Comparative study of general anaesthesia and spinal anaesthesia in severe pre-eclampsia patients undergoing emergency caesarean section in tertiary care centre

2020 ◽  
Vol 15 (3) ◽  
pp. 87-92
Author(s):  
Shailendra A Satpute ◽  
Author(s):  
Amit A. Gurunule ◽  
Himangi S. Warke

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.


Author(s):  
Shanthi C. ◽  
Mahalakshmi N. K.

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.


2015 ◽  
Vol 10 (1) ◽  
pp. 36-38
Author(s):  
PK Rajbhandari ◽  
P Pradhan ◽  
G Dangal

Aims: This study was done to find out the spinal anaesthesia failure rate necessitating the conversion to general anaesthesia and use of intraoperative supplemental analgesia. Methods: This was a retrospective study undertaken in Kirtipur hospital in 660 patients. Spinal anaesthesia (0.5% heavy bupivacaine 2.2 ml) was given to women who had undergone elective or emergency caesarean section from January 2009 to December 2013. Results: In this study spinal anaesthesia failure rate was 1.66% (n=11/660). Among them complete failed spinal anaesthesia rate was 0.75% (n=5/660) requiring conversion to general anaesthesia. Intraoperative supplemental analgesic and sedation like pethidine, ketamine or midazolam was required in 0.90% (n=6/660). Conclusions: The failure rate of spinal anaesthesia given for caesarean section was low (1.66%) and it was within the acceptable range.


Author(s):  
Lekshminath Gopinath ◽  
Rajani Vaidya

Background: Over the last few decades, there has been an alarming increase in the rate of deliveries by caesarean section (CS) in most of the countries, though the drivers of this trend are not completely understood. In 1985, WHO had proposed that ideal rate for regional CS rates should not exceed 10-15%. The Robson’s classification system is simple, robust and flexible. The study was done as it was important to have a tool to monitor, compare the CS rates in a same setting and between different settings over a period of time and to optimise the CS rates.Methods: It was a retrospective study conducted in the department of obstetrics and gynaecology in a tertiary care centre. The hospital delivery records were reviewed for a period of 15 months from April 2020 to June 2021.Results: The total number of deliveries during the study period was 1016. The total number of CSs was 441 and the total number of vaginal deliveries was 575.The CS rate was 43.4%. The relative contribution from groups 1, 2 and 5 in our study accounted for 76.36% and group 5 accounted for 44.4% of the total CSs. These 3 groups should be the focus of attention to reduce the overall CS rates.Conclusions: It is advisable that all institutions can use the Robson’s report table to analyse the population catered by them and to make institutional specific policies. This will allow comparing the data amongst the different institutions and countries which can help in policy making.


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