CLINICAL STUDY OF PRIMARY CESAREAN SECTION IN MULTIPAROUS WOMEN AT OBSTETRICS AND GYNAECOLOGY DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

2021 ◽  
pp. 7-8
Author(s):  
Kumari Nisha ◽  
Renu Jha ◽  
Kumudini Jha ◽  
Debarshi Jana
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Placenta Previa ◽  
Fetal Distress ◽  
Normal Vaginal Delivery ◽  
Major Surgery ◽  
Obstetrics And Gynaecology ◽  
Emergency Cesarean ◽  
Study Results ◽  
Multiparous Women

Background: Caesarean section is the most commonly performed major surgery among women. The aims and objective of this study was to know the incidence of primary Caesarean section in multigravidas, its indications and to know the maternal and foetal outcome among these patients. Methodology: This was an observational study conducted at Department of Obstetrics and Gynaecology of Darbhanga Medical College and Hospital, Laheriasarai, Bihar. Aim of the study was to study the indication, maternal and fetal outcome in primary cesarean in multiparous women. All multiparous women admitted for delivery were included in the study Results: The total number of deliveries were 3064 and cesarean section were 1026 (33%).The total number of primary cesarean section in multiparous women were 84 constituting 2.7%. In this study, majority of women were Gravida 2. 91.6% of the cases were underwent emergency cesarean section and anesthesia was spinal. Majority of patients were between age group of 22 to 27 yrs (70%). Indications for cesarean section in our study were severe oligohydroamnios (22%), fetal distress (15.4%), and breech presentation (14%), premature rupture of membrane (12%).Intra operative ndings were meconium stained liquor, post partum hemorrhage, thinned out lower segment and extension of incision. Out of 84 cases, 48 cases needed intra operative or immediate post operative blood transfusion. The post operative morbidity was present in 6 cases i.e paralytic ileus, puerperal fever, urinary tract infection and wound gaping. Majority of babies, weighed in the range of 2-3kgs (55%).Out of 84 cases 7 were causes were placenta previa, obstructed labor and fetal distress. Conclusion: Many unforeseen complications occur in women who previously had a normal vaginal delivery. It is recommended that all antenatal patients must be booked and receive proper and regular antenatal care. Also 100% deliveries in multigravida should be institutional deliveries in order to reduce maternal and perinatal morbidity and mortality.

scholarly journals Caesarean section: its rates and indications at a tertiary referral center in Eastern Nepal

1970 ◽  
Vol 9 (3) ◽  
pp. 179-183
Author(s):  
S Chhetri ◽  
U Singh
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Placenta Previa ◽  
Caesarean Section Rate ◽  
Breech Presentation ◽  
Fetal Distress ◽  
Tertiary Referral ◽  
Common Indication ◽  
Tertiary Referral Center ◽  
Referral Center

Background: There has been a sustained increase in the rate of caesarean section in the last few years around the world. Data regarding the current caesarean rate and the trends of its indications in eastern Nepal have not been estimated earlier. Aim: To assess the rate of caesarean sections and the varying indications for caesarean section in a tertiary referral center in eastern Nepal. Methods: All hospital deliveries that took place in BPKIHS between January 2006 and December 2007 were recorded to assess the caesarean section rate and its indications. Results: A total of 5330 deliveries were conducted in 2006. Likewise the total number of deliveries conducted in 2007 was 6634. In 2006 caesarean sections were performed in 28.6% (1524) of all patients. The rate of caesarean sections in 2007 increased and was 33.7% (2239). The most common indication for caesarean section was meconiumstained liquor, which constituted 23.4% (883). The next frequent indication was previous caesarean section, which accounted for 17.2% (650), followed by breech presentation in 11.1% (417), fetal distress in 9.6% (364), non-progress of labor in 7.2% (270), cephalopelvic disproportion in 6.2% (234, and placenta previa in 4.4% (165). Conclusions: There is a increasing trend of performing cesarean section in the tertiary referral center in east era Nepal. The most common indication for cesarean section is meconium-stained liquor. Keywords: Caesarean section; caesarean delivery rates; Nepal DOI: http://dx.doi.org/10.3126/hren.v9i3.5587   HR 2011; 9(3): 179-183

scholarly journals Study of primary caesarean section in multigravida patients

2017 ◽  
Vol 7 (1) ◽  
pp. 185
Author(s):  
Neelam Rajput ◽  
Priyanka Singh ◽  
Yogendra Singh Verma
Keyword(s):  
Caesarean Section ◽  
Neonatal Mortality ◽  
Vaginal Delivery ◽  
Low Socioeconomic Status ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Normal Vaginal Delivery ◽  
Major Surgery ◽  
Medical Disorders ◽  
Number Of Patients

Background: Caesarean section is the most commonly performed major surgery among women. The aims and objective of this study was to know the incidence of primary Caesarean section in multigravidas, its indications and to know the maternal and foetal outcome among these patients.Methods: It was a prospective study of primary caesarean section in multigravida admitted at Kamla Raja Hospital, G.R. Medical College and J. A. Group of Hospitals, Gwalior (Madhya Pradesh, India) during the period of 1 year from September 2014 to August 2015. Multigravida with pregnancy of >28 weeks gestation (gravida 2 and above), each of whom has had a previous vaginal delivery of > 20 weeks gestation were included. Women with previous abortions and previous section and Pregnancy with medical disorders were excluded.Results: During the study period of one year, total 8185 deliveries occurred, out of which 3061 (37.39%) underwent caesarean section and 386 (12.61%) were primary caesarean section in multigravida. Out of these multigravida patients who underwent primary caesarean section- most of the patients were unbooked (77.72%). Majority of the cases were direct admission in the hospital (61.13%). Maximum number of the patients were in the age group of 25-30 years (55.95%). Two third of the patients were literate (69.44%) Maximum number of patients were Gravida 2 (49.72%). Almost all of them (95.85%) underwent emergency caesarean section. The most common indication for primary LSCS in multigravida patients was Malpresentation 115 (29.79%) followed by Fetal distress in 71 (18.39%) patients, APH in 71 (18.39%), Obstructed labour in 33 (8.55%), Severe preeclampsia and Antepartum eclampsia in 39 (10.1%), Twin pregnancy in 21 (5.44%). Most common maternal complication was pyrexia 40 (10.36%). Postoperative morbidity was 21.24% among unbooked, 14.25% in Referred, 23.58% in those operated as an emergency, 12.43% in patients belonging to of low socioeconomic status and 3.88%, in patients with moderate to severe anemia. Birth asphyxia was found in 6.21% of neonates. Neonatal mortality was 2.33%. Neonatal mortality is more in Unbooked cases (90.47%).Conclusions: Many unforeseen complications occur in women who previously had a normal vaginal delivery. It is recommended that all antenatal patients must be booked and receive proper and regular antenatal care. Also 100% deliveries in multigravida should be institutional deliveries in order to reduce maternal and perinatal morbidity and mortality.

A Case of Emergency Cesarean Section on Client with Pseudopregnancy

2020 ◽  
pp. 1-6
Keyword(s):  
Heart Rate ◽  
Cesarean Section ◽  
Fetal Heart Rate ◽  
Medical Service ◽  
Fetal Heart ◽  
Placenta Previa ◽  
Urban Hospital ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Rural Health Center

Pseudopregnancy detection is significant while as the false pregnancy may show all symptoms. It is important to differentiate it. This is a case report of a pseudopregnancy which led to an emergency cesarean section. A 28-year-old woman who claimed to 7-month pregnancy was brought to the rural health center by husband families complaining of vaginal bleeding. The woman refers to an urban hospital by Emergency Medical Service with the diagnosis of placenta previa. In the hospital, she underwent an emergency cesarean section due to a severe deceleration of fetal heart rate, prior to assessing by sonography. No fetus or signs of uterine or abdominal pregnancy were found. Wrong auscultation of the mother's heart rate instead of fetal heart rate seems to be the main error. It is required to pay more attention to the methods of differentiation of fetal heart rate from the mother's heart rate. This report enlightens false pregnancy and early differentiation.

scholarly journals Marginal umbilical cord insertions in a bipartite placenta responsible for placenta abruption: a case report

2021 ◽  
Vol 12 (5) ◽  
pp. 309-310
Author(s):  
Elie Nkwabong ◽  
Sylvie Borassi
Keyword(s):  
Case Report ◽  
Cesarean Section ◽  
Umbilical Cord ◽  
Fetal Heart ◽  
Past History ◽  
Placenta Previa ◽  
Blood Clot ◽  
Normal Pregnancy ◽  
African Woman ◽  
Emergency Cesarean

Hemorrhage is one of the major causes of maternal death. Main causes of APH are placenta previa, placenta abruption and uterine rupture. Rare causes of placenta abruption include marginal and velamentous umbilical cord insertions. We hereby present a case of placenta abruption due to marginal umbilical cord insertions occurring on a bipartite placenta. A 40-year-old nulliparous African woman, 35 weeks pregnant consulted for dark red pervaginal bleeding, which occurred recently. Past history was unremarkable. Her pregnancy was well followed up. A recent ultrasound scan revealed a fundal inserted placenta. Physical examination revealed a fundal height of 37 cm, no uterine activity, normal fetal heart tones and a blood-stained vulva. Our diagnosis was a mild placenta abruption. An obstetrical ultrasound carried out revealed a normal pregnancy and a retroplacental blood clot of 11mm. A safe baby was born through an emergency cesarean section which revealed a normally inserted bipartite placenta with a 10% placenta detachment located on one placenta half and two cords inserted marginally. The postoperative period was uneventful and she was discharged five days after cesarean section. This case report shows that marginal cord insertion, which can lead to placenta abruption, can be also observed on a bipartite placenta.

EFFECT OF HBA1C LEVEL ON MODE OF DELIVERY

2018 ◽  
Vol 6 (2) ◽  
pp. 781-784
Author(s):  
SAIMA PERVEEN ◽  
PARVEEN NAVEED ◽  
NAZISH HAYAT ◽  
NADIA RASHID
Keyword(s):  
Cesarean Section ◽  
Teaching Hospital ◽  
Gestational Age ◽  
Maternal Age ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Dominant Mode ◽  
Normal Vaginal Delivery ◽  
Number Of Patients ◽  
Sugar Levels

BACKGROUND: Perinatal outcome is related to the onset and duration of glucose intolerance. Theobjective of the study is to determine the effect of HbAlc on mode of delivery in Obs/Gynea departmentof Saidu Teaching Hospital, Swat.MATERIAL AND METHODS: This observational & descriptive study was carried out in theDepartment of Obstetrics and Gynecology at Saidu Teaching Hospital, Swat, from 1st March 2015 to29th Feb 2016. Total 313 pregnant women were included in the study, who had Gestational Diabetes orEstablished Diabetes.Detail history was taken regarding maternal age in years, gestational age in weeks.Abdominal examination was done for lie and presenting part of the fetus, and vaginal examination wereperformed. These patients were followed till the end of labour and their mode of delivery i-e; normalvaginal delivery, instrumental delivery or cesarean section was recorded. Maternal HbAlc level wasdone at the time of delivery and was categorized as Mild (< 6.5), Moderate (6.5-9) and severe (>9).Maternal HbAlc was measured in hospital laboratory. The numerical variables of mean HbAlc,maternal age in years and gestational age in weeks were analyzed by mean ± SD (range). Categoricalvariables like; grades of severity of HbAlc levels and frequency of modes of delivery were analyzed byfrequency (number) and relative frequency (percentages). SPSS 20 (SPSS Inc. Chicago, Illnios, USA)was used to analyze the data.RESULTS:The total number of patients was 313. Mean age of the study population was 27.85 ± 6.37(43 - 15) (95% Cl 28.39 - 27.30). The mean age of gestational amenorrhea, at which most of thepatients presented was 38.31 ± 3.02, ranging from 41 to 29, (95%CI 38.57 - 38.5). The meanglycosylated Hemoglobin (HbAlc) was 6.9 ± 1.69 (95% Cl 6.17 - 5.88). Majority of the patients hadpoorly controlled diabetes, i-e: 64%. In different levels of HbAlc levels, normal vaginal delivery wasthe pre dominant mode of delivery.CONCLUSION:^ patients with uncontrolled diabetes the rate of complications increased and so doesthe rate of macrosomia and fetal distress, leading to higher rate of cesarean section and instrumentaldelivery, so by strict control of the blood sugar levels in a diabetic patient one can reduce the risk ofoperative deliveries and complications.KEY WORDS:Hbalc levels, Mode of delivery, cesarean section

Cervical Length Monitoring in Placenta Previa to Predict Emergency Cesarean Section for Antepartum Hemorrhage [06M]

2020 ◽  
Vol 135 ◽  
pp. 136S
Author(s):  
Aarti Chitkara ◽  
Sujata Siwatch ◽  
Rashmi Bagga ◽  
Subas Chandra Saha ◽  
Tulika Singh
Keyword(s):  
Cesarean Section ◽  
Placenta Previa ◽  
Cervical Length ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean

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.

Comparison of Melatonin Levels in the Colostrum between Vaginal Delivery and Cesarean Delivery

2017 ◽  
Vol 35 (05) ◽  
pp. 481-485 ◽  
Author(s):  
Ziya Kalem ◽  
Tuncay Yuce ◽  
Batuhan Bakırarar ◽  
Feride Söylemez ◽  
Müberra Namlı Kalem
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Elective Cesarean Section ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cross Sectional ◽  
Emergency Cesarean ◽  
Study Results ◽  
Elective Cesarean

Objective This study aims to compare melatonin levels in colostrum between vaginal and cesarean delivery. Study Design This cross-sectional study was conducted with 139 mothers who gave live births between February 2016 and December 2016. The mothers were divided into three groups according to the mode of delivery: 60 mothers (43.2%) in the vaginal delivery group, 47 mothers (33.8%) in the elective cesarean delivery, and 32 mothers (23.0%) in the emergency cesarean delivery group. Colostrum of the mothers was taken between 01:00 and 03:00 a.m. within 48 to 72 hours following the delivery, and the melatonin levels were measured using the enzyme-linked immunosorbent assay (ELISA) and compared between the groups. Results The melatonin levels in the colostrum were the highest in the vaginal delivery group, lower in the elective cesarean section group, and the lowest in the emergency cesarean group (265.7 ± 74.3, 204.9 ± 55.6, and 167.1 ± 48.1, respectively; p < 0.001). The melatonin levels in the colostrum did not differ according to the demographic characteristics of the mothers, gestational age, birth weight, newborn sex, the Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores, and for the requirement for neonatal intensive care. Conclusion Our study results showed that melatonin levels in the colostrum of the mothers who delivered vaginally were higher than those who delivered by cesarean section. Considering the known benefits of melatonin for the newborns, we believe that vaginal delivery poses an advantage.

scholarly journals POSTDATE PREGNANCIES

2009 ◽  
Vol 16 (03) ◽  
pp. 454-45
Author(s):  
MADIHA RASHID ◽  
SHAMAILA HALEEM ◽  
SADIA CHEEMA
Keyword(s):  
Caesarean Section ◽  
Study Design ◽  
Fetal Distress ◽  
Descriptive Study ◽  
Morbidity And Mortality ◽  
Common Mode ◽  
Study Results ◽  
Meconium Staining ◽  
Set Up ◽  
Study Setting

Objective: The study was designed to determine the fetomaternal morbidity and mortality in post date pregnancies and tocalculate various modes of delivery in post date pregnancies in our set up. Study design: Non interventional descriptive study. Setting: GyneaUnit- III Services Hospital, Lahore. Material and methods: The data was collected with the help of Proforma which was filled for every patientdelivered at 40 weeks of gestation or above. The proforma included all points relevant to study. Results: The rate of meconium staining of liquor,fetal distress and caesarean section (C-section) increased significantly after 40 weeks gestation. Conclusion: The study shows that morechances of meconium staining, fetal distress and macrosomia in Post date patients. The study further shows that the induction and operativedeliveries are more common mode of deliveries in post date patients.

scholarly journals THE RATE AND INDICATION OF CAESAREAN SECTION IN A TERTIARY CARE CENTRE

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Urvashi Kumawat ◽  
Neeta Natu
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Tertiary Care ◽  
Fetal Distress ◽  
The Elderly ◽  
Elderly Age ◽  
Tertiary Care Centre ◽  
Live Births ◽  
Cesarean Births ◽  
History Of

Method: The rate of caesarean section was only slightly higher than recommended by the WHO. Most of caesarean sections were emergency caesarean sections. Data on all live births were collected, including type of delivery, and indication was recorded if cesarean section was done. Total, primary, & repeat cesarean section rates were calculated for each year. The cesarean rate was calculated as the number of cesarean births divided by total live births. The rate for each indication was calculated annually as the number of cesarean births performed for each indication per 1,000 live births.   Result: These two groups constituted nearly 87.7% of total C-Sections. Only 3.4% of the cases belonged to the elderly age group of above 35 years. Maximum no. of caesarean sections was in multiparous females (54.3%).  Out of 550 caesarean deliveries 76.7% were from urban area. Also, result showed that only 68.7% were booked for antenatal care. Conclusion: The rate of cesarean section has increased with time with primary and repeat cesareans both showing an increase. In the primary CS rate, indications like labor arrest disorders & fetal distress show an increase more than the objective indications like malpresentation. In repeat CS, history of 02 or more previous sections & scar tenderness contributed more than the fetal distress. Keywords: Indication, Caesarean

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