe neck on mode of delivery and fetal outcome. Study design: Case control comparativestudy. Period: 1st August 2013 to 31st March 2014. Setting: Gyn /Obs Department at Sir SyedHospital Karachi. Material and Methods: A comparative study was carried out on 2 groupsof parturient ladies. The study group comprised of those ladies who at the time of delivery(vaginal delivery/caesarean-section) had clinically cord around the neck while the other group(control) did not have nuchal cord. Duration of labour, mode of delivery were noted. Perinataloutcome was measured in terms of Apgar score and NICU admission. High risk pregnancieswere excluded from the study. Result: Incidence of nuchal cord at the time of delivery was22.7%. A high rate of caesarean delivery observed in study group as compared to controlgroup (70 % vs 40%) (P value 0.00006). Fetal heart rate irregularities & meconium stainedliquor finding was not significantly different in two groups (p< 0.161) & (p<0.169) respectively.Similarly fetal outcome measured in terms of Apgar score at 1 & 5 min & NICU admissionwas also not significantly different between the two groups. Conclusion: A significant highrate of caesareans section rate was observed in the study group mainly due to fetal distress(FHR irregularities). This means cord around the neck is a risk factor & needs extra monitoringspecially through intermittent CTG monitoring during labour so that fetal distress can be pickedup early & emergency caesarean section can be performed to avoid fetal compromise.

scholarly journals Maternal and perinatal outcome of pregnancy in women with one previous caesarean section-a study at a tertiary care centre

2020 ◽  
Vol 9 (12) ◽  
pp. 5055
Author(s):  
Deepthi Venkatesh ◽  
Varun G. Huilgol ◽  
Gopalkrishna B. Huilgol
Keyword(s):  
Caesarean Section ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Previous Caesarean Section ◽  
Tertiary Care Centre ◽  
Hospital Department ◽  
Mortality And Morbidity ◽  
Select Group ◽  
History Of ◽  
Obstetric Population

Background: Increasing rates of primary caesarean section has led to an increased proportion of obstetric population with history of prior caesarean delivery. There is growing concern by obstetrician for optimizing the management of these high risk cases. The present study was undertaken to evaluate obstetric and fetal outcome of patients presenting at term with history of one previous LSCS.Methods: This was a prospective hospital based observational study conducted at Vani Vilas Hospital and Bowring and Lady Curzon Hospital, Department of OBG, BMC and RI, Bangalore. The study included 300 patients who had undergone previous one LSCS with term pregnancy.Results: Majority of patients, that is 186 (62%) were in the age group of 21 to 25 years. Out of 300 patients, 94 (31.33%) patients went for repeat LSCS without trial. 206 (68.67%) patients were included in the trial of labour group, out of which 109 (52.9%) patients had successful vaginal delivery. 97 (47.1%) patients went for repeat LSCS in trial group due to various indications, commonest being scar tenderness.Conclusions: Delivery of patients with previous caesarean section should always be conducted in a well-equipped hospital where facilities for immediate intervention are available if necessity arises. These patients should be counselled antenatally regarding institutional delivery, encouraging trial of labour after caesarean section in select group of patients with close fetal and maternal monitoring for early detection of complications and its management reduces maternal and perinatal mortality and morbidity.

scholarly journals ABNORMAL CARDIOTOCOGRAPHY;

2014 ◽  
Vol 21 (06) ◽  
pp. 1087-1091
Author(s):  
Saima Perveen ◽  
Farrukh Naheed ◽  
Mussarat Sultana ◽  
Azra Sultana
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Apgar Score ◽  
Case Series ◽  
Fetal Distress ◽  
Lateral Position ◽  
Fetal Outcome ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Case Series Study

Objective: To observe the effect of abnormal Cardiotocography to delivery interval on perinatal outcome in terms of Apgar score. Study design: Descriptive case series study. Place and duration of study: Baqai Medical University department of obstetrics and gynecology Fatima Hospital Karachi from Jan 2011 to July 2011. Material and method: One hundred patients were registered who had pathological Cardiotocography. Bishop’s score was noted and decision to deliver the patient was made according to the abnormality, and bishop’s score. If bishop’s score was good and vaginal delivery was imminent, then her second stage was shortened by operative vaginal delivery. Fetal distress was managed by left lateral position, O2 inhalation and hydration. If delivery was not imminent then decision of urgent LSCS was made, meanwhile fetal distress was managed. Decision – delivery interval was recorded, and fetal outcome was noted in terms of Apgar score and resuscitation needed. Results: During this period one hundred pregnant women at term had pathological CTG for which they were delivered urgently. Among them 12% of parturients were delivered within 30 min ,68% delivered within 30-60 min , 12% delivered in 60-90 min and only 8% were delivered in 90-120 min. Seventy four (74%) of parturients were delivered by emergency lower segment caesarean section and 26% of parturients were delivered by instrumental vaginal delivery. Fetal outcome in terms of 1 min Apgar score ,38% of neonates had Apgar score of <7 ,46% had >7 and 16% had Apgar score of <5. This group of neonates required resuscitation and 5 min Apgar was good. No neonate was admitted in Neonatal unit. Conclusions: In this study it is concluded that with fetal heart rate abnormality, if fetus is delivered within 60 min, it is not associated with poor fetal and neonatal outcome, provided fetal distress is managed while preparing for emergency lower segment caesarean section.

scholarly journals AN OBSERVATIONAL STUDY OF PRIMARY CAESAREAN SECTION & THEIR OUTCOMES IN MULTI-PAROUS WOMEN

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Narendra Vaghela
Keyword(s):  
Caesarean Section ◽  
Postpartum Haemorrhage ◽  
Early Recognition ◽  
Demographic Data ◽  
Operative Procedure ◽  
Fetal Distress ◽  
Clinical History ◽  
Clinical Analysis ◽  
Fetal Outcome ◽  
A Prospective Study

Background: The most frequently performed life-saving operative procedure in women & newborns is the Caesarean section. Maternal & fetal complications can be minimized by awareness of the need for caesarean section in multi-parous women. Aim & objective: To study the indication, maternal & fetal outcome in primary caesarean in multi-parous women. Methodology: The present research was a prospective study performed on multi-parous women who had undergone caesarean section for the first time in prior pregnancies who had delivered vaginally. Data was obtained using a pre-tested questionnaire. Demographic data, clinical history & clinical analysis were included in the data. Results: The majority of patients were 21-25 years of age (53 percent), followed by 26-30 years of age (28 percent). Second gravida (57 percent) was the bulk of the patients, followed by third gravida (28 percent). Fetal distress (19 %) accompanied by mal-presentations (14%) & oligo-hydramnios was the most common sign for the caesarean section (14 percent). Atonic postpartum haemorrhage (PPH), which was seen in 7 percent of patients, was the most frequently observed complication. Conclusion: Early recognition of complications in multi-para & proper management including caesarean section will improve maternal & fetal outcome. Keyword: multi-parous women, primary caesarean section, postpartum haemorrhage.

scholarly journals Prelabour Uterine Rupture In Two Patients With A Previous Caesarean Section For Placenta Previa

2020 ◽  
Author(s):  
Miriam Dellino ◽  
Francesco Maria Crupano ◽  
Xuemin He ◽  
Antonella Vimercati
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Uterine Rupture ◽  
Placenta Previa ◽  
Fetal Outcome ◽  
Pregnancy Complication ◽  
Previous Caesarean Section ◽  
Careful Evaluation ◽  
Spontaneous Uterine Rupture ◽  
History Of

Abstract Background Spontaneous uterine rupture is a severe pregnancy complication. Several risk factors have been described, especially for women with a previous caesarean section.Method We reported two cases of uterine rupture (UR) occurred outside of labour in patients with a history of caesarean section for placenta previa were reports. Results The current study evaluates how a higher hysterotomy, combined with some risk factors, can increase the prevalence of UR in the next pregnancy. Conclusion These cases presentation provide a supplement to over-all knowledge about UR showing that a careful evaluation of risk factors could promote the early UR management and consequently, improve the maternal-fetal outcome.

scholarly journals Profile of Caesarean Section in Kirtipur Hospital

2014 ◽  
Vol 9 (2) ◽  
pp. 51-54
Author(s):  
P Pradhan ◽  
S Shrestha ◽  
P K Rajbhandari ◽  
G Dangal
Keyword(s):  
Caesarean Section ◽  
Previous History ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
High Rate ◽  
Age Group ◽  
Acceptable Range ◽  
Operative Complications ◽  
History Of ◽  
Case Files

Aims: This study was done to find out the incidence and outcome of caesarean sections done at Kirtipur Hospital. Methods: This was a retrospective study conducted from 1st January 2009 to 31st December 2013. Case files of 660 patients who underwent caesarean section for various indications were analyzed for incidence, indication of caesarean section, booking status, parity, and maternal and fetal outcomes. Results: Out of 1295 deliveries, 50.9% (n=660) had caesarean section. Most of the caesarean section was done for fetal distress (40.2%; n=265) and on account of previous history of caesarean section (13.5%; n=89). Majority of caesarean section (44.4%, n=293) was done in age group of 25-29 years. Among them, 65.9% (n=435) were nulliparous. There were 35.3% (n=563) booked cases. Emergency caesarean sections were performed in 62.4% (n=412) cases. Maternal morbidity was less (7.2%, n=48). Conclusions: The study showed high rate of caesarean section. The most common indication was fetal distress. Post-operative complications and fetal outcome were within acceptable range. DOI: http://dx.doi.org/10.3126/njog.v9i2.11763  

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