scholarly journals Patients’ Lived Experiences of the Care Provided Before and After Caesarean Sections in the City of Tshwane, Gauteng, South Africa

2021 ◽  
Vol 23 (2) ◽  
Author(s):  
Tendani Ramukumba ◽  
Tshidi M. E. Masala-Chokwe ◽  
Takalani Mudau
Keyword(s):  
South Africa ◽  
Caesarean Section ◽  
Lived Experiences ◽  
Caesarean Section Rate ◽  
Elective Caesarean Section ◽  
Multidisciplinary Teams ◽  
District Hospitals ◽  
Before And After ◽  
The City ◽  
Nurses And Midwives

A caesarean section is an incision of the abdomen and uterine walls to deliver the foetus. An emergency caesarean section may be performed if complications during pregnancy or labour arise. Various indications such as abnormal presentation, a previous caesarean section, and other related conditions may need an elective caesarean section. In South Africa, the national average caesarean section rate between 2015 and 2016 was 26.2 per cent, whereas the rate in district hospitals was 24.1 per cent. At a community hospital in the City of Tshwane, the caesarean section rate of 32 per cent in 2015 was recorded as high. The aim of this research was to explore and to describe patients’ lived experiences of the care provided before and after a caesarean section in the City of Tshwane, Gauteng, South Africa. To achieve the aim of the study, a qualitative, exploratory, descriptive study was conducted. The sampling method used was purposive, and the sample size was determined by data saturation. An interview schedule was used to collect the data. The study concluded that some women were satisfied with the care provided, whereas the majority were dissatisfied. The need for strategies to improve such care provided by nurses and midwives was highlighted. Multidisciplinary teams have to acknowledge gaps and develop effective strategies to motivate nurses and midwives in the workplace to provide quality care. Research should be conducted to design an effective nursing framework for caesarean section care.

scholarly journals A clinical study of effect of standard labour protocols on rates of primary caesarean section at a tertiary care centre, Madurai, India

2018 ◽  
Vol 7 (9) ◽  
pp. 3766
Author(s):  
Shanthi C. ◽  
Mahalakshmi N. K.
Keyword(s):  
Clinical Study ◽  
Caesarean Section ◽  
Comparative Study ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
The World ◽  
Before And After ◽  
Failed Induction

Background: Caesarean section rates are on the rise all over the world. Primary caesarean section usually determines the future obstetric course of any woman and therefore should be avoided whenever possible. WHO recommended that caesarean rates should not be more than 15 %. In this view we started our study on how to reduce the rate of Primary caesarean section in Tertiary Care Centre, Madurai, India. The objective of the present study was to evaluate how the implementation of universally acceptable standards affects rates of primary caesarean section rates without compromising maternal and foetal safetyMethods: This a comparative study on the effect of standard labour protocols and guidelines devised after audit of cases from January 2017 to June 2017, on the rate of primary caesarean section rates, induction of labour, failed induction, maternal and fetal outcomes before and after the implementation of the guidelines.Results: Primary caesarean section rates from 52.85% to 45.02% noted in the induced cases. There were no significant adverse maternal and perinatal outcomes.Conclusions: Implementation of standard labour protocols can reduce primary caesarean section rate without compromising maternal or foetal safety.

Incidence of urinary ketosis and the effect of carbohydrate drink supplementation during fasting for elective caesarean section: Audit

2021 ◽  
pp. 175045892110090
Author(s):  
Hannah Bellwood ◽  
Kellie M Rozdarz ◽  
John Riordan
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Caloric Intake ◽  
Preoperative Fasting ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Fasting Time ◽  
Before And After ◽  
The Mean

Elective lower segment caesarean section patients are routinely instructed to fast from food for 6h before surgery, with clear fluids up until 2h before surgery. We conducted an audit examining the true fasting times of mothers undergoing an elective caesarean section and the incidence of urinary ketones before and after introducing a preop carbohydrate drink (Nutricia preOp 400ml) to be administered to all patients at 6am on the day of surgery. We audited 50 patients prior to introducing the preop carbohydrate drink and 54 patients after the introduction of a carbohydrate drink. We found the mean fasting time from last caloric intake was reduced from 13h 35min to 5h 5min after the introduction of a preoperative carbohydrate drink. We found that the incidence of urinary ketones was 40.4% prior to the introduction of a preoperative carbohydrate drink and 38.3% after the introduction of a preop drink (p = 1). If fasting times were limited to under 4h, the incidence of urinary ketones is 10%. Our audit demonstrates that reducing preoperative fasting times is possible and preventing metabolic derangements may be possible, requiring an approach targeted at keeping fasting times to a minimum.

scholarly journals Caesarean Section in a Tertiary Hospital in South-South, Nigeria: A 3-year Review

2021 ◽  
Vol 3 (2) ◽  
pp. 122-127
Author(s):  
Dennis O. Allagoa ◽  
Peter C. Oriji ◽  
Ebiye S. Tekenah ◽  
Lukman Obagah ◽  
Onyekachi S. Ohaeri ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Elective Caesarean Section ◽  
Tertiary Hospital ◽  
Medical Centre ◽  
High Rate ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Life Saving ◽  
Foetal Membranes

Background: Caesarean section is the delivery of the foetus, placenta, and foetal membranes through an incision on the abdominal and uterine walls after the age of foetal viability. It is a life-saving surgical procedure, which has helped reduce maternal and perinatal morbidity and mortality over the years. Objective: To determine the rates, indications, outcomes, and complications of Caesarean section at the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria. Materials and Methods: This research was carried out at the Department of Obstetrics and Gynaecology, Federal Medical Centre (FMC), Yenagoa, Bayelsa State, South-South, Nigeria between 1st January 2018 and 31st December 2020. It was a retrospective study. Data was retrieved from the labour ward records, delivery register, theatre records, and patients’ folders during the period under review, and entered into a pre-designed proforma. Data were analysed with IBM SPSS version 23.0. Results were presented in frequencies and percentages for categorical variables and mean and standard deviation for continuous variables. Results: About 959 women had Caesarean section (CS) out of 2,263 deliveries, giving a Caesarean section rate of 42.4%. The commonest indication for emergency Caesarean section was cephalopelvic disproportion (36.0%), while that for elective Caesarean section was repeat Caesarean section (19.6%). Conclusion: The Caesarean section rate in our Centre is extremely high, almost three times the acceptable upper limit set by the WHO. Encouraging vaginal birth after Caesarean section as a means to reduce this high rate is recommended as it was noted that previous Caesarean section was a leading indication for surgeries.

scholarly journals Evaluation of anaesthetic techniques for caesarean

2018 ◽  
Vol 6 (5) ◽  
pp. 1742
Author(s):  
Alaka Banerjee ◽  
Dhrubajyoti Sarkar ◽  
Banasree Bhadra
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Epidural Anaesthesia ◽  
Regional Anaesthesia ◽  
Caesarean Section Rate ◽  
Elective Caesarean Section ◽  
Anaesthetic Techniques ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Spinal Epidural

Background: The anaesthetic technique to be used in Caesarean section is determined according to factors such as urgency, presence of coexisting health problems, preference of patient and preference and experience of the anaesthetist and surgeon.Methods: This is a retrospective study of all the caesarean deliveries that occurred in the period between 1st Jan 2010 to 31st Dec 2017 in the department of obstetrics and Gynaecology in Silchar Medical College. The anaesthesia techniques used for caesarean sections were evaluated in this study. Anaesthesia methods were recorded as general anaesthesia (GA) and regional anaesthesia (RA), and RA was classified into spinal anaesthesia (SA), epidural anaesthesia (EA) and combined spinal epidural anaesthesia (CSEA) subgroups.Results: During the study period a total of 75685 patients delivered and 25805 patients had undergone caesarean section. The caesarean section rate at the institution comes to be around 34.1%. Among the indications, it was observed that foetal distress (32.8%) was the commonest cause followed by post caesarean pregnancy (26.76%). The majority of the CS (75.6%) were done as an emergency procedure. Regional anaesthesia was the most frequently used method both in emergency (92.87%) and elective caesarean section (84.21%). SA was the commonest used RA (89.2%).Conclusions: In recent years, the rate of regional anaesthesia administration in caesarean section is gradually increasing, and the spinal anaesthesia technique is the mostly preferred regional anaesthesia. There is need to explore the use of the other forms of regional anaesthesia also.

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