scholarly journals Morbidly adherent placenta –A burden on tertiary care centre.

2020 ◽  
Vol 27 (09) ◽  
pp. 1795-1798
Author(s):  
Zahra Safdar ◽  
Sumera Zaib ◽  
Sumera Fatima
Keyword(s):  
Caesarean Section ◽  
Hospital Stay ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Case Series ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Prolonged Stay ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta

Objectives: To determine the burden of Morbidly Adherent Placenta on tertiary care centre in terms of prolonged hospital stay, multiple blood transfusions, Intensive care unit stay, involvement of surgical urological colleges. Study Design: Descriptive Case Series. Setting: Department of Obstetrics and Gynaecology, Unit I Lahore, General Hospital Lahore LGH. Period: 06 months (1st August 2017-28th February 2018). Material & Methods: Total Obstetrical patients admitted in this period were 2754 total births 2567, lower segment caesarean 1184 patients, with Morbidly Adherent Placenta were 28. Date was analysed regarding maternal age, parity, previous surgeries and diagnosis prior to admission. The complications analysed were hospital stay >10 days, multiple transfusions>04 days, ICU admission>72hours, requirement of surgical and urological colleges. Patients fulfilling inclusion and exclusion criteria were studied. Results: Morbidly Adherent Placenta results in patient’s prolonged stay in hospital and ICU which results in high consumption of hospital resources. Conclusion: Morbidly Adherent Placenta is directly related with caesarean section rate. Every effort should be made to reduce the %age of primary caesarean section so that incidence of Morbidly Adherent Placenta can be minimised.

scholarly journals Analysis of caesarean section rate according to modified Robson’s classification at tertiary care centre in Uttarakhand, India

2019 ◽  
Vol 8 (4) ◽  
pp. 1288
Author(s):  
Kusum Dogra ◽  
Neetu Arora ◽  
Bhawna Sharma ◽  
Meenakshi Tanwar
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Maternal Characteristics ◽  
Robson Classification ◽  
Group 4 ◽  
Spontaneous Labour ◽  
Group 5

Background: High caesarean section rate worldwide including India is matter of concern. The aim of this study is to analyse caesarean section rate at tertiary care centre according to Modified Robson’s classification.Methods: This retrospective study was conducted at Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIMHS) and Shri Mahant Indiresh Hospital at Dehradun from April 2018 to September 2018. All women delivered during this period were classified according to modified Robson’s classification using their maternal characteristics and obstetric history. For each group, authors calculated the caesarean section rate within the group and its contribution to overall caesarean section rate.Results: Out of total 1302 women delivered, 395 underwent CS (30.3%).The major contribution to overall caesarean section rate was 33.4% by group 5 (Previous CS, singleton, cephalic, >37weeks) followed by 16.7% by group 1 (nullipara, singleton, cephalic, >37 weeks, spontaneous labour), 12.4% by group 3 ( multipara, singleton, cephalic, >37 weeks, spontaneous labour ).CS rates among various group ranges from 100% among women with abnormal lie (group 9) to 77.5% in nulliparous breech (group 6), 73.7% in previous CS (group 5) and least 11.2%  in multipara induced or pre labour CS (group 4).Conclusions: Modified Robson classification is simple, systematic, reproducible and can be effectively utilized in analyzing delivering women. Major contribution to overall caesarean section is made by previous CS.

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.

scholarly journals A randomised single blind control study to assess the effect of intrapartum amnioinfusion on maternal caesarean section rate and fetal outcome in a tertiary care centre

2017 ◽  
Vol 6 (10) ◽  
pp. 4347
Author(s):  
Michelle Fonseca ◽  
Jyotsna S. Dwivedi
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Meconium Aspiration Syndrome ◽  
Control Group ◽  
Study Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Meconium Stained Amniotic Fluid

Background: The procedure of instilling normal saline/Ringer’s lactate into the uterine cavity is called amnioinfusion. Objective of present study was to assess the effect of intrapartum amnioinfusion on maternal caesarean section rate and fetal outcome in a tertiary care centre in cases of meconium stained amniotic fluid.Methods: A total of 160 women at term in labor with meconium stained amniotic fluid were randomized into two groups: study and control group. The study group received transcervical amnioinfusion at detection of MSAF. The control group was given the routine obstetric care. Both groups were started on O2 and intrapartum monitoring. The outcomes in both groups were analyzed statistically.Results: The control group had caesarean section rate of 45% and in the study group it was 31.25%. The difference was statistically significant. The outcome in the neonate was assessed on the parameters such as respiratory distress, neonatal intensive care unit admission, meconium aspiration syndrome, neonatal deaths.Conclusions: Amnioinfusion in cases of meconium stained amniotic fluid cases significantly reduces the risk of meconium aspiration syndrome. It also decreases the need for operative intervention thus reducing the risk of maternal morbidity and mortality.

scholarly journals Assessment of indications of lower section caesarean section at tertiary care centre: a cross sectional study

2017 ◽  
Vol 4 (4) ◽  
pp. 1253
Author(s):  
Vijay L. Badge ◽  
Sumit Suresh Aggarwal ◽  
Deepti D. Ambalkar ◽  
Arun Humne ◽  
Neethika Raghuwanshi
Keyword(s):  
Caesarean Section ◽  
Care Center ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College

Background: Caesarean section is one of the commonly performed surgical procedures in obstetrics and is certainly one of the oldest operations in surgery. One of the most dramatic features of modern obstetrics is the increase in the caesarean section rate. The present study was conducted to estimate proportion of various indications of LSCS and also to assess socio demographic profile of mothers undergoing caesarean section in a tertiary care centre. Methods: The present cross sectional observational study was conducted at Government Medical College & Hospital, Akola in the post natal ward (PNC). Non probability convenient sampling method was used. All patients admitted to PNC ward after LSCS were included in study. For data collection paper based pre tested, semi –structured questionnaire was used. Results: Previous LSCS was indication for LSCS in 32% cases. Eclampsia, preeclampsia and Anaemia were the indications for LSCS in 19.3%, 8.6% and 5.3% cases respectively. Other common indications includes CPD, meconium stained liquor, fetal distress, breech presentations, twin pregnancy and preterm labour. Conclusions: The proportion of LSCS is more than WHO recommended proportion of LSCS. It may be due to present institute acts as tertiary care center. Still this proportion is high, so encouragement should be given to trial of labour in selected low risk cases and in Primi patients whenever possible. 

S153 – Radiological Balloon Dilatation of Neo-Pharyngeal Strictures

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P127-P128
Author(s):  
Robert L Harris ◽  
Grundy Alan ◽  
Tunde A Odutoye
Keyword(s):  
Total Laryngectomy ◽  
Balloon Dilatation ◽  
Malignant Disease ◽  
Outcome Measure ◽  
Tertiary Care ◽  
Case Series ◽  
Stent Insertion ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Main Outcome Measure

Objectives Radiological balloon dilatation of lower oesophageal strictures is common practice. Other than some early reports from our own centre, there is little published regarding radiological dilatation of pharyngeal and upper oesophageal strictures and less still on radiological balloon dilatation of post-total laryngectomy and pharyngolaryngectomy neo-pharyngeal strictures. Standard practise is bouginage under general anaesthaesia. The objective of this study is to assess the efficacy of radiological balloon dilatation for the treatment of dysphagia secondary to neopharyngeal strictures in patients who have undergone laryngectomy. Methods A tertiary care centre case series of 20 consecutive patients (17 males and 3 females aged 40 to 84) with pharyngeal stricture and dysphagia post-total laryngectomy or pharyngolaryngectomy who underwent balloon dilatation of the stricture under radiological guidance. Maintenance of swallowing was the main outcome measure. Results 5 patients gained relief of their dysphagia with 1 balloon dilatation only. 9 patients required more than 1 dilatation to maintain swallowing. 2 patients had balloon dilatation procedures and stent insertion for palliative relief of dysphagia from known recurrent malignant disease. 3 patients failed to maintain swallowing with repeat dilatations. No patients suffered any significant complications such as perforation. Conclusions Balloon dilatation is minimally invasive and less traumatic than rigid pharyngoscopy with bouginage dilatation. It is well tolerated. It may be repeated frequently and can successfully relieve strictures of the pharynx in patients who have undergone total laryngectomy or pharyngolaryngectomy.

scholarly journals The ten group Robson classification: an institutional study to analyse the caesarean section rates

2021 ◽  
Author(s):  
Lekshminath Gopinath ◽  
Rajani Vaidya
Keyword(s):  
Caesarean Section ◽  
Policy Making ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Robson Classification ◽  
Relative Contribution ◽  
Obstetrics And Gynaecology ◽  
Vaginal Deliveries ◽  
Group 5

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.

scholarly journals A RETROSPECTIVE STUDY ON EVALUATION OF CAESAREAN SECTION RATE USING THE ROBSON’S 10 GROUP CLASSIFICATION IN SARDAR PATEL MEDICAL COLLEGE, BIKANER

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Sudesh Agrawal ◽  
Virendar Singh Rawat
Keyword(s):  
Caesarean Section ◽  
Scientific Evidence ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Group Classification ◽  
Health Concern ◽  
International Studies ◽  
Negative Consequences ◽  
Tertiary Care Centre ◽  
Pregnant Females

Introduction : Despite the lack of scientific evidence indicating any substantial maternal and perinatal benefits from increasing caesarean section rates, most of the studies are showing that higher rates could be linked to negative consequences in maternal and child health, still caesarean rates continues to increase worldwide, particularly in middle and high income countries, and have become a major and controversial public health concern. Therefore, we conducted this study to analyse the LSCS rate in the institute, to classify the indications of LSCS as per RTGCS and to find out strategy to decrease the prevalence of lower segment caesarean section. Material & Methods : This is a retrospective hospital based study at tertiary care centre. Data collection of one thousand pregnant females who delivered by caesarean section from the period of January 2018 onwards was assessed for the study. There are six parameters as per Robson’s classification to classify all pregnant females for caesarean section. Entire information was entered in Microsoft excel sheet and analysis were done to decrease caesarean section rate. Results : In the present study, a total of 1000 pregnant women delivered by caesarean section was taken from January 2018 onwards. The total number of deliveries during this study period was 2919 and the overall caesarean section rate was 34.25%. Most of the patients belonged to Robson’s group 1,2&5 which contributed to 65.6% to total. Conclusion :  The overall CSR in the study is 34.25% which is high as compared to international studies, contribution of repeat CS is high. It is important that efforts to reduce the overall CS rate should focus on reducing the primary CS rate. More analytical studies based on Robson’s 10-group classification system are needed locally, to evaluate the indications of CS within each group.  

scholarly journals Analysis of repeat LSCS in a tertiary care centre

2018 ◽  
Vol 7 (5) ◽  
pp. 1963
Author(s):  
M. Poovathi ◽  
Suilharsini T. S.
Keyword(s):  
Caesarean Section ◽  
Tamil Nadu ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Management Strategies ◽  
Negative Consequences ◽  
Care Needs ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Set Up

Background: Caesarean section (CS) rates continue to increase worldwide, particularly in middle and high-income countries without evidence indicating substantial maternal and perinatal benefits from the increase and some studies showing negative consequences for maternal and neonatal health. The objective of this study is to analyse the repeat caesarean section rates in a tertiary centre.Methods: This is a retrospective study carried out in the Department of Obstetrics and Gynaecology, Pudhukottai Medical College, Tamil Nadu, India for a 12-month period from January 2017 to December 2017 with the aim to analyse the rate and indications for caesarean section and to identify the measures to decrease its incidence if possible. A total of 2654 cesarean deliveries were conducted in one year, out of which 1380 (51.99%) were primary cesarean sections and 1274(48%) were repeat cesarean sections.Results: Repeat LSCS is more common in age group of 21-30 years (80%) and in second gravida (90.42%). The incidence of caesarean section is 94.6%. Patients who had successful trial of scar were 73. In all these patients, measures were taken to shorten the 2nd stage of labour either by giving episiotomy alone or by application of outlet forceps or vacuum. Out of these 62 (84.9%) patients were delivered by episiotomy alone.Conclusions: Caesarean section has become one of the commonly performed surgeries in obstetric practice. Implementation of standard labour management strategies can reduce primary caesarean section rate without compromising maternal and fetal safety. One important strategy is ROBSON ‘S 10 GROUP classification system for caesarean section needs to be adopted. Targets of care needs to be set up which also depends on the available resources and expertise. With continuous critical review as described and frequent comparison with other delivery units, the caesarean section rate in each individual unit can be reduced to an appropriate level.

scholarly journals Analysis of caesarean section rate in tertiary care hospital according to Robson`s 10 groups classification

2018 ◽  
Vol 7 (4) ◽  
pp. 1380
Author(s):  
Varija T. ◽  
Veerendra Kumar C. M. ◽  
Chandrasekhar Tarihalli
Keyword(s):  
Caesarean Section ◽  
Classification System ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Case Series ◽  
Breech Presentation ◽  
Group Classification ◽  
Care Hospital ◽  
Case Series Study ◽  
Group 5

Background: The caesarean section (CS) delivery rate is steadily increasing worldwide, including India. Identifying the proportion of women in various categories as per Robson's ten group classification system and CS rate among them is important to bring down the increasing CS rate.Methods: This case series study was conducted at Vijayanagar Institute of Medical Sciences (VIMS), a tertiary care teaching hospital in Ballari, Karnataka, India. All pregnant women who have been admitted for delivery were enrolled and the data was collected for the women delivered by CS during January 2016 to December 2016 and proportions in various groups as per Robson’s ten-group classification system were calculated.Results: Among a total of 6980 women delivered during study period, 2992 (42.8%) delivered by CS. The CS rates among various groups varied from 100% among women with abnormal lies and group 6-95% (all nulliparous breeches) group 5-94% (Previous CS, single cephalic, >37 weeks) to 10 to 15% among multiparous women with spontaneous labour having single cephalic pregnancy (group 3). Among women with previous section, CS rate was very high (89.6%). Women with previous CS (group 5) contributed maximum (40.24%) to the total number of CS.Conclusions: In the present study, all women with breech presentation and abnormal lies delivered by CS and repeat CS was the highest contributor to all CS deliveries.

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