scholarly journals Frequency of Caesarean Delivery on maternal request in a private teaching hospital

2020 ◽  
Vol 24 (2) ◽  
pp. 139-143
Author(s):  
Fozia Umber Quraishi ◽  
Saima Jabeen ◽  
Wajiha Alvi
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Teaching Hospital ◽  
Caesarean Delivery ◽  
Caesarean Section Rate ◽  
Normal Vaginal Delivery ◽  
Maternal Request ◽  
Normal Delivery ◽  
Vaginal Deliveries ◽  
Private Teaching

Introduction: Caesarean section rates are increasing worldwide. There are many reasons for this increasing caesarean section rate one of them is increasing requests by women for caesarean section in the absence of medical indications. Most women think that elective caesarean section is safe both for women and babies. Some clinician also considered caesarean section safe. An increasing rate of caesarean section is alarming in developed as well as underdeveloped countries. Objective: To investigate the frequency of caesarean section on maternal request and factors leading to it in a private teaching hospital. Materials and Methods: This was a cross-sectional descriptive study carried out at Shalamar hospital from 1st May 2018 to 30th April 2019. Women of all ages who were pregnant and were going to have caesarean delivery during the study period at Shalamar hospital. Results: There were 3438 total births during the study period. There were 2380(69%) caesarean section and 1058(31%) were normal vaginal deliveries. Caesarean section rate was 69%. Caesarean sections performed on maternal request were 167(7%) out of 2380 caesarean. Out of these 167 Seventy-two, 43.1% of women were those who already have a previous caesarean section for different non-recurrent indications and now they don’t want the trial of labour and requested for caesarean section. Forty, 24% of women requested for a caesarean section because of fear of labour pains and eighteen, 10.8% were those who had a bad experience of the previous child-birth. Twelve, 7.2% of women had fear of failed vaginal delivery and eight women had fear of trauma to baby and three, 1.8% had fear of perineal trauma during the trial of normal vaginal delivery. Six, 3.6% of women had some social reasons for caesarean section and six, 3.6% had some bad experience of normal delivery of their relatives or friends and two, 1.2% were those who were requesting caesarean section because of their family members preferences. Conclusion: Most of the women requesting for caesarean section were those who had previously trial of labour. We can control the caesarean section rate by proper counselling of pregnant women.

A STUDY OF POSTPARTUM INTRAUTERINE CONTRACEPTIVE DEVICE INSERTIONS IN CAESAREAN SECTIONS AND FOLLOWING VAGINAL DELIVERIES

2021 ◽  
pp. 1-3
Author(s):  
Shweta Pathak ◽  
Manaswita Samanta ◽  
Debarshi Jana
Keyword(s):  
Caesarean Section ◽  
Prospective Study ◽  
Clinical Outcomes ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Contraceptive Device ◽  
Obstetrics And Gynaecology ◽  
Vaginal Deliveries ◽  
Intrauterine Contraceptive

Aim: To study clinical outcomes of immediate postpartum IUCD insertion and to compare immediate postpartum IUCD insertion as a factor of route of insertion (caesarean vs. vaginal). Material and methods: This prospective study was conducted in a Department of Obstetrics and Gynaecology, College of medicine and JNM Hospital, Kalyani, Nadia. Duration of the study was one and half years [ 15 months inclusion, 3 months follow up]. Total 100 cases are included [50 vaginal and 50 caesarean]. Women who were attending or referred to OPD or ER of Dept. of Obst and Gynae, College of medicine and JNM Hospital and delivering either vaginally or by caesarean section, have received counseling for postoperative contraception and have consented to PPIUCD insertion Result:It was found that in Caesarean, 26(52.0%) patients had bleeding P/V 6 weeks. In Vaiginal, 28(56.0%) patients had bleeding P/V 6 weeks. Association of bleeding P/V 6 weeks vs. group was not statistically signicant (p=0.61968). In Caesarean, 11(22.0%) patients had bleeding P/V 3 weeks. In Vaiginal, 13(26.0%) patients had bleeding P/V 3 weeks. Association of bleeding P/V 3 weeks vs. group was not statistically signicant (p=0.6395). Conclusion:Infection was not statistically signicant in two groups at 6 week and 3 month.Missing thread was signicantly higher caesarean delivery compared to vaginal delivery.It was also found that refusal/ continuation was more common in vaginal delivery compared to caesarean delivery, which was not statistically signicant.

scholarly journals On demand caesarean section: What’s women’s attitude?

1970 ◽  
Vol 2 (2) ◽  
pp. 12-15
Author(s):  
Nira S Shrestha ◽  
Sumita Pradhan
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
University Teaching ◽  
Normal Vaginal Delivery ◽  
On Demand ◽  
Assisted Delivery ◽  
The Right

Objectives: To evaluate the knowledge and attitude of Nepalese women towards mode of delivery and caesarean on demand. Study design: Hospital based cross sectional descriptive study where 200 pregnant women after 37 completed weeks of gestation were recruited randomly and interviewed, and their answers were analyzed. Results: Of the 200 interviewed pregnant women, all of them knew about normal vaginal delivery and caesarean delivery, but only 30% knew about instrumentally assisted delivery and 9% had heard about painless labour. Vaginal delivery was the preferred mode in 93% and 7% preferred caesarean delivery. Only 35% of the interviewed women believed that women should have the right to demand a caesarean section Conclusion: Knowledge assessment of two hundred women regarding the mode of delivery clearly indicates the need for strengthening counseling aspect of antenatal care and awareness program regarding mode of delivery. In Nepal on demand caesarean section is not provided in the University Teaching Hospital. However one third of women still felt that women should have the right to choose caesarean section on demand. Key words: Attitude, mode of delivery, Caesarean on demand. doi:10.3126/njog.v2i2.1448 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 12 - 15

scholarly journals Postpartum quality of life after normal vaginal delivery and caesarean section

2015 ◽  
Vol 2 (2) ◽  
pp. 13-18
Author(s):  
Yogendra Amatya ◽  
Samita Acharya
Keyword(s):  
Quality Of Life ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Elective Caesarean Section ◽  
Family Type ◽  
Normal Vaginal Delivery ◽  
Cross Sectional ◽  
Normal Delivery ◽  
Physical Health Composite Score

Introductions: Caesarean section is rising. The best method of delivery, vaginal or caesarean, for postpartum quality of life in women is a matter of controversy both from professionals’ perspectives and from women’s experience of childbirth. This study analyses quality of life after these two methods of deliveries.Methods: This was a cross-sectional comparative study in postnatal care outpatient department at Patan Hospital. Primipara women with normal delivery and elective caesarean section done in Patan Hospital were enrolled to analyse postpartum quality of life. The SF-12 questionnaire tool at 6 weeks post delivery was used to compare age, ethnicity, education, family type and employment. Data was analysed using ANOVA test for descriptive parameters.Results: There were 468 primipara, age 30-45 years, 94% in 15-30 years77.8% educated, 74.4% in joint family,73.5% housewife. Normal vaginal delivery was 360 (72.6%) and 128 (27.4%) elective caesarean. Vaginal delivery group had average SF score of Physical Health Composite Score of 68.7, Mental Health CompositeScore69.5 and total SF score 67.7. While in caesarean group, it was 64.8,64.1 and 63.4.Conclusions: Normal vaginal delivery had better quality of life resulting in both superior physical as well as mental health.Journal of Patan Academy of Health Sciences, Vol. 2, No. 2, 2015. page:13-18

scholarly journals COMPARISON OF POST PLACENTAL INTRAUTERINE CONTRACEPTIVE DEVICE INSERTION BETWEEN VAGINAL DELIVERY AND CAESAREAN SECTION IN A TERTIARY CARE HOSPITAL

2020 ◽  
Vol 70 (6) ◽  
pp. 1707-11
Author(s):  
Saira Tasneem ◽  
Sanum Kashif ◽  
Erum Pervaiz ◽  
Faisal Azam
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Acceptance Rate ◽  
Intrauterine Contraceptive Device ◽  
Normal Vaginal Delivery ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Vaginal Deliveries ◽  
Intrauterine Contraceptive ◽  
Post Placental

Objective: To compare the acceptability of insertion of post placental intra uterine contraceptive device, withrespect to gravidity between vaginal deliveries and caesarean sections. Study Design: Prospective comparative study. Place and Duration of Study: Frontier Corp Hospital, Quetta, from Jan 2019 to Jan 2020. Methodology: A total of 399 females with age of 18 to 45 years with gravidity (primi, multi and grand multigravida) were counselled during antenatal visits about benefits and risks of post placental intrauterine contraceptive device (PPIUCD) insertion. For complications, females were assessed at 1 and 6 weeks after delivery. Results: A total of 399 females with mean age 27.95 ± 5.07 years were included in study. About 235 (55.9%)women delivered vaginally and 164 (41.4%) women by caesarean section. Acceptance rate was 3.8% and 4.3% for vaginal and caesarean deliveries respectively. Eleven (73.3%) women were grand multi gravida and 4 women(26.6%) were multi gravid in vaginal delivery acceptance group versus 8 women (47%) grand multi and 9 women (52.9%) multi gravida in caesarean acceptance group. Five (15%) females presented with complications (3 with abdominal pain and 1 each with infection and expulsion). Conclusion: The overall acceptance rate of PPIUCD was low in this study, the acceptance rate was higher inwomen undergoing normal vaginal delivery (NVD) as compared to lower segment caesarean section (LSCS),similarly more of the grand multiparas accepted the method as compared to other participants however thedifferences were not statistically significant.

scholarly journals Changing trends in the indication of caesarean delivery in multigravida- experience from a referral center in Eastern India: a prospective study

2020 ◽  
Vol 9 (8) ◽  
pp. 3367
Author(s):  
Nikhil Sebastian ◽  
Anup Pradhan ◽  
Pesona Grace Lucksom
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Clinical Laboratory ◽  
Medical Science ◽  
Normal Vaginal Delivery ◽  
Maternal Request ◽  
Intraoperative Complication ◽  
Multiparous Women ◽  
A Prospective Study ◽  
Pro Forma

Background: Caesarean delivery is one of the commonly performed surgical procedures in obstetrics in today's practice. The objective of this study was to estimate the overall incidence and indications of primary caesarean delivery among multiparous women and to study the immediate maternal and perinatal outcome.Methods: It was a prospective observational study done in Sikkim Manipal Institute of Medical Science, Sikkim, India. It included all pregnant women after 28 weeks of gestation who had normal vaginal delivery in previous pregnancy but underwent caesarean delivery during current pregnancy (n=120) from January 2016 to December 2016. Authors collected data using a pro forma. Relevant history including demographic details, relevant clinical, laboratory and radiological examination, indication for caesarean delivery, details of delivery and neonate, and duration of hospital stay were noted. Data was described using descriptive data like mean and percentages.Results: Out of 1646 deliveries conducted, 49% were by caesarean section. It included 7.29% primary caesarean delivery in multigravida.  Majority of women (27%) were in the age group 25-29. Maternal request was the commonest indication for caesarean delivery (21.66%). Atonic PPH was the commonest intraoperative complication (2.5%). Surgical site infection was the commonest post-operative morbidity (3.33%). There were 51 perinatal morbidity and 2 perinatal mortality. There was no maternal mortality.Conclusions: Caesarean section rates in this study was higher than WHO recommendation (15% versus 49.69%). This shift in trend can be attributed to higher number of maternal request for caesarean delivery which can be avoided by good analgesic facility and good counselling.

scholarly journals Obstetrical outcome in post caesarean pregnancy

2018 ◽  
Vol 7 (11) ◽  
pp. 4561
Author(s):  
Anitha Aldur Manjappa ◽  
Soundara Raghavan Subrahmanian
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Clinical Situation ◽  
Labour Induction ◽  
Previous Caesarean Section ◽  
Success Rates ◽  
Vaginal Deliveries ◽  
History Of ◽  
Obstetrical Outcome

Background: Rates of caesarean delivery have increased over past 40 years. The increase has been attributed to liberalization of indications for caesarean sections. Repeat caesarean section is a major contributor to caesarean rates; Vaginal Birth After Caesarean (VBAC) is one of the methods to contain increasing caesarean rates. Success rates of 60-80% have been reported.Methods: This was a descriptive study involving 1000 pregnancies of period of gestation more than 28 weeks with history of one previous caesarean section. The women under study were subjected to either trial vaginal delivery or elective repeat caesarean delivery depending upon the clinical situation. The percentage of successful vaginal deliveries, factors responsible for failure of vaginal delivery and differences in outcome between successful vaginal delivery and caesarean delivery group were analyzed.Results: Out of the 1000 women, 423 underwent elective repeat caesarean delivery, of the remaining 577, 403 (69.8%) had successful vaginal delivery. Age of the woman and onset of labour were the only factors influencing the success of vaginal delivery. Women aged 35 years or more and women who needed labour induction had lower success of vaginal delivery. Maternal and perinatal outcome were worse in failed vaginal delivery group when compared to elective repeat caesarean delivery or successful vaginal delivery groups.Conclusions: Factors which are usually thought to influence the decision about trial vaginal delivery like prior vaginal delivery, indication for previous caesarean section and interpregnancy interval are not absolute in determining the decision or the outcome. Labour induction should be resorted with great caution in women with post caesarean pregnancy.

scholarly journals Caesarean delivery on maternal request (CDMR): clinical and ethical dilemma

2017 ◽  
Vol 6 (7) ◽  
pp. 3201
Author(s):  
Ankita Mann ◽  
Sumita Mehta ◽  
Anshul Grover
Keyword(s):  
Developing Countries ◽  
Caesarean Section ◽  
Ethical Dilemma ◽  
Maternity Care ◽  
Patient Autonomy ◽  
Caesarean Delivery ◽  
Caesarean Section Rate ◽  
Maternal Request ◽  
Research Education ◽  
Bioethical Debate

Now a days, in developing countries like India, one of the most common contributing factor for increasing caesarean section rate is CDMR (Caesarean delivery on maternal request). Incidence of CDMR reached upto 18 percent of total caesarean deliveries worldwide. The issue of CDMR is ongoing bioethical debate which highlights the struggle to balance patient autonomy with duty of obstetrician to uphold the principle of beneficence, non maleficence and justice. Our mission should be to promote safe, effective and satisfying maternity care for all women and their families through research, education, expertise and advocacy.

scholarly journals Outcome of Assisted Vaginal Deliveries in a Tertiary Care Centre in Bengaluru

2021 ◽  
Vol 10 (40) ◽  
pp. 3538-3542
Author(s):  
Sivasambu Gayatri ◽  
Sujani B. K. ◽  
Urvashi Urvashi ◽  
Priyanka Sinha
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity ◽  
Assisted Vaginal Delivery ◽  
Safe Delivery ◽  
Vaginal Deliveries

BACKGROUND The lower segment caesarean section (LSCS) audit shows an increase in caesarean section rates worldwide. Assisted vaginal delivery and, if needed, emergency caesarean section are options available to the obstetrician to handle challenges in the second stage when spontaneous and safe delivery is not imminent. Judicious use of the instrument as well as continuing medical education in the art of assisted vaginal delivery is a must to achieve the twin goal of containing the surging caesarean section rate as well as bring about a successful and safe assisted vaginal delivery. The objective of this study was to quantify the various morbidities associated with assisted vaginal deliveries among patients in a tertiary care teaching hospital in Bengaluru. METHODS It is a retrospective study carried for four years between July 2016 and June 2020 at Ramaiah Medical College at Bengaluru. The total number of vaginal deliveries was 6318 out of which 1020 had a successful assisted vaginal delivery and were studied in terms of outcomes, maternal and foetal indications and morbidity. RESULTS Out of 1020 assisted vaginal deliveries, 86.96 % were vacuum-assisted, 3.9 % were forceps assisted and 9.11 % were both vacuum and forceps assisted. The success rate of forceps deliveries was more compared to vacuum. No significant maternal and neonatal mortality and morbidity were observed in our study. CONCLUSIONS In this study, vacuum was the most used method of assisted vaginal delivery and was safer for mothers and babies. It is also easier to teach and learn. Forceps delivery was more used in preterm delivery. KEY WORDS Assisted Vaginal Delivery, Vacuum, Forceps, Sequential use of Instruments, Maternal and Neonatal Morbidity.

Effects of morphine administration on the fetal production of oxytocin in labour

1998 ◽  
Vol 95 (1) ◽  
pp. 91-95 ◽  
Author(s):  
S. W. LINDOW ◽  
M. S. HENDRICKS ◽  
J. W. THOMPSON ◽  
Z. M. VAN DER SPUY
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Umbilical Artery ◽  
Umbilical Vein ◽  
Elective Caesarean Section ◽  
Normal Vaginal Delivery ◽  
Endogenous Opiates ◽  
Second Stage Of Labour ◽  
Morphine Administration ◽  
Vaginal Deliveries

1.Animal and human work has indicated that maternal oxytocin secretion is under the control of endogenous opiates. Previous workers have described the fetal production of oxytocin in addition to maternal production. The study of the interaction between exogenously administered opiates and oxytocin secretion may give insight into the activity of any opiate-mediated regulatory mechanism of oxytocin secretion in the fetus. This study was designed to investigate the effect of an opiate (5 mg of morphine) given to the mother on the fetal production of oxytocin in labour. 2.Morphine was given by the attending clinicians for analgesic purposes to women in the first stage of labour. After delivery umbilical artery vein and maternal vein specimens were taken. 3.Four groups of patients were studied: women after normal vaginal delivery without analgesia in labour (n = 10); women after normal vaginal delivery who had morphine administration in the first stage of labour (n = 12); women who had an emergency Caesarean section in the first stage of labour (n = 11); women who had an elective Caesarean section at term who were not in labour (n = 11). 4.Oxytocin levels were measured by radioimmunoassay in the maternal vein, umbilical artery and umbilical vein specimens. Morphine was measured by radioimmunoassay in the umbilical vein specimens. 5.The umbilical artery minus vein concentration of oxytocin was calculated for each patient (A-V). There was no change in the umbilical (A-V) concentration of oxytocin if morphine had been given to the mother in labour; this applied to fetuses delivered vaginally or by Caesarean section. When the fetuses who were exposed to morphine were analysed separately, there was no correlation between the umbilical vein morphine concentration and the umbilical (A-V) oxytocin concentration either in Caesarean or vaginal deliveries. 6.Fetal oxytocin production was not affected by the maternal administration of morphine in the first stage of labour. This applies to the oxytocin production in the first and second stage of labour.

scholarly journals Changing Trend of Instrumental Vaginal Deliveries at Patan Hospital

2016 ◽  
Vol 10 (2) ◽  
pp. 33-35
Author(s):  
B Lamichhane ◽  
A Singh
Keyword(s):  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Forceps Delivery ◽  
Normal Delivery ◽  
Progressive Decline ◽  
Vaginal Deliveries ◽  
Increasing Trend ◽  
Vacuum Delivery ◽  
Changing Trend ◽  
The Mean

Aims: The aim of the study was to evaluate the changing trend of the instrumental vaginal deliveries at Patan hospital over the last 10 years.Methods: This was a retrospective study done at Patan hospital. The study included data of 10 years duration (July 15th, 2004 – July 14th, 2014). The data included total normal delivery, caesarean section, vacuum delivery, forceps delivery and total delivery of the respective years.Results: Out of 80,149 deliveries over 10 years, 1635 (2.03%) were instrumental vaginal delivery (IVD). The study revealed progressive decline in overall trend of instrumental vaginal delivery.  The highest percentage of IVD in the year 2005 was 265 (16.02%) and tangential dropped to 49 (2.9%) by 2014.  The study revealed markedly decreased trend in vacuum delivery from 2005 to 2010, but a positive deflection was noticed till 2013, and abrupt fall in the year 2014.Regarding forceps delivery, a gradual fall in trend was noticed over the years. Over the last 10 years the mean percentile value of vacuum delivery was 78.47% while that of forceps was 21.52 %.Conclusions: The trend of instrumental vaginal delivery has markedly declined. On the other hand, it has shown increasing trend in caesarean delivery.

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