scholarly journals Repeat Caesarean Sections: Complications and Outcomes

2019 ◽  
Vol 10 (2) ◽  
pp. 74-79
Author(s):  
Aforza Ghani ◽  
Israt Jahan Ila ◽  
Jannat Ara Ferdouse ◽  
Nasrin Sultana ◽  
Jesmin Sultana

Background: The rising incidence of caesarean section all over the world has been of great concern both to the patients and obstetrician.1 Repeat caesarean section is one of the major reasons which have contributed greatly to high caesarean section (CS) rate.1,2 Although maternal death as a result of CS is now rare, reports of the short-and long-term consequences of the rising CS rate on the childbearing population are conflicting.3 Available data show that repeat caesarean section is associated with many maternal complications, specially intra-abdominal adhesions, central placenta praevia, uterine rupture, caesarean scar pregnancy, caesarean hysterectomy etc.4 Objective: To evaluate outcome and complications of multiple repeat caesarean section. Methodology: This was a cross sectional prospective study conducted in Shaheed Suhrawardy Medical College Hospital (ShSMCH) from 1st June’2016 to 30th November’2016 for a period of six months. The study population were 102 patients, selected randomly who were admitted in ShSMCH for repeat caesarean section. Results: Out of 102 patients admitted with history of previous caesarean section, maternal morbidity was 26 (25.49%), which includes intra-abdominal adhesions 19 (18.62%), excessive blood loss 6(5.88%), placenta praevia 4 (3.94%), placenta accreta 1 (.98%), postpartum haemorrhage 11 (10.78%), wound infection 12 (11.76%) etc. Conclusion: As the rate of repeat caesarean section continue to rise, surgeons should be more judgemental in doing caesarean section. J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 74-79

Author(s):  
Joyita Bhowmik ◽  
Amit Kyal ◽  
Indrani Das ◽  
Vidhika Berwal ◽  
Pijush Kanti Das ◽  
...  

Background: The Caesarean section epidemic is a reason for immediate concern and deserves serious international attention. The purpose of this study was to evaluate adverse maternal and fetal complications associated with pregnancies with history of previous caesarean section.Methods: A cross-sectional, observational study carried out over a period of 1 year from 1st June 2016 to 31st July 2017 in Medical College Kolkata. 200 antenatal patients with previous history of 1 or more caesarean sections were included. In all cases thorough history, complete physical and obstetrical examination, routine and case specific investigations were carried out and patients were followed till delivery and for 7 days thereafter. All adverse maternal and fetal complications were noted.Results: Out of 200 women, 30 candidates were tried for VBAC, of them 20 (66.66%) had successful outcome. Most common antenatal complication was APH (5.5%) due to placenta praevia followed by scar dehiscence. There were 12 cases (6.66%) of PPH and 6 cases (3.33%) of scar dehiscence in the study group. 3 cases required urgent hysterectomy due to placenta accreta. 42 out of 196 babies required management in SNCU immediately or later after birth.Conclusions: Women with a prior cesarean are at increased risk for repeat cesarean section. Vigilance with respect to indication at primary cesarean delivery, proper counselling for trial of labor and proper antepartum and intrapartum monitoring of patients are key to reducing the cesarean section rates and maternal complications.


Author(s):  
Shanmugapriya Kumaresan ◽  
Malarvizhi Loganathan

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. With this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlights includes the rate of caesarean deliveries in the second stage of labour, the indications for delivery and the associated maternal morbidity in this cohort of women.  Methods: This was a prospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between July, 2016 and December 31, 2017 at government medical college hospital Dharmapuri. The main outcome measures were second stage caesarean section, indications and its maternal morbidity.Results: 250 women underwent caesarean delivery in the advanced labor. Among the 250 patient’s majority of them were in the age group of 21-30 yrs. about 76% of the patients were primigravidae and only the remaining 24% were multigravida. The commonest indications for doing caesarean section in the second stage of labor was cephalo pelvic disproportion and non-reassuring fetal heart rate patterns. The difficult task was delivery of the deeply engaged head, the increased likelihood of intraoperative and post-operative complications.Conclusions: Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and morbidity.


2018 ◽  
Vol 30 (1) ◽  
pp. 66-69
Author(s):  
Shahela Jesmin ◽  
Nishat Anam Borna ◽  
Mosammat Nargis Shamima ◽  
Iftekhar Md Kudrate E Khuda ◽  
Shahin Mahmuda

Aim: To assess effectiveness of Hayman suture to control postpartum haemorrhage due to placenta praevia during caesarean sectionMethods: It is a cross sectional observational study performed in Rajshahi Medical College Hospital, tertiary level hospital, from January 2016 to December 2016. It included 32 patients with PPH following placenta praevia during elective& emergency caesarean section (C/S). All 32 patients underwent horizontal compression suture (bilateral anteroposterior compression) of lower uterine segment. Vicryl 0 tapercut needle was used. All patients were followed postpartum for evaluation of uterine cavity and menstrual cycles.Results Hayman suture was applied in 32 cases. In 27 cases Hayman suture was the only intervention. Hayman with uterine artery ligation required in 2 cases. In 1 patient along with Hayman B-lynch compression suture was given and 2 patients required total hysterectomy.Conclusion: The quick and simple Hayman technique seems to be effective, safe, lifesaving method in stopping hemorrhage due to placenta praevia.TAJ 2017; 30(1): 66-69


2018 ◽  
Vol 27 (2) ◽  
pp. 11-13
Author(s):  
M Akhtarul Islam ◽  
PM Basak ◽  
BC Sarkar ◽  
MMR Khan ◽  
MM Khanam ◽  
...  

This study was done to find out the prevalence of fatty liver in type2 Diabetic patients. This was a descriptive cross-sectional comparative study carried out in Department of Medicine, Rajshahi Medical College Hospital and Rajshahi Diabetic Association Hospital from July 2008 to June 2010. 100 (one hundred) diagnosed type2 diabetic patients were included. All of those study population were free from taking any hepatoxic drugs and free from any preexisting liver disease. This exclusion was done by history, through clinical examination and relevant investigations. Among 100 type2 diabetic patients, 66 (66%) had normal, 25 (25%) had mild fatty change, 6 (6%) had moderate fatty change in liver; 2 (2%) had mild hepatomegally and 1 (1%) had congested liver. Non had cirrhosis or hepatocellular carcinoma.TAJ 2014; 27(2): 11-13


Author(s):  
Abhishek Padha ◽  
Prateek Koul ◽  
Swati Sharma

Background: Pterygium, derived from the Greek work ‘pteryx’, meaning wing is a growth of fibrovascular tissue on the cornea and conjunctiva in the palpebral fissure. The present study was conducted to find out the prevalence and Socio-demographic determinants of pterygium in Sub Himalayan region of Himachal Pradesh, India.Methods: A cross-sectional study was conducted between the months of May-June 2018, in the outpatient department of Ophthalmology of Pt. Jawahar Lal Nehru Govt. Medical College and Hospital, Chamba, H.P, India. Among all the patients visiting the OPD in the given duration, a total of 200 patients having Pterygium were selected for the study. Detailed history of the all the patients were taken and required examination was done. Data collected was analysed with Microsoft excel software.Results: Out of the 200 patients, 59% were males and 41% were females. 70% of the total study population were seen in the age group 41-60years. In present study a total of 130 patients (65%) were outdoor workers. Left eye (40.5%) was the eye most frequently involved eye in present study, right eye (36.5%) also both the eyes were involved in 23% of study population. Nasal pterygium was seen in 93%, temporal pterygia 5.5% and double pterygium (both nasal and temporal presentation in same eye) in 1.5% patients. Grade I pterygium was seen in 43.5% patients, grade II in 40% and grade III pterygia were found in 16.5% of the study population.Conclusions: People living in high altitude regions and who work outdoors, are subjected to increased U.V. exposure. So, they must take appropriate precautions like wearing protective glasses and caps etc.


2014 ◽  
Vol 15 (2) ◽  
pp. 110-113
Author(s):  
Tania Mahbub ◽  
Md. Nizamuddin Chowdhury ◽  
Ferdous Jahan ◽  
Aparna Das ◽  
Md. Motlabur Rahman ◽  
...  

Background: Worldwide haemodialysis(HD) is the mostly used method of renal replacement therapy. Arteriovenous fistula use is on rise due to Fistula First Initiative due to least complications of fistulae than catheters.But they are also subjected to many complications. Thereby appropriate surveillance of the fistulae is important.Objectives: To measure the blood flow as well as fistula related complications in study population. Materials and Methods: This was a cross sectional study, conducted in the department of Nephrology, Dhaka Medical College Hospital during September 2010 to December 2011.Total 118 subjects were included in the study. Besides visualization technique colour Doppler ultrasonogram of fistula and  echocardiography were performed for each patients. Results: Most of the patients had adequate fistula flow. Aneurysm was most common complication. Many subjects were suffered from primary and secondary fistula failure. Conclusion: Arterio-Venous fistula is subjected to many complications and appropriate surveillance should be launched to detect complications and to prevent fistula failure.DOI: http://dx.doi.org/10.3329/jom.v15i2.20681 J MEDICINE 2014; 15 : 110-113


2021 ◽  
pp. 161-163
Author(s):  
Hannah Roberts O R ◽  
Saranya Bai S ◽  
Sangeetha N ◽  
Mahendranath P

OBJECTIVE: To determine the awareness and knowledge of blood donation among undergraduate medical students MATERIALS AND METHODS: A cross sectional study was conducted at ACS Medical College and Hospital, Chennai, from st nd rd th January to March 2021.The study population was 400 medical students of 1 , 2 , 3 and 4 year. Pre-tested and self-structured equestionnaire was sent to the study population and the responses were viewed using a separate email id. RESULTS: Of the 400 medical students, 41.5% males and 58.5% females. The mean age is 20.6 years. 368 (92.0 %) are aware of voluntary blood donation. Online platforms or web portals are used by 267 (66.8 %) to assess information about Voluntary Blood Donors. Only 11 (2.7 %) have donated blood regularly. CONCLUSION: We infer that the knowledge and awareness on voluntary blood donation was comparatively higher among males and nal year students. The facts pertaining to voluntary blood donation, when conveyed by the online platforms were found to have greater impact on the current youth generation. Hence, this study recommends organising regular talks and interactive sessions as a must to bridge the gap in knowledge, to identify and remove misconceptions and motivate them for voluntary blood donation on a regular basis.


Author(s):  
Rina V. Patel ◽  
Divyanshi J. Shani ◽  
Parul T. Shah ◽  
Dipali Pandey

Background: Caesarean section constitutes a major surgical procedure characterized with morbidity even if it is performed a planned procedure. Postoperative infection in obstetrics continues to affect the practice of every surgeon. Infection can cause an increase in patient’s stay in the hospital, create discomfort, cause disfigurement and lead to morbidities to the patient. Thus, preventive measures need to be constantly evaluated and updated and hence authors have to study and analyse prevalence of postoperative infectious morbidities.Methods: The study was conducted in an Urban Based Medical College Hospital in Ahmedabad. It was a retrospective cross-sectional study of 50 cases of patients who suffered infectious complications post caesarean from 1st March 2019 to 31st March 2020.Results: The prevalence rate of surgical site infection in my study is 5.9% whereas of post-operative puerperal sepsis is 0.6%, of post-operative urinary tract infection is 1.09%, of post-operative breast abnormalities is 0.16%. The most common infectious morbidity amongst all was surgical site infection (surgical site) infection and its prevalence was 5.9%.Conclusions: The development of post-operative infection is an important event that can be prevented by taking proper precautions and following prescribed guidelines. There should be specific use of antibiotics in the post-operative period. In the event of early signs of sepsis antibiotics should be administered properly as per culture sensitivity report. The decrease in infection rate also indirectly reduce the health costs involved in treating them post operatively.


2019 ◽  
Vol 43 (2) ◽  
pp. 102-105
Author(s):  
Mahmuda Begum ◽  
LE Fatmi ◽  
Khandaker Tarequl Islam ◽  
Syeda Mehnaz ◽  
SM Shamsul Huda ◽  
...  

Background: Skeletal manifestations associated with ALL in children are common findings with a high prevalence (11.6 to 50%). The most common skeletal manifestations are bone pain, arthritis, failure to use an extremity as well as other complaints mimicking orthopedic condition such as osteomyelitis. The objective of this study is to determine the rate of skeletal manifestations commonly present in ALL to reduce mortality and morbidity. Methods: This cross-sectional study was carried out in the department of Pediatrics in Dhaka medical college Hospital, BSMMU and Dhaka Shishu (Children) Hospital between January 2010 to July 2010. Total Fifty patients of ALL were Selected consecutively from the study population. At first, we assessed skeletal manifestations like bone pain, arthritis, radiological findings present or not in ALL. Then specify the rate of bone pain, arthritis, radiological findings of ALL patients. Results: After six months 35 patients were present with skeletal manifestations. Among them 20 patients, presented with bone pain,10 patients presented with arthritis and 5 patients presented with radiological manifestations. Out of 5 patients 3 patients had soft tissue swelling 1 patient had periarticular osteoporosis and 1 patient had joint effusion in x-ray findings. Conclusion: Skeletal manifestations may be the only presentation in ALL. Bangladesh J Child Health 2019; VOL 43 (2) :102-105


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