scholarly journals Caesarean Section and Perinatal Outcome in a Sub-urban Tertiary Hospital in Northwest Nigeria

2016 ◽  
Vol 10 (2) ◽  
pp. 29-32
Author(s):  
EA Ugwa ◽  
AO Ashimi ◽  
MY Abubakar
Keyword(s):  
Caesarean Section ◽  
Perinatal Mortality ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Caesarean Section Rate ◽  
Tertiary Hospital ◽  
Medical Centre ◽  
Retrieval Rate ◽  
Case Files ◽  
Ethical Clearance

Aims: This study was undertaken to review the caesarean section rate and perinatal mortality in Federal Medical Centre, Birnin Kudu from 1 January 2010 to 31 December 2012.Methods: This was a retrospective study involving review of 580 case files. Ethical clearance was obtained. The records of labour ward, neonatal intensive care unit and operating theatre were use. Information extracted includes age, parity, booking status, total deliveries, indications for caesarean section and perinatal outcome from 1st January 2010 to 31st December 2012 at Federal Medical Centre, Birnin Kudu. The data obtained was analyzed using SPSS version 16.0 statistical software (Chicago). Absolute numbers and simple percentages were used to describe categorical variables.Results: A total of 590 caesarean sections were done which is rate of 17.69%. Of the 590 caesarean deliveries, 580 case notes were retrieved giving a retrieval rate of 98.3%. A total of 96 out of 580 babies died within the first one week of caesarean delivery, giving a perinatal mortality rate of 17.4 per 1000. The average age of the women was 25.9±6.2 years. Majority of them were uneducated and unemployed. Obstructed labour was the most common indication for emergency caesarean section accounting for 31.7% of caesarean sections followed by pre-eclampsia/eclampsia.Conclusions: Caesarean section rate in the present study is comparatively high and perinatal mortality is low but it is unclear if there is a correlation between caesarean section rate and perinatal mortality. This needs further studies.

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 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.

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 Trends in caesarean section rates in a rural block of southern India

2018 ◽  
Vol 7 (8) ◽  
pp. 3305 ◽  
Author(s):  
Divya Elizabeth Muliyil ◽  
Manjunath K. ◽  
Jasmin Helan ◽  
Shantidani Minz ◽  
Kuryan George ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Caesarean Section ◽  
Perinatal Mortality ◽  
Tamil Nadu ◽  
Caesarean Section Rate ◽  
Mortality Rates ◽  
Annual Rate ◽  
Average Annual Rate ◽  
Live Births ◽  
Rate Of Increase

Background: Over the last decade many programmes have been implemented to improve the health of pregnant women and neonates. This study aims to look at the changes in modes of delivery and perinatal mortality rates in a rural block of Tamil Nadu between 2006 and 2015.Methods: Data on all the births that have occurred in this rural block of Tamil Nadu that has been prospectively collected between 2006 and 2015 was analysed. A longitudinal analysis was done to calculate the primary and overall caesarean section rate and the average annual rate of increase. The perinatal mortality rate was also calculated.Results: The primary LSCS rate has increased from 9.08% in 2005 to 16.1% in 2015. The overall caesarean section rate has increased from 11.7% to 19.2% in the same time with an average annual rate of increase of 5.1%. During this period the perinatal mortality has decreased from 33 per 1000 live births to 17 per 1000 live births.Conclusions: Though the overall caesarean section rate is higher than the 15% prescribed by WHO the rates are lower than the rest of the country and rural Tamil Nadu.

scholarly journals A double-blind randomised placebo-controlled trial of melatonin as an adjuvant agent in induction of labour (MILO): a study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e032480
Author(s):  
Kamala Swarnamani ◽  
Miranda Davies-Tuck ◽  
Euan Wallace ◽  
Ben W Mol ◽  
Joanne Mockler
Keyword(s):  
Caesarean Section ◽  
Neonatal Intensive Care ◽  
Controlled Trial ◽  
Caesarean Section Rate ◽  
Primary Outcome Measure ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Double Blind ◽  
Vaginal Pessary ◽  
Estimated Blood Loss

IntroductionInduction of labour (IOL) is a common practice. In Australia, up to 40% of women undergoing labour induction will ultimately have a caesarean section. As a biological role for melatonin in the onset and progress of labour has been demonstrated, we aim to test the hypothesis that addition of melatonin will reduce the need for caesarean section.Methods and analysisThis is a double-blind, randomised, placebo-controlled trial in women undergoing IOL at term. We plan to randomise 722 women (1:1 ratio) to receive either melatonin (four doses of 10 mg melatonin: first dose—in the evening at the time of cervical balloon or Dinoprostone PGE2vaginal pessary insertion, second dose—at time of oxytocin infusion commencement, third dose—6 hours after the second dose, fourth dose—6 hours after the third dose) or placebo (same dosing regime). Participants who are having artificial rupture of the membranes only as the primary means of labour induction will receive up to three doses of the trial intervention. The primary outcome measure will be the requirement for a caesarean section. Secondary outcomes will include duration of each stage of labour and time from induction to birth, total dose of oxytocin administration, epidural rate, indication for caesarean section, rate of instrumental deliveries, birth within 24 hours of induction commencement, estimated blood loss, Apgar score at 5 min, neonatal intensive care unit admissions and participant satisfaction. Maternal melatonin levels will be measured immediately before commencement of the oxytocin intravenous infusion and 3 hours after and at the time of birth in order to determine any differences between the two trial arms.Ethics and disseminationThe study is conducted in accordance with the conditions of Monash Health HREC (RES-17-0000-168A). Findings from the trial will be disseminated through peer-reviewed publications and conference presentations.Protocol versionV.7.0, 30 July 2019.Trial registration numberACTRN12616000311459, Universal trial number: (UTN) U1111-1195-3515.

scholarly journals Analisis Angka Seksio Caesarea di RSUP Dr. Sardjito Yogyakarta Tahun 2009-2013

2016 ◽  
Vol 3 (1) ◽  
pp. 14
Author(s):  
Netty Katrina Dameria ◽  
Djaswadi Dasuki ◽  
Rukmono Siswishanto
Keyword(s):  
High Risk ◽  
Caesarean Section ◽  
Perinatal Outcome ◽  
Risk Group ◽  
Caesarean Section Rate ◽  
National Level ◽  
High Risk Group ◽  
Low Risk ◽  
Mortality And Morbidity ◽  
Low Risk Women

Background: Caesarean section is a procedure to reduce maternal and perinatal mortality and morbidity. The caesarean section rate is continuously uprising in the last 3 decades. However, the increasing rate, especially in low risk women, may compromise maternal and perinatal outcome. In 1985, WHO recommended that optimal national caesarean rates should be in the range of 5% to 10% and the rate above 15% might be less benefits. Previous study conducted in DR Sardjito hospital reported caesarean section rate in 1996 was 13.38%, while in 2001 was 18.39%. In national level, based on Indonesia Basic Health Survey 2010, caesarean section rate was 10.8%. Therefore, in this study we analyzed the rate of Caesarean section performed in DR Sardjito hospital, and studied whether the operations occurred in high-risk group or low-risk group.Objective: To compare the rate of caesarean section between high-risk group and low-risk group in DR Sardjito hospitalMethod: Retrospective cohortResult and Discussion: Participants of this study were 7821 patients undergoing labor at RSUP DR Sardjito in 2009-2013. Among them, 3152 patients underwent caesarean section and 4669 patients underwent vaginal delivery. There was an increasing in the overall caesarean section rate of 38,7% in 2009 to 43% in 2013. T-test found the presence of significant differences between the caesarean section rate of high-risk group and low-risk group in 2009-2013 (p<0.05) with a mean difference was 28.5 (20.2-36.8). Caesarean section rate of high-risk group was significantly higher than the low-risk group (p<0.05).Conclusion: There was a difference in caesarean section rate of high-risk group compared to low-risk group. Caesarean section rate in high-risk group was significantly higher than in the low-risk group.Keywords: caesarean section rate, caesarean section, low-risk group, high- risk group

scholarly journals Measuring the effectiveness of maternal delivery services: A cross-sectional and qualitative study of perinatal mortality in six primary referral hospitals, Kenya

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 732
Author(s):  
Richard Ayah ◽  
Dismas Ongore ◽  
Alfred T.O. Agwanda
Keyword(s):  
Caesarean Section ◽  
Health System ◽  
Perinatal Mortality ◽  
Perinatal Death ◽  
Caesarean Section Rate ◽  
Public Hospitals ◽  
Standards Of Care ◽  
Cross Sectional ◽  
Referral Hospitals ◽  
Delivery Services

Background: The effective performance of hospitals is critical to overall health system goal achievement. Global health system performance frameworks are often used as part of global benchmarking, but not within low and middle-income countries as part of service delivery performance measurement. This study explored the utility of perinatal mortality as a measure of hospital effectiveness. Methods: A cross sectional, mixed methods study of six primary referral hospitals, differentiated by ownership, was conducted from 10th June to 9th October 2015. Monthly summary hospital data of maternal delivery services (MDS) were abstracted to determine the perinatal mortality. Tests of associations were used to correlate bed turnover, skilled staffing, method of delivery and perinatal mortality. Additionally, 40 questionnaire interviews were held with hospital board members and the management team to assess the availability of standard operating procedures (SOP) in MDS. Qualitative data was analysed thematically. Results: All six hospitals reported having SOP in managing MDS. The average perinatal mortality rate for all the hospitals was 24.63 per 1,000 live births. However, a perinatal death was 2.6 times more likely in public hospitals compared to private hospitals (29.8 vs 11.4 per 1,000 births respectively). The average caesarean section rate for all hospitals was 25.9%, but the odds of a caesarean section were 1.67 higher in a private hospital compared to a public hospital (P<0.001 95% CI: 1.58-1.77). Perinatal mortality was associated with bed turnover ratio (R squared 0.260, P=0.001), and skilled staff availability (R squared 0.064,P<0.001). Discussion: The high perinatal mortality reported in public hospitals may be due to high bed turnover and relatively low caesarean section rate. Input measures of performance such as reporting standards of care and staffing levels are not useful performance indicators. Perinatal mortality as a performance indicator may be an ideal measure of the effectiveness of hospitals.

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