scholarly journals ETHICAL DILEMMA OF CESAREAN SECTION ON MATERNAL REQUEST (CSMR)

2021 ◽  
Vol 71 (2) ◽  
pp. 535-39
Author(s):  
Abeera Choudary ◽  
Asifa Siraj ◽  
Humaira Tariq ◽  
Faiqa Chughtai ◽  
Uzma Urooj
Keyword(s):  
Pain Relief ◽  
Cesarean Section ◽  
Vaginal Delivery ◽  
Birth Outcome ◽  
Military Hospital ◽  
Cross Sectional ◽  
Maternal Request ◽  
Lower Segment Cesarean Section ◽  
Child Bearing ◽  
Negative Perceptions

Objective: To study the demographic characteristics of pregnant ladies and factors contributing towards rise in cesarean section on maternal request to aid the obstetricians in decision making. Study Design: Cross sectional analytical survey. Place and Duration: Gynecology Department of Pak Emirates Military Hospital, Rawalpindi, from Nov 2019 to Mar 2020. Methodology: One hundred and fifteen women of child bearing age requesting cesarean section were included in the study. Demographic details were noted. A study proforma was filled for determinants of primary and secondary tocophobia and factors that may be improved for vaginal delivery.Results: A total of 115 patients with mean age of 27.99 years were included. Amongst them, 88 (76.5%) were Punjabi with 92 (80%) living in rural area. Primigravida were 11 (9.6%), 83 (72.2%) had previous lower segment cesarean section and 3 (2.6%) had vaginal delivery. For primary tocophobia, 22 ( 24.4%) experienced anxiety. Fear of labor pains was seen in 20 (19.2%) and lack of control in 27 (26%). For secondary tocophobia, 15 (37.5%) were fearful of prolonged labor and 5 (22.5%) of sub optimal birth outcome. In women with previous one cesarean section, 13 (14.8%) correlated negatively with birth experience and 20 (22.7%) found timed cesarean section convenient. For vaginal delivery, pain relief was preferred by 19 (20.2%) and 31 (33%)wanted pain relief and attendant. Conclusion: Better understanding of fears behind maternal request for cesarean section can lead to improved attitudes towards vaginal delivery. The negative perceptions of pregnant ladies should be addressed in antenatal.........

scholarly journals Secondary Postpartum Hemorrhage Following Cesarean Section

2018 ◽  
Vol 9 (1) ◽  
pp. 23-25
Author(s):  
Surayea Bul Bul ◽  
Zobaida Sultana Susan ◽  
Raunak Jahan ◽  
Abu Nayeem ◽  
Farzana Rahman ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Causes Of Death ◽  
Severe Anaemia ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Pregnancy And Childbirth ◽  
Child Bearing ◽  
Secondary Postpartum Hemorrhage

Background : Complications of pregnancy and childbirth have always been one of the leading causes of death and disability among women of reproductive age in developing countries .Globally, postpartum haemorrhage is the single most important cause of maternal death, accounting for about 25% of the total and claiming an estimated 1,50,000 lives annually. Among the postpartum hemorrhage, the primary postpartum hemorrhage is more prevalent, but sufferings from secondary postpartum hemorrhage have been emerging. With the rising trend of cesarean section rate, the incidence of secondary postpartum hemorrhage is also rising.Objective: The objectives of this study is to evaluate secondary postpartum hemorrhage cases following cesarean section and vaginal delivery with the aim of reducing the maternal mortality at child bearing age.Methods: This is a cross sectional observational study in the department of Obstetrics and Gynaecology, DMCH , by purposive sampling method. Total 100 cases of secondary PPH were observed during 1st January 2013 to 31 December 2013.Result: In this study, among the cases 67% were following cesarean section and 33% were following vaginal delivery, mean age of the patients were 29 year, parity ranges from 1 to 5. Regarding the outcome of secondary PPH, severe anaemia, anaemic heartfailure, renal failure and DIC were common in cesarean sections along with hazards of massive blood transfusion and jaundice. 7 patients were died in post cesarean cases and 2 died in post vaginal delivery cases. Causes of death were due to hemorrhagic shock & septicemia.Conclusion: In this is study, the rate of secondary PPH is 67% following cesarean section which is very much alarming . The outcome of secondary PPH following cesarean section is worse than vaginal delivery.J Shaheed Suhrawardy Med Coll, June 2017, Vol.9(1); 23-25

scholarly journals Effect of transcutaneous electrical nerve stimulation on labour pain relief among primigravida and multigravida mothers

2017 ◽  
Vol 6 (3) ◽  
pp. 980 ◽  
Author(s):  
Ramamoorthy Veyilmuthu ◽  
Sumathi Govindan ◽  
Mahalakshmi Venugopalan ◽  
Seetha Panicker
Keyword(s):  
Pain Relief ◽  
Cesarean Section ◽  
Vaginal Delivery ◽  
Labour Pain ◽  
Normal Vaginal Delivery ◽  
Good Effect ◽  
Second Stage Of Labour ◽  
Lower Segment Cesarean Section ◽  
Multiparous Women ◽  
Postnatal Mothers

Background: TENS by neuro-physiological means seems to help in relieving labour pain. Most of the pregnant women are not aware of the coping strategies for labour pain. As a result they tend to be restless and stress themselves by shouting or screaming due to pain. By using TENS, women in labour can save their energy without stressing themselves and make use of the saved energy for pushing the fetus during the second stage of labour. The objective was to analyze the effect of TENS on relieving labour pain among the postnatal mothers who had used TENS to cope up with the labour pain.Methods: Data collected from 1041 women [Primipara (n=702) and Multipara (n=339)] who used TENS to cope up pain throughout the labour was used for this retrospective study.Results: 88% of women had vaginal delivery and only 12% of women had cesarean section. More than 50% of both primiparous and multiparous women who had normal and vacuum assisted vaginal delivery experienced excellent pain relief using TENS. Almost 40 % of both primiparous and multiparous women who had forceps delivery and lower segment cesarean section experienced excellent pain relief using TENS. Except 2% of women with normal vaginal delivery, none of them stated that there was no relief of pain using TENS.Conclusions: TENS had a very good effect in coping up the labour pain and could be used during the first and second stages of labour.

scholarly journals Diagnostic Accuracy of Lower Uterine Segment Scar Thickness ≤1.6mm in Prediction of Scar Dehiscence in patients

2021 ◽  
Vol 15 (10) ◽  
pp. 2682-2684
Author(s):  
Fiza Asif ◽  
Sobia Zafar ◽  
Tehmina Zafar ◽  
Tayyaba Majeed ◽  
Zahid Mahmood
Keyword(s):  
Cesarean Section ◽  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Lower Uterine Segment ◽  
Transvaginal Sonography ◽  
Cross Sectional ◽  
Standard Material ◽  
Lower Segment Cesarean Section ◽  
Study Results ◽  
Uterine Scar

Background: Cesarean section uterine scar dehiscence (CSD) is a rare but notable complication of Lower segment cesarean section (LSCS) surgery. The cause for a uterine scar dehiscence is based on the etiology behind the uterine scar defect or any event that would predispose the cesarean scar to dehisce. Globally accepted option for assessing the CS scar is transvaginal ultrasonography of the non-pregnant uterus. Objective: To determine the diagnostic accuracy of lower uterine segment scar thickness≤1.6mm in the prediction of scar dehiscence in patients with previous one LSCS who are undergoing repeat LSCS after trial of labour taking intraoperative findings as gold standard. Material and methods: This cross sectional study was conducted in Services Hospital, Lahore for 6 months. The Non probability consecutive sampling technique was used to include women with previous one LSCS at 36-38 weeks were asked to get their TVS done for scar thickness. Women with scar thickness≤1.6mm and scar thickness>1.6mm were identified. Their intraoperative findings of scar dehiscence were confirmed. All the data was entered and analyzed on SPSS version 20. Results: The mean age of patients was 29.87±6.07 years. The emergency LSCS was done in 599(49.1%) patients and elective LSCS was done in 621(50.9%) patients. The sensitivity, specificity & diagnostic accuracy of TVS was 98.31%, 99.05% & 98.69% respectively. Conclusion: According to our study results the TVS for uterine scar is a very useful and effective tool in the prediction of scar dehiscence in patients with previous one LSCS taking intraoperative findings as gold standard. Keywords: Transvaginal sonography, TVS, Uterine, Scar, dehiscence, LSCS, Intraoperative

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 Obstetric and Neonatal Outcome in Second-Pregnancy Patients with One Prior Cesarean Section at A Costarican Hospital 2006-2007

2011 ◽  
Vol 52 (1) ◽  
Author(s):  
Manrique Leal Mateos ◽  
Loretta Giacomin Carmiol ◽  
Rafael A Moya Sibaja
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Neonatal Resuscitation ◽  
Obstetric Complications ◽  
Obstetric Outcomes ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Neonatal Complications ◽  
Vaginal Deliveries ◽  
Prior Cesarean Section

Aim: To analyze neonatal and obstetric outcomes in second-pregnancy patients with 1 prior cesarean section.Materials and methods: This study is a cross-sectional observational study. We analyzed 306 medical records of patients treated at the Dr. Rafael A. Calderón Guardia Hospital (HCG), from January 1st 2006 to December 31st of 2007. Maternal variables associated to prenatal control were age and obstetrical indication of the previous cesarean delivery. Variables associated to delivery were gestational age, type of delivery, obstetric complications, and length of hospital stay. The neonatal variables were weight at birth, 5 minute Apgar score, neonatal complications, need for neonatal resuscitation or newborn hospitalization and length of hospital stay.Results: 59, 1% of the patients with 1 prior cesarean section had successful vaginal delivery. The percentage of maternal complications was significantly higher for those who underwent a cesarean section during labor.Uterine rupture occurred in 1,3% of the cases and no maternal or neonatal deaths were found as a consequence of such complication. The percentage of neonatal complications was similar for both groups. The need for neonatal resuscitation was significantly higher in the group that underwent an elective caesarean delivery.Conclusion: Our results show that at the HCG from January 1st 2006 to December 31st of 2007, a vaginal delivery in second-pregnancy patients with 1 prior caesarean delivery appears to be safe. The percentage of successful vaginal deliveries, obstetric complications and uterine rupture were similar to those reported in international literature. 

scholarly journals Perbandingan Nilai Apgar antara Persalinan Normal dengan Seksio Sesarea Elektif

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Neila Azka ◽  
Syahredi Syahredi ◽  
Eva Chundrayetti
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Apgar Score ◽  
Cross Sectional Study ◽  
Elective Cesarean Section ◽  
Normal Vaginal Delivery ◽  
Sectional Study ◽  
Cross Sectional ◽  
Elective Cesarean ◽  
Minute Apgar Score

AbstrakPada masa sekarang ini telah terjadi perubahan tren dalam persalinan, yaitu berupa peningkatan angka seksio sesarea. Peningkatan ini dipengaruhi berbagai faktor seperti: adanya kekhawatiran akan terjadinya cedera janin, peningkatan permintaan ibu untuk melakukan persalinan seksio sesarea, serta faktor sosioekonomi. Beberapa penelitian justru menunjukkan seksio sesarea dapat menimbulkan morbiditas pada bayi. Tujuan penelitian ini adalah membandingkan kondisi bayi antara persalinan normal dan seksio sesarea elektif dilihat dari nilai Apgar Penelitian dilaksanakan dari Mei 2014 sampai Januari 2014 di bagian rekam medis RSUP Dr. M. Djamil Padang.. Jenis penelitian yang digunakan adalah analitik dengan desain cross-sectional study. Sampel dalam penelitian ini terdiri dari 179  pasien dengan persalinan normal dan 56 pasien dengan seksio sesarea. Hasil penelitian menunjukkan bahwa pada menit pertama nilai Apgar 4-6 adalah 3,4% pada persalinan normal. Nilai Apgar 7-10 sebanyak 96,6% pada persalinan normal dan 100% pada seksio sesarea pada menit pertama. Pada menit kelima, nilai Apgar 4-6 adalah 1,1% pada persalinan normal, sedangkan nilai Apgar 7-10 sebanyak 98,9% pada persalinan normal dan 100% pada seksio sesarea pada menit kelima. Setelah dilakukan analisis dengan mann-whitney test didapatkan bahwa tidak terdapat perbedaan nilai Apgar pada menit-1 (p=0,777) dan menit-5 (p=0,887) antara persalinan normal dengan seksio sesarea.Kata kunci: persalinan normal, seksio sesarea elektif, nilai Apgar AbstractIn recent years, cesarean section have increased. Several factor are contributing, such as fears of injury to the fetus, increased women's request to do a cesarean section deliveries and socioeconomic factors. Some studies have also shown that cesarean section can lead to morbidity in infants. The objective of this study was to compare between Apgar scores of infant born by elective cesarean section and normal vaginal deliveries. The research was done from May 2013 to January 2014 at the medical records department of general hospital center Dr. M. Djamil Padang. This was an analytic study with cross-sectional study design. This study used 179 samples with normal vaginal delivery and 56 samples with cesarean section. The result showed that 1st minute Apgar score of 4-6 in normal vaginal delivery was 3.4%, and Apgar score 7-10 was 96.6% in normal vaginal delivery while in cesarean section was 100%. The 5th minute Apgar score of  4-6 in normal vaginal delivery was 1.1%, and Apgar score 7-10 was 98.9% in normal vaginal delivery while in cesarean section was 100%. After being analyzed using Mann-Whitney test, the study showed that there was no significant different in Apgar score of neonates born through normal vaginal delivery and neonates born trough cesarean section at first minute (p=0.777) and fifth minute (p=0.887).Keywords: normal vaginal delivery, elective cesarean section, Apgar score

scholarly journals The Commonest Indications of Cesarean Sections at Ghalib Teaching Hospital in Year 2017; Cross-sectional Study

2021 ◽  
Author(s):  
Mohammad Rafi Fazli ◽  
Amena Mansouri ◽  
Hania Wahidi
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Teaching Hospital ◽  
Cross Sectional Study ◽  
High Rate ◽  
Cesarean Sections ◽  
Sectional Study ◽  
Cross Sectional ◽  
Previous Cesarean

Abstract Background: In the past few decades, the rate of cesarean section (CS) has increased worldwide which is common in high income countries. Although cesarean section has lots of socioeconomic impacts in the career of mothers and babies especially in LMICs like Afghanistan, it is also increasing in such countries. In compare to vaginal delivery the cesarean section has higher risks for maternal health. The most important aim of this study is to search the commonest indications of cesarean section at the only teaching hospital in west region of Afghanistan, Ghalib Teaching Hospital in 2017.Material and Method: This was a cross-sectional study. Among 456 pregnant women who came to Ghalib Teaching Hospital, 287(63%) had vaginal delivery and 169 (37%) had cesarean section delivery in 2017. Data was collected reviewing medical records; patients discharge certificate and a questionnaire which consisted of the data like; history of previous cesarean sections, age, and so on. Data was analyzed by epi info 7.Results: the prevalence of cesarean section in Ghalib Teaching Hospital was 37%, the median age was 28 years old, the mean age was 23.83 and the most ages were between 21-25 (42.5%). The commonest indications were severe oligohydramnios (29.5%) followed by previous cesarean section (12.4%) and elective cesarean section 10.9% (on maternal request). The least indication was cephalopelvic disproportion (3.09%). In our research we had more than one indication about 10.3%.Conclusion: according to the research the commonest indication of cesarean section was severe oligohydromnios which shows emergency indication among pregnant women. As the women in Afghanistan want many children so they usually do not consider having cesarean section deliveries. Cesarean section on maternal request also has high rate which needs appropriate guidelines and also policies to decrease this high rate of selective cesarean section. In our research 52.1% of indications of CS was fetal factors. This shows in LMICs many fathers have valued to the health of babies instead of mothers. It is highly needed to inform fathers to know about health of both babies and mothers.

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