scholarly journals Maternal outcomes following second stage caesarean section in a tertiary hospital in Malaysia: A 6-year retrospective review

2021 ◽  
Author(s):  
Nurul Nafizah Mohd Rashid ◽  
Nik Mohamed Zaki Nik Mahmood ◽  
Mohd Pazudin Ismail ◽  
Adibah Ibrahim ◽  
W Fadhlina W Adnan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Post Partum ◽  
Neonatal Morbidity ◽  
Tertiary Hospital ◽  
Outcome Data ◽  
High Rate ◽  
Maternal Outcomes ◽  
Total Blood ◽  
Second Stage

Introduction: The trend for second stage caesarean section (SSCS) has been rising, and it carries a high rate of maternal and neonatal morbidity. Aim: To determine the prevalence of caesarean section (CS) performed during the second stage of labour and identify maternal outcomes and associated risk factors in these women. Material and methods: This retrospective study was performed in the Hospital University Sains Malaysia (HUSM). Medical records of 207 women with singleton cephalic pregnancies at term who underwent a SSCS between January 1, 2010 and December 31, 2015 were reviewed, and demographic and outcome data were collected. Results and discussion: During the study period, 8,197 (19.3%) out of 42,546 babies were delivered by CS, including 257 (4.1%) SSCSs. Nearly half (49.3%) the women were nulliparous, 182 (87.9%) experienced spontaneous labour and 123 (59.4%) received oxytocin augmentation. Furthermore, 26 (12.6%) of women had post-partum haemorrhage (≥1000 mL), of whom 22 (10.6%) required blood transfusion. Only 1 (0.5%) woman was admitted to the intensive care unit postoperatively, but 163 (78.7%) had an overall hospital stay length of 3 days. Furthermore, 38 (18.4%) and 33 (15.9%) of women experienced extended uterine tear and uterine atony, respectively. Parity (P < 0.001), attempted instrumentation (P < 0.001) and baby’s weight (P < 0.004) were statistically significantly associated with total blood loss. Parity (P < 0.012) and attempted instrumentation (P < 0.001) were risk factors for extended uterine tear. Conclusions: The overall outcomes from SSCS were better compared with studies performed in other centres. Current practices must be maintained or improved to provide the best patient caree.

scholarly journals Caesarean Section During Second Stage of Labor in a Tertiary Centre

2017 ◽  
Vol 15 (2) ◽  
pp. 178-181 ◽  
Author(s):  
Padma Gurung ◽  
Sameer Malla ◽  
Sushma Lama ◽  
Anagha Malla ◽  
Alka Singh
Keyword(s):  
Caesarean Section ◽  
Post Partum ◽  
Caesarean Section Rate ◽  
Neonatal Morbidity ◽  
Adverse Outcomes ◽  
Perinatal Complications ◽  
Maternal Complications ◽  
Postoperative Fever ◽  
Second Stage Of Labor ◽  
Second Stage

Background: There is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. Within this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlight the feto-maternal outcome of caesarean section in second stage of labour.Methods: This was a retrospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between April 1, 2013 and March 30, 2017 at Patan Academy of Health Sciences. The main outcome measures were second stage caesarean section, indications and its maternal and fetal morbidity.Results: During the study period, there were 40,860 deliveries. A total of 18,011 (44%) babies were born by caesarean section, 10484 emergency and 7527 elective. Out of the emergency caesarean section, 200 (1.9 %) were performed in second stage of labor. In this study, the most common indication was cephalopelvic disproportion. (92.4%) were delivered without a trial of instrumental delivery. In terms of maternal complications, atonic post partum haemorrhage uterine incision extension 18 (12.5%), postoperative fever 27(18.8%), wound infection 7 (4.8%) were observed. In perinatal complications, meconium stained amniotic fluid 49(34.2%), neonatal hyperbilirubinemia 14(9.7%) and increased nursery admission 2(15.3%) and 2(1.3%) perinatal mortality were seen.Conclusions: Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and neonatal morbidity.

scholarly journals Retrospective study of maternal and neonatal outcome in second stage lower segment caesarean section in a tertiary hospital

2020 ◽  
Vol 9 (12) ◽  
pp. 4924
Author(s):  
M. P. A. Sailakshmi ◽  
Vidhyadhare G. S.
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Neonatal Morbidity ◽  
Tertiary Hospital ◽  
Clinical Exposure ◽  
Medical College ◽  
Lower Segment Caesarean Section ◽  
Second Stage ◽  
Safe Performance

Background: Caesarean section at second stage are increasing and are associated with significant maternal morbidity. The overall caesarean section rates are also increasing from last two decades.Methods: A retrospective study conducted in Department of Obstetrics and Gynaecology, Raja Rajeswari Medical College and Hospital, Bangalore from January 2018 to July 2019. Second stage LSCS were analysed in terms of indications, intraoperative and post-operative complications, neonatal morbidity.Results: In our hospital during study period there were 2639 deliveries and total number of LSCS 1146 (43.42%) and caesarean section rate was 35-45% and second stage LSCS 60 (5.23%).Conclusions: Second stage LSCS associated with more number of maternal and neonatal morbidity. Adequate clinical exposure and appropriate training are essential for safe performance in second stage LSCS. 

scholarly journals Risk factors for post-partum hemorrhage in patients who underwent operative vaginal delivery in a tertiary care center

2021 ◽  
Author(s):  
Gayatri Devi Sivasambu ◽  
Sujani B. Kempaiah ◽  
Urvashi Thukral
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Vaginal Delivery ◽  
Post Partum ◽  
Tertiary Care ◽  
Significant Risk ◽  
Post Partum Hemorrhage ◽  
Second Stage ◽  
Operative Vaginal Delivery ◽  
Vaginal Deliveries

Background: Operative vaginal delivery is a timely intervention to cut short second stage labor when imminent delivery is in the interests of mother, fetus, or both. It reduces second stage cesarean section morbidity and uterine scar and its influence on future obstetric career. The possible structural neonatal adverse outcomes due to operative vaginal delivery are well quantified. However, its effects on maternal outcome need to be understood better. In this paper, we study the effect of operative vaginal delivery on maternal post-partum hemorrhage (PPH) and the associated risk factors.Methods: It was a retrospective study carried out for the period July 2016 to July 2020 at Ramaiah Medical College, Bengaluru. Total number of vaginal deliveries in this period were 6318. Out of these, 1020 patients underwent assisted vaginal delivery using vacuum/ forceps/ sequential use of instrument. Blood loss greater than 500 ml is considered PPH for the purpose of this study. 15% of the study population was noted to have PPH. We employ a multivariate logistic regression to identify statistically significant risk factors for PPH in women undergoing operative vaginal delivery.Results: The logistic regression model identifies multiparity, maternal age, neonatal birth weight more than 3.5 kg, application of forceps in women with hypertensive disorders, III-degree tear, cervical tear to significantly increase the risk of PPH in our study population.Conclusions: Certain factors seem to increase the risk of PPH in operative vaginal delivery. The risks and benefits must be weighed properly before use of instruments.

scholarly journals An evaluation of risk factors of leprosy and how it affects treatment outcome in a low endemic state of India

2018 ◽  
Vol 6 (7) ◽  
pp. 2485
Author(s):  
Mannat K. Bhatia ◽  
Ripudaman Singh ◽  
Dimple Chopra
Keyword(s):  
Risk Factors ◽  
Treatment Outcome ◽  
National Level ◽  
Tertiary Hospital ◽  
High Rate ◽  
Current Status ◽  
Access To Health Services ◽  
Health Seeking ◽  
Lower Socioeconomic ◽  
Endemic State

Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae. India achieved elimination at the national level in 2005. But it still had world’s leprosy burden in 2015 and currently has a prevalence rate of 0.81 per 10,000. The aim of our study was thus to identify the risk factors associated with the development of leprosy and assess their effect on the treatment outcome of the disease, especially in a low endemic state like Punjab.Methods: A retrospective study conducted across Punjab by assessing the medical records of 55 leprosy admissions that were diagnosed, treated, and monitored at a tertiary hospital and those living in leprosy homes, from a time period of 2015 to 2018. Data was analysed using SPSS 25 software and presented in the form of figures and percentages.Results: Maximum number of leprosy patients under study belonged to upper lower socioeconomic class (46.2%) according to The Modified Kuppuswamy Scale. 48.7% of the patients were migrants to the state of Punjab. Overall, 24 patients (61.5%) were successfully treated. 20.5% were relapse cases while 7.7% default and 2.6% failure cases were seen.Conclusions: This study shows the current status of disease in an otherwise low endemic state. Leprosy is associated with a lower socioeconomic status due to lesser access to health services and lower levels of education. The high rate of disease, lower case reporting and treatment outcomes, as compared to the national averages is a cause for alarm thus more health seeking practices need to be encouraged.

scholarly journals Determinants and aetiologies of postpartum pyrexia; a retrospective analysis in a tertiary health facility in the Littoral Region of Cameroon.

2020 ◽  
Author(s):  
Yannick Lechedem Ngunyi ◽  
Gregory Halle-Ekane ◽  
Nicholas Tendongfor ◽  
Etheldreda Leinyuy Mbivnjo ◽  
Armel Evouna Mbarga ◽  
...  
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Tertiary Hospital ◽  
High Rate ◽  
E Coli ◽  
Factors Associated ◽  
Littoral Region ◽  
Perineal Tears ◽  
Chi Squared ◽  
Tract Infections

Abstract Background Postpartum febrile morbidity is relatively common, occurring in approximately 5–7% of births. Differentiating between potentially serious and benign causes of postpartum pyrexia (PP) is fundamental in curbing the mortality rate from sinister causes such as sepsis. The paucity of data on PP in Cameroon makes it difficult to access its actual burden. This study was aimed at determining the prevalence, risk factors and aetiologies of PP at a tertiary hospital in Douala, Cameroon. Methods This was a 2 – year hospital – based retrospective cohort study carried out at the Douala General Hospital (DGH), during which medical records of all postpartum admissions between January 1 st 2017 and December 31st 2018 were reviewed. The review consisted of collecting data on socio-demographic characteristics, clinical profile, investigations and final diagnoses. The collected data was analysed in SPSS 23.0. Chi-squared test was used to test the association between variables and a logistic regression analysis was fitted to identify risk factors associated to PP. Results A total of 1520 postpartum files were reviewed. The prevalence of PP was 8.82%. The most frequent causes of PP were: malaria (46.7%), urinary tract infections (18.7%), puerperal sepsis (17.9%) and pneumonia (8.7%). E. coli was the most (49.3%) cultured germ isolated in positive cultures. Onset of PP was more common (85%) within the first 3 days postpartum and malaria (60%) was the leading aetiology within this period. Five or more vaginal examinations prior to delivery (OR 59.151, 95% CI: 21.463-163.019; p<0.001), perineal tears (OR 45.157, 95% CI: 2.266-899.722; p<0.001), and duration of labour >18hours (OR 26.760, 95% CI: 7.100-100.862; p<0.001) were the most significant risk factors associated with PP. Conclusion Approximately 1 in every 12 postpartum cases in the DGH presents with PP . Malaria was the leading cause of PP at DGH especially for cases registered within 3 days postpartum. The risk factors identified were mostly associated to perinatal events, such as frequent vaginal examinations, perineal tears and prolonged labour. Efforts towards preventing identified risk factors thus becomes paramount in order to curb this high rate of PP in the DGH.

scholarly journals Feto-maternal outcome in second versus first stage caesarean delivery in a tertiary medical care centre

2018 ◽  
Vol 7 (12) ◽  
pp. 5084
Author(s):  
Nupur Gupta ◽  
Taru Gupta ◽  
Ritu Singh
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Maternal Outcomes ◽  
New Delhi ◽  
Perinatal Morbidity ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Obstetrics And Gynaecology ◽  
Nicu Admission ◽  
Febrile Morbidity

 Background: The aim is to study neonatal and maternal outcomes of the caesarean sections performed in first stage versus second stage of labour. Methods: The retrospective analysis of data were done of caesarean section done at Department of Obstetrics and Gynaecology at ESI PGIMSR Basaidarapur New Delhi between January 2016 to December 2016. 45 women, who underwent second stage caesarean section were studied. For each case, two consecutive cases, who underwent caesarean delivery during the first stage of labour were taken as control for the study. Primary maternal outcomes of interest were uterine atonia, transfusion requirement, urinary system injury and postoperative complications. Results: Out of 4477 deliveries, 1466 had caesarean section with a rate of 32%. The rate of second stage caesarean section was 3% of total caesarean section and 1% of total deliveries. Second stage caesarean section had higher maternal and perinatal morbidity like atonic PPH (33.3%), lower uterine segment extension (7%), febrile morbidity (10%), and need for blood transfusion (15%). There were 15.5% NICU admission in second stage caesarean group while none in first stage group. Conclusions: Caesarean section in the second stage of the labour is associated with increased maternal and neonatal morbidities. Special attention is required to the patients undergoing caesarean section in the second stage of the labour. They should be handled by senior and experienced obstetrician. Neonatologist should be present for every second stage caesarean section.

scholarly journals A comparison of technicques to disimpact the fetal head on a second stage caesearean simulator

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Anastasia Martin ◽  
Diane Nzelu ◽  
Annette Briley ◽  
Graham Tydeman ◽  
Andrew Shennan
Keyword(s):  
Caesarean Section ◽  
Neonatal Morbidity ◽  
Previous Experience ◽  
Fetal Head ◽  
Digital Technique ◽  
Second Stage ◽  
Head Elevation ◽  
Digital Elevation ◽  
Single Operator ◽  
Established Technique

Abstract Background The rate of second stage caesarean section (CS) is rising with associated increases in maternal and neonatal morbidity, which may be related to impaction of the fetal head in the maternal pelvis. In the last 10 years, two devices have been developed to aid disimpaction and reduce these risks: the Fetal Pillow (FP) and the Tydeman Tube (TT). The aim of this study was to determine the distance of upward fetal head elevation achieved on a simulator for second stage CS using these two devices, compared to the established technique of per vaginum digital disimpaction by an assistant. Methods We measured elevation of the fetal head achieved with the two devices (TT and FP), compared to digital elevation, on a second stage Caesearean simulator (Desperate Debra ™ set at three levels of severity. Elevation was measured by both a single operator experienced with use of the TT and FP and also multiple assistants with no previous experience of using either device. All measurements were blinded Results The trained user achieved greater elevation of the fetal head at both moderate and high levels of severity with the TT (moderate: 30mm vs 12.5mm p<0.001; most severe: 25mm vs 10mm p<0.001) compared to digital elevation. The FP provided comparable elevation to digital at both settings (moderate: 10 vs 12.5mm p=0.149; severe 10 vs 10mm p=0.44). With untrained users, elevation was also significantly greater with the TT compared to digital elevation (20mm vs 10mm p<0.01). However digital disimpaction was significantly greater than the FP (10mm vs 0mm p<0.0001). Conclusion On a simulator, with trained operators, the TT provided greater fetal head elevation than digital elevation and the FP. The FP achieved similar elevation to the digital technique, especially when the user was trained in the procedure.

Second stage caesarean section at a tertiary hospital in South Africa

2010 ◽  
Vol 23 (10) ◽  
pp. 1151-1155 ◽  
Author(s):  
Vineshree Govender ◽  
Mala Panday ◽  
Jagidesa Moodley
Keyword(s):  
South Africa ◽  
Caesarean Section ◽  
Tertiary Hospital ◽  
Second Stage

scholarly journals First versus second stage caesarean section: a comparison of maternal and neonatal outcomes

2017 ◽  
Vol 6 (8) ◽  
pp. 3477
Author(s):  
Sushma Sinha ◽  
Surya Malik ◽  
Mala Dixit
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Caesarean Delivery ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
P Value ◽  
Neonatal Complications ◽  
Second Stage ◽  
Number Of Patients ◽  
One Year

Background: A retrospective study was done to compare the maternal and neonatal complications of caesarean delivery performed in the second stage compared with the first stage of labor.Methods: This is a one year retrospective study done in a 100-bedded hospital, govt of NCT OF Delhi, New Delhi from 1st November 2015 to 31st October 2016.  Total number of deliveries in this one year duration were 1785, including both normal and caesarean deliveries. Total number of patients who underwent caesarean delivery in the first stage of labor were 159, and in 2nd stage of labor were 15 during this time period. These were designated into two groups, group 1 and group 2. These two groups were then compared in terms of maternal demographics, labor characteristics, maternal outcomes and neonatal outcomes. Numerical variables were compared between groups by calculating P-value for each variable. P-value <0.05 was considered statistically significant.Results: Caesarean deliveries performed in the second stage were associated with increased maternal morbidity in terms of blood loss, unintended extensions, blood transfusions, prolonged hospital stay, febrile morbidity. Similarly, Neonatal morbidity was much higher in the patient who underwent LSCS in 2nd stage of labor compared to 1st stage. There was increase in neonatal complications, for e. g. –5 minute Apgar <7, NICU admissions >24 hrs, neonatal septicaemia, (P-value <0.05).Conclusions: In conclusion, present study suggests that women undergoing caesarean section in the second stage of labor have increased maternal and fetal morbidity. Therefore, selection of birthing method should be made very carefully and meticulously to decrease maternal and neonatal morbidity.

scholarly journals Prevalence of high-grade perineal tear during labor in Mexican adolescents

2018 ◽  
pp. 261-264
Author(s):  
María Teresa Sánchez-Ávila ◽  
Marisol Galván-Caudillo ◽  
Jaime Javier Cantú-Pompa ◽  
Natalia Vázquez-Romero ◽  
Jhanea Patricia Martínez-López ◽  
...  
Keyword(s):  
Risk Factors ◽  
Obstetric Care ◽  
Tertiary Hospital ◽  
High Rate ◽  
Adult Women ◽  
High Grade ◽  
Hospital Data ◽  
Perineal Tear ◽  
Fourth Degree ◽  
Perineal Tears

Introduction: There is a high rate of deliveries in adolescents in Mexico. This age group is vulnerable to obstetric complications, including lacerations of the anal sphincter. Objective: To determine the prevalence of third and fourth degree perineal tears in adolescents during childbirth, and to evaluate risk factors in comparison with deliveries with lacerations of adult women. Methods: All obstetric care episodes were reviewed from a public tertiary hospital data in Monterrey, Mexico in 2014. Age, primiparity, delivery instrumentation, episiotomy, body mass index, product weight and tear´s degree were documented at the deliveries with tears of third and fourth degree. Results: The prevalence of third and fourth degree tears of 2.0% was found in the general population, being adolescents the most affected with 2.5%. The unadjusted odds ratio of high-grade tears in adolescent females at delivery, compared to adult females, was 1.36 (95% CI = 0.99-1.86, p= 0.05). No difference was found when comparing risk factors among high-grade tear deliveries in adolescents versus adults. Conclusions: A higher prevalence than previous reported for high grade tears during delivery was found. The data suggest adolescence as a risk factor for high-grade tears during delivery.

Sign in / Sign up

Export Citation Format

Share Document