scholarly journals AN OBSERVATIONAL STUDY OF PRIMARY CAESAREAN SECTION & THEIR OUTCOMES IN MULTI-PAROUS WOMEN

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Narendra Vaghela
Keyword(s):  
Caesarean Section ◽  
Postpartum Haemorrhage ◽  
Early Recognition ◽  
Demographic Data ◽  
Operative Procedure ◽  
Fetal Distress ◽  
Clinical History ◽  
Clinical Analysis ◽  
Fetal Outcome ◽  
A Prospective Study

Background: The most frequently performed life-saving operative procedure in women & newborns is the Caesarean section. Maternal & fetal complications can be minimized by awareness of the need for caesarean section in multi-parous women. Aim & objective: To study the indication, maternal & fetal outcome in primary caesarean in multi-parous women. Methodology: The present research was a prospective study performed on multi-parous women who had undergone caesarean section for the first time in prior pregnancies who had delivered vaginally. Data was obtained using a pre-tested questionnaire. Demographic data, clinical history & clinical analysis were included in the data. Results: The majority of patients were 21-25 years of age (53 percent), followed by 26-30 years of age (28 percent). Second gravida (57 percent) was the bulk of the patients, followed by third gravida (28 percent). Fetal distress (19 %) accompanied by mal-presentations (14%) & oligo-hydramnios was the most common sign for the caesarean section (14 percent). Atonic postpartum haemorrhage (PPH), which was seen in 7 percent of patients, was the most frequently observed complication. Conclusion: Early recognition of complications in multi-para & proper management including caesarean section will improve maternal & fetal outcome. Keyword: multi-parous women, primary caesarean section, postpartum haemorrhage.

scholarly journals Perinatal Outcome of Deliveries after One Previous Caesarean Section

2015 ◽  
Vol 3 (1) ◽  
pp. 19
Author(s):  
Narinder Kaur ◽  
Sushila Jain
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Previous Caesarean Section ◽  
Lower Segment Caesarean Section ◽  
History Of ◽  
Live Fetus ◽  
The Right ◽  
A Prospective Study

Introduction: Contrary to the WHO recommended caesarean section (CS) rate of 15%, there is an alarming trend of increasing caesarean section rates. An important reason for this is repeat caesarean section (RCS). Vaginal birth after caesarean (VBAC) is one of the methods of reducing CS rates in women with history of previous CS. This study was done with the aim to see the maternal and fetal outcome among parturient with history of single previous caesarean section and to determine the rate of VBAC at Lumbini Medical College, Nepal. Methods: This is a prospective study done for a period of ten months. Seventy parturient fulfilling inclusion criteria of term pregnancy with single live fetus and history of one Lower Segment Caesarean Section (LSCS) were enrolled in the study. Patients meeting the criteria for VBAC were given trial of labour and others were taken for elective repeat CS. This cohort was analyzed further, with respect to age, parity, period of gestation, mode of delivery, indication for CS, maternal and fetal complications and outcomes. Results: VBAC was successful in 27.14% of patients (n=19) while the rest 51 (72.85%) underwent RCS . Indications for RCS was mainly scar tenderness 7 (13.7%), fetal distress 6 (11.7%), non progress of labour 6 (11.7%), meconium stained liquor 6 (11.7%) and post-dated pregnancy 6 (11.7%). Maternal morbidity was comparable in women undergoing RCS or VBAC. There was one still birth and one early neonatal death in each group due to complications of meconium aspiration. Conclusion: Patients with previous CS are at high risk of RCS. If trial of labor is allowed under careful patient selection and supervision, the rate of vaginal delivery after caesarean section can be increased safely. As there is no added perinatal morbidity and mortality in cases of VBAC as compared to RCS, VBAC shows the right way forward to decrease the rate of caesarean section.

scholarly journals Cholestasis of pregnancy: a prospective analysis from a South Andaman teaching hospital

2019 ◽  
Vol 8 (5) ◽  
pp. 1895
Author(s):  
Bhabani Pegu ◽  
Manju Mehrotra ◽  
Anita Yadav ◽  
Pinky S. K. Sahoo
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Fetal Distress ◽  
Complete Recovery ◽  
Liver Disorder ◽  
Favourable Outcome ◽  
Spontaneous Preterm Delivery ◽  
Increased Risk ◽  
A Prospective Study ◽  
Cholestasis Of Pregnancy

Background: Intrahepatic cholestasis of pregnancy (IHCP) is one of the commonest pregnancy related liver disorder. Although the maternal course is usually benign, there is an increased risk of spontaneous preterm delivery, fetal compromise, meconium stained amniotic fluid and even intrauterine fetal demise. The objective of this study was to study the incidence of IHCP and its impact on maternal and perinatal outcome.Methods: A prospective study carried out in 68 number of IHCP cases. Diagnosis was done on the basis of clinical and laboratory parameters. All the cases were followed up to the puerperium to find out maternal and perinatal outcome.Results: The incidence of cholestasis of pregnancy was 2.73%. Most (88%) of the cases were presented with generalized pruritus, relived with ursodeoxycholic acid and complete recovery was observed after delivery. The rate of instrumental delivery was 8.82% and caesarean section rate was 30.88%. Most common indication of caesarean section was fetal distress and non-progress of labour. There was one stillbirth at 35 weeks however none of the mother had complication during labour or puerperal period.Conclusions: Increased level of liver enzymes in patients of IHCP associated with poor perinatal outcome. Therefore, careful monitoring during antenatal period and termination of pregnancy at term will result in favourable outcome of both mother and baby.

scholarly journals FETAL BIOPHYSICAL PROFILE

2010 ◽  
Vol 17 (04) ◽  
pp. 670-675
Author(s):  
BUSHRA BANO ◽  
UZMA HUSSAIN ◽  
BUSHRA ZAHID
Keyword(s):  
Caesarean Section ◽  
Apgar Score ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Fetal Hypoxia ◽  
Effective Technique ◽  
Biophysical Profile ◽  
Fetal Movements ◽  
History Of ◽  
One Year

To evaluate fetal Biophysical Profile as an effective technique for the assessment of fetal condition and to improve fetal outcome by early detection of fetal hypoxia. Design: Co relational study: Place and Duration of Study: The study was carried out for a period of one year from Oct 2004-Oct 2005 at Obstetrics and Gynecology Department of Fatima memorial hospital Lahore. Patients and Methods: All patientswith history of sluggish fetal movements and clinical suspicion of IUGR, were underwent BPP from 32-42weeks. 100 patients were selected and their BPP score was recorded and were followed till delivery. Those who went into spontaneous labor and who were induced monitored during labor and at any sign of fetal distress immediate caesarean section performed. APGAR score of newborn was noted at one and five minutes and those having poor APGAR score were resuscitated and were followed till one week after delivery. APGAR score was compared with BPP score. Results: During this study 100 BPP were performed. 34patients were primigravidas and 66 were multigravidas. Among 100 patients 73had a BPP score of 9-10/10, 21 patients had a score of 7-8/10 and 6 patients had 4-6/10.In 2 patients with 4/10score emergency caesarean section led to the delivery of neonates with APGAR score of 8 at 5 minutes. Majority of patients with normal BPS of 8-9/10 had good APGAR score of 7- 8/10.Only 8 patients having BPP of 9-10/10 had poor APGAR score 6/10 or <6/10. Conclusion: The fetal BPP appears to be an effective technique for assessment of fetal condition.

scholarly journals CARDIOTOCOGRAPHY

2018 ◽  
Vol 25 (10) ◽  
pp. 1537-1545
Author(s):  
Muhammad Ikram ◽  
Amna Javed ◽  
Shafqat Mukhtar
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Vaginal Birth ◽  
Cross Sectional ◽  
Group A ◽  
Group B ◽  
Labour Room

Introduction: The cardiotocography (CTG) is more commonly knows aselectronic fetal monitoring (EFM). A cardiotocography measures the fetal heart and the frequencyof uterine contractions. Using two separate disc shaped transducers. Objectives: The objectiveof this study is to co-relate the intrapartum cardiotocography monitoring with fetomaternaloutcome. Study Design: Cross sectional analytical study. Setting: Department of Obstetricsand Gynaecology, Shaikh Zayed Hospital, Lahore, Pakistan. Period: From September 2012 toMarch 2013 (Six Months). Patient & Method: Total 60 patients (pregnant females) fulfilling theinclusion criteria were selected for this study, who were admitted in labour room in early andactive labour. In group A normal CTG monitoring and in Group B women with abnormal CTGmonitoring. Maternal outcomes in terms of mode of delivery and fetal outcome (APGAR Score,neonatal seizures, admission to nursery and time of neonatal discharge were seen). Result: Themean age in group A was 26.13+3.90 years and in group B was 26.53+4.17 years. The meangestational age in group A was 38.40+1.50 weeks and in group B was 36.60+1.59 weeks. Ingroup A, 25 (83.3%) woman were delivered through spontaneous vaginal birth and 4(13.4%)women, who were delivered by caesarean section (for all indication except fetal distress), 1(3.3%) woman by assisted vaginal birth (for all other indications). In group B there were 7(23.8%)women who delivered through spontaneous vaginal birth. 3(10%) women by assisted vaginalbirth (for abnormal CTG monitoring) and 20(66.7%) women by caesarean section (for abnormalCTG). In group A, there were 7(23.3%) neonates who were admitted in nursery, while in groupB, there were 19(63.3%) neonates, who were admitted in nursery. Conclusion: Intrapartumexternal fetal cardiotocography is not a single indicator of fetal distress. An increased caesareansection rate in babies with a pathological cardiotocography stresses on the need for additionaltests to differentiate hypoxic fetuses from non-hypoxic.

scholarly journals The maternal and fetal outcome of repeat previous one caesarean section

2021 ◽  
Author(s):  
Uma Jain ◽  
Deepali Jain ◽  
Shaily Sengar ◽  
Preeti Gupta
Keyword(s):  
Caesarean Section ◽  
Placenta Previa ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Bladder Injury ◽  
History Of ◽  
Caesarean Hysterectomy ◽  
Placenta Accrete

Background: The rates of adverse maternal and neonatal outcomes have increased significantly in the last decade. Patients with repeated caesarean deliveries also have a greater risk of placenta previa, placenta accrete, uterine rupture, bowel and bladder injury, and unplanned hysterectomy.Methods: This retrospective study was performed between 01 April 2017 to 31 March 2021, at a private hospital to know about the surgical difficulties and maternal and neonatal complications encountered in cases of repeated LSCS. The outcome of 1028 women admitted with a history of previous LSCS was studied.Results: The 613 patients were given a trial of labour. 40.07% of patients delivered normally. The most common indication for repeat LSCS was CPD in 20.94% and fetal distress 20.12%. The most common complication observed was adhesion in 37.65%. Scar dehiscence in 8.92 %, scar rupture in 0.64%, uterine atony in 4.8%, placenta previa in 3.57%, placenta accrete in 0.64%, injury to the bladder was seen in 0.97%, caesarean hysterectomy was done in only 2 cases and gaped wound was found in 1.13% of cases. 19.15% of neonates were admitted to NICU. Apgar score <7 at 5 minutes in 14.77%. premature neonates were 8.44% RDS was found in 7.62%, birth asphyxia was found in 2.92% cases and neonatal sepsis was found in 1.13%.Conclusions: The dramatic increase in caesarean section rates over the past three decades has been associated with a corresponding increase in maternal morbidity but there a continuous decrease in neonatal morbidity and mortality rates because of advances in neonatal medicine.

scholarly journals Prevalence and determinants of caesarean section in a rural tertiary teaching hospital: a 6-year retrospective study

2019 ◽  
Vol 8 (2) ◽  
pp. 560
Author(s):  
Ke Manga Reddy ◽  
Lakshmi Sailaja P. ◽  
Shiva Charana Kodimala ◽  
Poojitha Pathakamudi ◽  
Kalpana Betha
Keyword(s):  
Caesarean Section ◽  
Demographic Data ◽  
Caesarean Section Rate ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Primary Reason ◽  
Changing Trends ◽  
Tertiary Teaching ◽  
Common Causes ◽  
Tertiary Teaching Hospital

Background: Caesarean section is the most commonly performed surgery in obstetrics and there is a rise in caesarean section rates in recent times. This study was undertaken to know the changing trends in caesarean section rate in a rural hospital and to examine the indications contributing to it. The objective of the present study was to know the prevalence and changing trends in caesarean section over the last 6 years (April 2012-March 2018).Methods: Demographic data for all the deliveries, mode of delivery and indications of caesarean sections performed from April 2012 to March 2018 that occurred at MIMS were collected in a retrospective manner.Results: Among a total of 12,522 women delivered during the study period of 6 years, 44.93%, 48.49%, 48.41%, 50.9%, 45.48% and 49.62% were delivered by caesarean section during 2012-2013, 2013-2014, 2014-2015, 2015-2016, 2016-2017 and 2017-2018 respectively. Increase in repeat caesarean section is the primary reason for these increased rates followed by fetal distress. There is a rise in the repeat caesarean section from 44.36% in 2012-2013 to 55.67% in 2016-2017 and 47% in 2017-2018. Whereas primary caesarean section rate reduced from 55.63% in 2012-2013 to 44.32% in 2016-2017 and 53% in 2017-2018.Conclusions: As repeat caesarean section and fetal distress are the most common causes of caesarean section we need to address these to bring down the caesarean section rate.

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 FETAL OUTCOME;

2017 ◽  
Vol 24 (03) ◽  
pp. 462-465
Author(s):  
Afsheen Memon ◽  
Aisha Abdullah Sheikh ◽  
Anisa Kamal
Keyword(s):  
Caesarean Section ◽  
Apgar Score ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
High Rate ◽  
P Value ◽  
Study Group ◽  
Nuchal Cord ◽  
Nicu Admission

Objectives: To compare the effect of nuchal cord versus without cord aroundthe neck on mode of delivery and fetal outcome. Study design: Case control comparativestudy. Period: 1st August 2013 to 31st March 2014. Setting: Gyn /Obs Department at Sir SyedHospital Karachi. Material and Methods: A comparative study was carried out on 2 groupsof parturient ladies. The study group comprised of those ladies who at the time of delivery(vaginal delivery/caesarean-section) had clinically cord around the neck while the other group(control) did not have nuchal cord. Duration of labour, mode of delivery were noted. Perinataloutcome was measured in terms of Apgar score and NICU admission. High risk pregnancieswere excluded from the study. Result: Incidence of nuchal cord at the time of delivery was22.7%. A high rate of caesarean delivery observed in study group as compared to controlgroup (70 % vs 40%) (P value 0.00006). Fetal heart rate irregularities & meconium stainedliquor finding was not significantly different in two groups (p< 0.161) & (p<0.169) respectively.Similarly fetal outcome measured in terms of Apgar score at 1 & 5 min & NICU admissionwas also not significantly different between the two groups. Conclusion: A significant highrate of caesareans section rate was observed in the study group mainly due to fetal distress(FHR irregularities). This means cord around the neck is a risk factor & needs extra monitoringspecially through intermittent CTG monitoring during labour so that fetal distress can be pickedup early & emergency caesarean section can be performed to avoid fetal compromise.

scholarly journals Relaparotomy after Caesarean Section - An Obstetrician’s Ordeal

2020 ◽  
Vol 7 (52) ◽  
pp. 3126-3130
Author(s):  
Sandhyarani Behera ◽  
Sony Nanda ◽  
Puspanjali Khuntia ◽  
Jayashree Rout
Keyword(s):  
Caesarean Section ◽  
Postpartum Haemorrhage ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Primary Surgery ◽  
Initial Surgery ◽  
Total Incidence

BACKGROUND The term "Relaparotomy" (RL) refers to operations performed within 60 days in association with the initial surgery. The aim of current study was to investigate the indications, risk factors, procedures undertaken during relaparotomy after caesarean section (CS). METHODS We conducted a retrospective observational study in all patients undergoing relaparotomy after caesarean section, at a tertiary care centre in Odisha over a period of 2 years from January 2017 to December 2018. RESULTS The total incidence of relaparotomies was 0.7 % and the incidence among the sections conducted in our hospital alone was 0.2 %. Obstructed labour (20 %), oligohydramnios with fetal distress (20 %) are major indications of caesarean section. Most of the surgeries (60 %) took place within the first 24 hours of the primary surgery. Most common indication of relaparotomy in our study was postpartum haemorrhage (63.3 %). All women were in the age group of 20 - 35 years and most of them were multiparous (60 %). Pre-existing anaemia is the major (50 %) comorbid factor associated with atonic postpartum haemorrhage which leads to relaparotomy. Major indication of relaparotomy in the present study was haemorrhage (76.5 %). CONCLUSIONS Undertaking proper precautions to ensure proper haemostasis and asepsis, taking calculative decision before embarking a hasty decision is important in decreasing the incidence of relaparotomy. KEYWORDS Relaparotomy, Caesarean Section, Postpartum Haemorrhage, Asepsis

scholarly journals Prelabour Rupture of Membrane : Maternal and Foetal Outcomes

2020 ◽  
Vol 19 (2) ◽  
pp. 23-27
Author(s):  
Monira Jamal ◽  
Rajat Kumar Biswas
Keyword(s):  
Caesarean Section ◽  
Gestational Age ◽  
Care Service ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Income Group ◽  
Fetal Outcome ◽  
Morbidity And Mortality ◽  
Cross Sectional ◽  
The Mean

Background: The leading cause of perinatal morbidity and mortality is prematurity in developed and underdeveloped countries. In one third of the patients with preterm labour, there is associated premature rupture of membranes. The study was conducted to evaluate the clinical presentation of Pre-labour Rupture of Membrane (PROM) in pregnancy and obstetric outcome. Materials and methods: This is a cross sectional study carried out in the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University, Dhaka, between September 2013 to February 2014. About 50 women having PROM with more than 32 weeks gestational age who admitted in the above department for delivery were enrolled in this study. Results: The mean age was found 27.4 ± 4.42 years with range from 17 to 41 years. Forty eight percent of PROM patient were primi and 52.0 percent of patients were multigravida. Six percent patients were illiterate. Almost two third patients were housewives. More than half (54.0%) of the patients were came from poor class income group family. Majority (64.0%) patients had term PROM (>37 weeks) gestational age and the mean gestational age was 38.1 ± 2.7 weeks with range from 32- 40 weeks. More than half (54.0%) didn't received any antenatal checkup. A total of (56.0%) patients had associated disease, out of which anaemia was more common. Twelve percent had diabetes mellitus and 8.0% had UTI infection. Almost two third (64.0%) was vaginal delivery and 18(36.0%) were caesarean section and common indication for caesarean section was fetal distress (38.9%). Two third patients were healthy and 17 patients had morbidities, wound infection is highest (29.4%). The mean birth weight was found 2.74 ± 0.7 kg. APGAR score >7 at 1 minute was found (92.0%) and (94.0%) at 5 minutes of birth of baby after birth. Fetal outcome take home alive (98.0%) and neonatal death 2.0%. Among 50 foetus morbidity develop in 26 cases. Among them respiratory insufficiency is highest (38.5%). Conclusion: Motivation of the patients, health education, improvement of nutritional status of mother, neonatal care service, early diagnosis, treatment, overall institutional delivery is needed for reduction of neonatal morbidity and mortality, as well as maternal morbidity. Chatt Maa Shi Hosp Med Coll J; Vol.19 (2); July 2020; Page 23-27

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