scholarly journals A Descriptive Analysis of the Indications for Caesarean Section in Lumbini Zonal Hospital, Butwal

2018 ◽  
Vol 5 (2) ◽  
pp. 31-34
Author(s):  
Shreedhar Acharya ◽  
Bhaktabatsal Raut
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Caesarean Section Rate ◽  
Descriptive Analysis ◽  
Fetal Distress ◽  
Age Group ◽  
Medical Sciences ◽  
Cephalopelvic Disproportion ◽  
Case Files ◽  
One Year

AIM: This study was done to find out the incidence and to analyse the various indications for caesarean sections at Lumbini Zonal Hospital.MATERIALS & METHODS: This was a hospital based retrospective study done at Lumbini Zonal Hospital, Butwal. The case files of all the women who had caesarean delivery over the period of one year from 2071/4/1 to 2072/3/32 were reviewed. Various indications of caesarean sections were analysed for the incidence, age, parity, elective vs emergency caesareans.RESULTS: Out of 7589 deliveries, 1316 (17.34%) had caesarean section. Most common indications were previous caesarean 275 (20.89%), non progress of labour 245 (18.61%), cephalopelvic disproportion 222 (16.86%), fetal distress 215 (16.33%), etc. Majority of caesarean 1226 (93.16%) was done in the age group of 20-30yrs, primipara 702 (53.34%), and elective caesarean sections 766 (58.2%).CONCLUSION: Caesarean section rate at Lumbini Zonal Hospital was optimal. Most common indication was repeat caesarean. The overall reduction in caesarean section rate can be met through reduction of elective caesarean with the promotion of trial of labour.Study also concludes that there is a relation between working duration and health problems, and the problems increase as the duration at work increases.Journal of Universal College of Medical Sciences, Vol. 5, No, 2, 2017, Page: 31-34

scholarly journals Towards optimizing caesarean section: a five-year review of caesarean sections at a Southern Nigeria hospital

2019 ◽  
Vol 9 (1) ◽  
pp. 205
Author(s):  
Nkencho Osegi ◽  
Olakunle I. Makinde
Keyword(s):  
Social Sciences ◽  
Caesarean Section ◽  
Collaborative Research ◽  
Caesarean Section Rate ◽  
Breech Presentation ◽  
Fetal Distress ◽  
Hospital Level ◽  
Cephalopelvic Disproportion ◽  
Study Centre ◽  
Previous Cesarean

Background: Monitoring caesarean sections at hospital level is essential to reduce unnecessary caesarean sections while still ensuring adequate access to caesarean section. This study was conducted to determine the caesarean section rate and indications for caesarean section at the study centre and provide objective data for institutional interventions towards reducing unnecessary caesarean sections in the centre.Methods: A retrospective descriptive study of patients that had caesarean sections between 1st January 2013 and 31st December 2017 at the Federal Medical Centre, Yenagoa, Nigeria. Data were analyzed using Statistical Package for Social Sciences version 22.Results: There were 5,793 deliveries and 1,654 were by caesarean section. The average caesarean section rate was 28.6%. The leading indications for caesarean section were cephalopelvic disproportion (26.6%), previous cesarean section (18.2%), suspected fetal distress (11.2%), severe preeclampsia/eclampsia (7.9%), obstructed labour (6%), and breech presentation (5.9%).Conclusions: The 28.6% caesarean section rate in this study falls within a widely varied rate across Nigeria at hospital level but is comparable to rates within the south-south geopolitical zone of Nigeria. The leading indications for caesarean section are modifiable, thus there is room for institutional intervention to reduce unnecessary caesarean sections. Collaborative research between institutions is required to assess peculiar regional determinants of caesarean section towards developing suitable interventions to reduce unnecessary caesarean sections regionally.

Trend of Caesarean Section in Bheri Zonal Hospital

2018 ◽  
Vol 16 (1) ◽  
pp. 41-44
Author(s):  
Kalpana Kumari Thapa ◽  
Urmila Parajuli
Keyword(s):  
Caesarean Section ◽  
Geographical Location ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Health Concern ◽  
Routine Practice ◽  
Age Group ◽  
Public Health Concern ◽  
Case Files

Introduction: Caesarean Section (CS) rates are a major public health concern and cause worldwide debates according to latest data from 150 countries. Currently 18.6% of all births occur by CS, ranging from 6 to 27.2% in the least and most developed regions. This study was done to find out incidence and outcome of CS and geographical variation of women coming for the service in this Zonal Hospital. Methods: A retrospective review of case files of 771 women who had CS from 16th April 2017 to15th April 2018 were analyzed for demographic profile like age, parity, geographical location. Similarly, gestational age, various indications of CS, incidence, parity, maternal and fetal outcome and duration of hospital stay were recorded. Results: Out of 5083 deliveries, 771 (15.17%) had CS. Most of the CS was done for Cephalopevic disproportion (CPD) which was 175 (22.70%) and previous CS, 140 (18.15%). Majority of CS which was 328 (42.54%), in age group 20-24 years. In relation to parity nulliparous were 463 (60.05%). Maternal morbidity was 31 (4.02%) and maternal mortality was one after CS. Apgar score of the baby between 0-3 was 3.24%. Three babies were expired within 24 hours due to severe birth asphyxia. The patients from Banke district were 408 (52.92%). Conclusion: Study showed CS rate, 15.7% which is in upper limit of WHO recommendation and 60.50% were nulliparous had CS and most common indication of CS was CPD and fetal distress. There was no CTG used in routine practice.

scholarly journals Impact of maternal nationality on caesarean section rate variation in a high-income country

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Saheed Shittu ◽  
Lolwa Alansari ◽  
Fahed Nattouf ◽  
Tawa Olukade ◽  
Naji Abdallah
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Reference Group ◽  
Caesarean Section Rate ◽  
Fetal Distress ◽  
Maternity Hospital ◽  
High Income ◽  
Rate Variation ◽  
Cross Sectional ◽  
Medical Indications

Background: Caesarean section (CS) rates have been reported to differ between immigrants and native-born women in high-income countries. Objective: We assessed the CS rate and its relationship with the CS rate in country of nationality and other explanatory factors among women of different nationalities including Qatari women who underwent deliveries at our hospital to generate evidence that will quantify and help explain the observed CS rates in our hospital. Methods: In this retrospective cross-sectional study conducted at the second-largest public maternity hospital in Qatar, Al-Wakra Hospital (AWH), data for all births delivered in 2019 were retrieved from the hospital's electronic medical records. The CS rates and the crude and adjusted risks of Caesarean delivery for mothers from each nationality were determined, and the common indications for CS were analyzed based on nationality. The association between nationality and Caesarean delivery was examined using binomial logistic regression analysis, with Qatari women as the reference group. The correlation between CS rate in country of nationality and observed CS rates in Qatar was also examined using Pearson's correlation. Results: The study population consisted of 4816 births by women of 68 nationalities, of which 4513 births were by women from 25 countries. The highest proportion of deliveries (n-1247, 25.9%) was by Indian women. The frequency of CS was the highest and lowest among Egyptian (49.6%) and Yemeni women (17.9%), respectively. Elective CS was predominantly performed in women of Arab nationalities; the most common indication was a history of previous multiple CSs. Emergency CS was primarily performed in women of Asian and Sub-Saharan African nationalities; the most common indications were failure to progress and fetal distress. For most nationalities, the CS rate in Qatar was associated with those of the countries of nationality. Conclusions: The observed CS rates varied widely among women of different nationalities. The variation was influenced by maternal factors and medical indications as well as the CS rates in the country of nationality. We posit that cultural preferences, acculturation, and patient expectations influenced observed findings. More efforts are required to reduce primary CS rates and to help women make the most informed decisions regarding modes of delivery. Key Message: CS rates varied widely among women of different nationalities. The variation was influenced by medical indications, maternal preferences, and CS rate in countries of nationality. The solution to reducing CS rates should be a culturally informed response.

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  

Advanced Maternal Age and Pregnancy Outcome at Manipal Teaching Hospital: Cross-sectional Analytical study

2021 ◽  
Vol 6 (1) ◽  
pp. 20-25
Author(s):  
Vibha Mahato ◽  
Pravin Shrestha ◽  
Pradeep Bhattarai
Keyword(s):  
Caesarean Section ◽  
Postpartum Hemorrhage ◽  
Perinatal Outcome ◽  
Maternal Age ◽  
Analytical Study ◽  
Fetal Distress ◽  
Advanced Maternal Age ◽  
Age Group ◽  
Cross Sectional ◽  
Very Advanced Maternal Age

Introduction: Advanced and very advanced maternal age are associated with several adverse maternal and fetal outcome. The objective of this study was to find out the possible association between advance maternal age and adverse pregnancy outcomes at Manipal Teaching Hospital.Methods: A cross sectional analytical study conducted at department of Obstetrics and Gynecology, Manipal Teaching Hospital, Pokhara, Nepal. A total of 198 patient who were ≥30 years and >24 weeks pregnant admitted in obstetric ward were selected. These patient were divided into three groups according to their age (30-34, 35-39 and ≥ 40years). We compared the incidence of adverse maternal and perinatal outcome among these groups. We also calculated odds ratio of maternal and perinatal outcomes in 35-39 years and ≥ 40years women, compared with women aged 30-34 years.Results: Comparison of the three age groups revealed that advanced maternal age constitute a predisposing factor for malpresentation, gestational diabetes mellitus, placenta previa, fetal distress and caesarean section. Whereas, risk of non progress of labour, preterm birth, postpartum hemorrhage, perinatal death and congenital anomalies were increased in very advanced maternal age group. From these, statistical significance was reached in case of greater risk of malpresentation (p=0.01,OR=6.66), fetal distress (p=0.04, OR=2.6) and caesarean section(p=0.02,OR=2.06) in advanced age group when compared to the patients aged 30-34. Furthermore, very advanced age group were higher risk of postpartum hemorrhage (p=0.03, OR=2.47) and congenital anomalies, which were statistically significant (p=0.04, OR=29.57) when compared to the 30-34 years.Conclusion: Advanced and very advanced maternal age is associated with several adverse maternal and perinatal outcome. The risk of perinatal complication begin to increase after the age of 35 but significantly increased after 40 years.

scholarly journals Trial of scar in post caesarean pregnancies

2018 ◽  
Vol 7 (3) ◽  
pp. 1173
Author(s):  
G. Kuppulakshmi ◽  
S. Saranya
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Uterine Wall ◽  
Perinatal Morbidity ◽  
Surgical Incision ◽  
Medical College ◽  
Caesarean Birth ◽  
Obstetric Management ◽  
One Year ◽  
Present Pregnancy

Background: The term caesarean delivery used to describe the delivery of a fetus through a surgical incision of the intact anterior uterine wall. The objective of this study was to analyse the maternal and perinatal morbidity between successful VBAC and failed vaginal delivery in cases selected for trial of labour.Methods: Prospective study conducted in Government RSRM Lying In Hospital, Government Stanley Medical College, Chennai over a period of one year from January 2017 to December 2017.Results: Trial of labour in previous caesarean section was more successful when the interval between previous caesarean and present pregnancy was between two to four years 86.40%. Conclusions: Most patients with a prior caesarean birth are candidates for VBAC. In properly selected women, a trial of labour after one previous low transverse caesarean section constitutes the best and safest form of obstetric management.

scholarly journals Caesarean delivery rate and indications at a secondary healthcare facility in Ibadan, South Western Nigeria: a five-year review

2021 ◽  
Vol 21 (1) ◽  
pp. 320-6
Author(s):  
Waheed O Ismail ◽  
Ibrahim S Bello ◽  
Samuel A Olowookere ◽  
Azeez O Ibrahim ◽  
Tosin A Agbesanwa ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Care Setting ◽  
Primary Care Setting ◽  
Caesarean Section Rate ◽  
Healthcare Facility ◽  
Surgical Skill ◽  
Maternal Morbidity And Mortality ◽  
Study Population ◽  
Caesarean Delivery Rate

Background: Caesarean delivery is an essential surgical skill within the primary care setting aimed at reducing maternal morbidity and mortality. Objectives: To determine the rate and indications for caesarean deliveries with a view to improving on the service delivery in the study area. Methods: A retrospective review of all caesarean deliveries over a five-year period, January 1st, 2012 to December 31st, 2016. Results: A total of 2321 deliveries were recorded during the study duration and 481 of them were through caesarean sec- tion (CS) giving a caesarean section rate of 20.4%. The rate was higher in the multigravida 255 (53.1%). The commonest indication for caesarean section was previous caesarean section 131 (27.2%). Emergency caesarean delivery accounted for 278 (57.8%). Only 16 (3.3%) stayed more than five days postoperatively while the rest, 465 (96.7%), stayed less than five days. There was a gradual yearly increase in rate from 12.1% in 2012 to 19.5% in 2016. Conclusion: The rate of CS in this study has shown a gradual yearly increase with emergency CS having a higher percentage. Early diagnosis and referral of high-risk pregnancies from peripheral hospitals could reduce emergency CS among the study population. Keywords: Caesarean section; rate; secondary healthcare; Nigeria.

scholarly journals Study of caesarean section at tertiary care centre: a retrospective study

2020 ◽  
Vol 9 (5) ◽  
pp. 2138
Author(s):  
Varsha Kose ◽  
Kumari Sadhvi
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Tertiary Care ◽  
Fetal Distress ◽  
High Rate ◽  
Audit And Feedback ◽  
Research Centre ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Failure Of Induction

Background: Caesarean section (C-section) is one of the most widely performed surgical procedure in obstetrics worldwide. The WHO guidelines revised in 1994 states that the proportion of C-section birth should range between 5-15% but both in developed and developing countries C-section rate is on the rise. This study was conducted to analyse the frequency and indications for C-section and associated maternal morbidity and mortality.Methods: This retrospective study was conducted over a period from January 2018 to May 2019 at the department of obstetrics and gynecology, NKP Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Hingna, Nagpur, Maharashtra, India. Data of patients who delivered by C-section in our hospital during the defined study period were studied and statistically analysed according to various parameters namely, the frequency of caesarean section, its indications, age, parity and gestational age of the patient.Results: The total number of women delivered over the study period were 2811. Out of which C-sections were done in 1461 women (51.97%). Previous C-section was the leading indication in 35.72% women followed by fetal distress 14.09%, failure of induction 12.93%, arrest of labour 7.93%, PIH 7.18%, oligo/IUGR 6.50%, breech 4.44%, refusal of vaginal birth 4.24%, CPD 1.71%, bad obstetrics history (BOH) 1.43%, malpresentation 1.30%, prematurity 1.23%,  and multifetal gestation in 1.09% women. Two women had classical C-section 0.07. 14.09% women had various complications. There was no maternal mortality.Conclusions: A high rate of caesarean deliveries was observed. Individualization of the indication and careful evaluation, following standardized guidelines can help us to limit C-section. Audit and feedback are the best way to judge clinical practice and to reduce the frequency of caesarean section in any tertiary setup.

scholarly journals Evaluation of caesarean section practices according to Robson's 10-group classification at a level two maternity ward in Conakry, Guinea

2019 ◽  
Vol 8 (11) ◽  
pp. 4468
Author(s):  
Daniel W. A. Leno ◽  
Mamoudou E. Bah ◽  
Jerry C. Moumbagna ◽  
Tamba M. Millimouno ◽  
David Lamah ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Medical Center ◽  
Caesarean Section Rate ◽  
Relative Size ◽  
Newborn Care ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Maternity Ward ◽  
Cross Sectional ◽  
Robson Classification

Background: The frequency of caesarean sections (CS) increased dramatically in the world over the last twenty years. The objective of this study was to evaluate caesarean section practices based on Robson classification in an urban referral hospital in Conakry, GuineaMethods: We conducted a cross-sectional study of 2,266 birthing records collected at the maternity ward of the Coronthie Communal Medical Center in Conakry, from January 1st to December 31st 2016. We included in the study all women who had a caesarean section and whose medical records were complete. Robson's classification was used to classify women into 10 groups based on maternal and fetal characteristics. The relative size of each group, its gross caesarean section rate as well as its contribution to overall caesarean section rate and the main caesarean section indications were calculated.Results: In 2016, 769 caesarean sections were performed out of 2,266 deliveries, corresponding to a hospital section rate of 33.9%. Groups 5 (11.0%), 1 (4.8%), and 3 (4.3%) of the Robson classification were the most contributors to registered hospital caesarean section rate. The main indications for caesarean section were uterine scar in group 5 and acute fetal distress in groups 1 and 3.Conclusions: The systematic reference to the Robson classification could help to identify and avoid the relative indications of the caesarean section in urban Guinea. Besides, increasing induction of labor and strengthening providers’ capacities in emergency obstetric and newborn care services could contribute to reduce caesarean section rates in Guinea.

scholarly journals Prophylactic amnioinfusion in oligohydramnios

2019 ◽  
Vol 9 (1) ◽  
pp. 305
Author(s):  
Dhiviya Narbhavi T. ◽  
Cicily T. J. ◽  
Kala B. S.
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Perinatal Outcome ◽  
Fetal Heart ◽  
Caesarean Section Rate ◽  
Fetal Distress ◽  
Study Group ◽  
Amniotic Fluid Volume ◽  
Fetal Complications ◽  
Labour Room

Background: Oligohydramnios causes many intrapartum maternal and fetal complications. Intrapartum amnioinfusion effectively increases amniotic fluid volume and thereby decreases FH decelerations. The objective of this study was to compare the frequency of fetal heart decelerations and its perinatal outcome with and without amnioinfusion in patients with oligohydramnios and the cesarean rates for fetal distress between them.Methods: In study group, 100 patients in labour with AFI < 5 cm, oligohydramnios and IUGR with normal doppler, postdated pregnancies with AFI ≤ 5 cm with normal doppler were selected and prophylactic amnioinfusion with 300 ml lukewarm saline is given aseptically for 15 minutes after amniotomy. Continuous CTG monitoring done till delivery. If FH decelerations occur, the bolus was repeated up to 3 times. 100 age matched controls managed with conventional methods without amnioinfusion were selected retrospectively from labour room case records.Results: Incidence of FH decelerations was lower in study group (59% versus 84%). Cesarean section for fetal distress was reduced (20.9% versus 79.1%) Perinatal outcome was better. Babies with normal 1-minute Apgar was 86% compared to 75% in controls. Frequency of FH decelerations was reduced (20% versus 73%). Occurrence of 2 FH decelerations were 13% versus 33%, 3 FH decelerations were 7% versus 27% and > 3 times was 0% versus 13%.Conclusions: Prophylactic amnioinfusion can easily and effectively reduce the FH decelerations and caesarean section rate for fetal distress in oligohydramnios improving both maternal and fetal outcomes with negligible risks.

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