“THE WAR WHEN YOU ALREADY HAVE A SCAR” -STUDY OF DIFFICULTIES IN EXTRACTION OF BABY IN PREVIOUS CESAREAN SECTION

2021 ◽  
pp. 68-70
Author(s):  
Ashwini N Hotkar ◽  
Prashanth Bhingare ◽  
Srinivas Gadappa ◽  
Sasireka Kuppuswami ◽  
Priyanka Kesharwani
Keyword(s):  
Cesarean Section ◽  
Care Hospital ◽  
Previous Cesarean Section ◽  
Trial Of Labor ◽  
Tertiary Centre ◽  
Risk Pregnancy ◽  
Pregnancy Status ◽  
Repeat Cesarean Section ◽  
Time Of Operation ◽  
Previous Cesarean

Background:The study of intraoperative difculties in extraction of baby in previous cesarean section Method:This is a tertiary centre based prospective observational study conducted in the department of Obstetrics and Gynaecology, at our tertiary health Care hospital between the study period October 2018-september 2020.A total 1200 cases of patients with previous cesarean section were studied . They are divided into number of previous scar and the intraoperative surgical difculty encountered by the surgeon in delivering the baby based on the consequences of scar from previous cesarean section. Results: The incidence of repeat cesarean section being 9.4%, among which only of 38% cases were encountered with difculties in cesarean section by the surgeons in the institute. Among which 26.3% cases were encountered with Adhesions,4.2% with difculty in delivery of baby, 1.5% cases needed assistance by senior surgeon in delivering baby and 6% among that had poor perinatal outcome. Conclusions: The common clinical entity of “previous cesarean section” in subsequent pregnancies, giving a high risk pregnancy status to the reference pregnancy. The risks associated with repeat cesarean section can be reduced by many measures including-vigorous ANC surveillance to reduce the risk of primary CS, intervention by operative vaginal delivery whenever needed, giving trial of labor in cesarean section(TOLAC) with skilled monitoring, counselling of patients regarding perineal exercises in pregnancy. Most complications will be recognized at the time of operation and easily corrected either by the operating surgeon or by seeking assistance from other specialties

scholarly journals Trail of labor versus elective repeat cesarean section: a comparison of morbidity and mortality at tertiary care teaching hospitals in India

2018 ◽  
Vol 7 (11) ◽  
pp. 4476
Author(s):  
Balwan Singh Dhillon ◽  
Nomita Chandhiok ◽  
M. Vishnu Vardhana Rao
Keyword(s):  
Cesarean Section ◽  
Maternal Morbidity ◽  
Management Practices ◽  
Tertiary Care ◽  
Teaching Hospitals ◽  
Previous Cesarean Section ◽  
Trial Of Labor ◽  
Repeat Cesarean Section ◽  
Elective Repeat Cesarean ◽  
Previous Cesarean

Background: As cesarean birth rates continue to rise, more women are faced with the choice of planning a vaginal delivery or a repeat cesarean section after a previous cesarean section. The objective of this prospective study was to study the morbidities and mortality of women attempting a trial of labor after cesarean (TOLAC) versus elective repeat cesarean section (El-RCS).Methods: Prospective data was recorded on management practices, associated complications and morbidity & mortality for a period of 8 months on 15664 consecutive cases of previous cesarean section reporting at 30 medical colleges/ teaching hospitals for delivery.Results: A trial of labor was planned in 25.8% (4035) women and 34.5% (5399) women underwent elective repeat cesarean section and rest had emergency repeat cesarean section. Overall maternal morbidity due to any cause was 20.7% among El-RCS as compared to 14.2% in TOLAC which was statistically significant (OR: 1.57, CI: 1.41-1.76, P=0.00). Blood loss of more than 1000ml was around 8.0% among TOLAC where as in El-RCS it was 8.8% (OR: 0.89, CI: 0.77-1.94, p=0.14 not statistically significant). Blood transfusion was given in 3.7% in TOLAC where as in El-RCS it was given in 6.5% (OR: 0.56, CI: 0.45-0.68, p=0.00 highly significant).  Complication like dehiscence of scar was similar in both groups. Post-operative complication were seen in 2.8% cases in TOLAC where as in El-RCS it was 5.8% (OR: 0.47, CI: 0.38-0.59, p=0.00 highly significant). Uterine rupture was 0.3% in TOLAC where as in El-RCS it was 0.7% (OR: 0.43, CI: 0.21-0.87, p=0.009 statistically significant). Maternal mortality was reported in 0.2% cases of TOLAC as compared to 0.1% cases in El-RCS (p=0.17) which was not statistically significant.Conclusions: Maternal morbidity was found to be more in elective repeat cesarean section than trial of labor after cesarean section.

scholarly journals Prevalence of Repeat Cesarean Section in a Tertiary Care Hospital

2020 ◽  
Vol 58 (229) ◽  
Author(s):  
Jyotshna Sharma ◽  
Sanjeeb Tiwari ◽  
Saraswati M Padhye ◽  
Bidya Mahato
Keyword(s):  
Cesarean Section ◽  
Teaching Hospital ◽  
Vaginal Birth ◽  
Care Hospital ◽  
Previous Cesarean Section ◽  
Vaginal Birth After Cesarean ◽  
Medical College ◽  
Increased Risk ◽  
Repeat Cesarean Section ◽  
Previous Cesarean

Introduction: Cesarean section is the surgical delivery of a baby through an incision made in the mother's abdomen and uterus. Repeat cesarean section has recently increased, partly because of concern about increased risk of uterine rupture in women attempting vaginal birth after cesarean delivery. Among the women who underwent cesarean section in their first delivery, 80-96% had a second surgical delivery. Therefore, the present study aimed to describe the prevalence of repeat cesarean section among Nepali women presented at Kathmandu Medical College and Teaching Hospital who had a previous cesarean section.   Methods: This was a descriptive cross-sectional study conducted in Kathmandu Medical College and Teaching Hospital from 1st of February to 31st of May 2020. Ethical approval was taken from the Institutional Review Committee of the Kathmandu Medical College. Convenient sampling was done. All pregnant patients between gestational ages of 37-40 weeks with previous cesarean section admitted for safe confinement were included in the study.   Results: Among the 104 women, who had prior cesarean section, 99 (95.19%) had second cesarean section and 5 (4.81%) had vaginal birth after cesarean. The most common indication for the first cesarean section was fetal distress 31 (29.81%) while the indication for the second cesarean section among previously cesarean section women was cephalo pelvic disproportion 39 (39.40%).   Conclusions: The proportion of cesarean section in both first and subsequent delivery is quite high. This high rate may compromise the reproductive future of the women who underwent consecutive cesarean section with possible consequent complications.

scholarly journals Analysis of Cesarean Sections using Robson’s Ten Group Classification System

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Rashida Parveen ◽  
Mehnaz Khakwani ◽  
Anum Naz ◽  
Rabia Bhatti
Keyword(s):  
Cesarean Section ◽  
Classification System ◽  
Fetal Distress ◽  
Group Classification ◽  
Care Hospital ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Group 10 ◽  
Group 5 ◽  
Previous Cesarean

Objective: To analyze trends of CSs and evaluating them according to Robson’s Ten Groups Classification System (TGCS) at a leading government tertiary care hospital of South Punjab, Pakistan. Methods: This cross-sectional study was conducted at Department of Obstetrics and Gynaecology, Nishtar Medical University Hospital, Multan Pakistan, from October 2019 to March 2020.The study population included a total of 167 women who underwent CS in the hospital during the specified study period. For each case, we collected data regarding maternal characteristics and pregnancy-related information. The dependent variable was Robson classification group. Results: Overall, mean age was 26.53+5.1 years. Majority of the women, 116 (69.5%) belonged to urban areas of residence, 74 (44.3%) gestational aged between 37-42 years while 108 (64.7%) had history of cesarean section. Most of the patients, 85 (50.9%) turned out to be from TGCS Group-10. Group-5 and Group-1 were the 2nd and 3rd most common group, accounted for 24 (14.4%) and 19 (11.4%) cases respectively. Previous cesarean section (20.4%) and fetal distress (19.8%) were found to be most common indications leading to cesarean section. Conclusion: As per Robson’s Ten-Group Classification, Group-10 and Group-5 were found to be the most contributing among deliveries done. Previous cesarean section and fetal distress were the most common indications of cesarean section. doi: https://doi.org/10.12669/pjms.37.2.3823 How to cite this:Parveen R, Khakwani M, Naz A, Bhatti R. Analysis of Cesarean Sections using Robson’s Ten Group Classification System. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3823 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Prevalence of Cesarean Section and Its Indications in A Tertiary Care Hospital

2019 ◽  
Vol 57 (216) ◽  
Author(s):  
Smrity Maskey ◽  
Manisha Bajracharya ◽  
Sunita Bhandari
Keyword(s):  
Cesarean Section ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Hypertensive Disorder ◽  
Care Hospital ◽  
Previous Cesarean Section ◽  
Common Indication ◽  
Vaginal Deliveries ◽  
Previous Cesarean

Introduction: Cesarean section is a surgical procedure performed to deliver fetus through abdominal route. Increasing rate of cesarean section worldwide is an alarming concern for public health and obstetricians due to increase in financial burden and risk to health of the mother in comparison to vaginal delivery. The aim of the study was to find the prevalence of cesarean section and its most common indication in a tertiary care hospital. Methods: This descriptive cross-sectional study was done in a tertiary care hospital, from July 2016 to June 2018 after taking ethical clearance from institutional review board. Convenience sampling was done to reach the sample size. Data was collected and entry was done in microsoft excel, point estimate at 95% CI was calculated along with frequency and proportion for binary data and analysis was done. Results: Out of total deliveries conducted, 862 (36.8%) were CS deliveries, 1477 (63.1%) were vaginal deliveries, and 12 (0.51%) were instrumental deliveries. Prevalence of CS is 862 (36.8%) at 95% CI (34.82%-38.78%). Mean age±S.D of delivering mother was found to be 26.1±0.25 years. Primi cesarean section was more than repeat cesarean section. Most common indication of cesarean section was fetal distress 243 (28%) followed by previous cesarean section 165 (18%), non-progress of labour 106 (12%), oligohydramnios 59 (7%), malpresentation 59 (7%), cephalo pelvic disorders 52 (6.5%), and hypertensive disorder in pregnancy 33 (4%). Conclusions: Prevalence of cesarean section in a tertiary care hospital is high compared to WHO data. The most common indication of cesarean section are fetal distress and previous cesarean section.

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