Analytic Study of Indications and Complications Associated with Cesarean Section in Omar AL-Mukhtar Hospital

Cesarean section (C-section) is a surgical procedure designed to ensure the safety of the mother and the child when vaginal delivery is not possible. There is a progressive increase in cesarean deliveries across the world. C-section is associated with increased morbidity and mortality in pregnant mothers and infants, particularly in developing countries. The aim of the current study was designed to determine the rate and identify the indications and find out complications associated with C-sections in Omar AL-Mukhtar hospital. The descriptive retrospective study was carried out with data retrieved from statistics files from January 2018 to December 2018. A total of 754 births during the study period, out of the 226 were delivered by C-section. The overall C-section rate was 29.9%. The maximum number of C-sections was in the age group of 31-40 years (42%) followed by 41.2% of women in the age group of 21-30 years. The most common indication was elective repeated C-section (17%) followed by previous one C-section with other causes (10.6%), fetal distress (9.29%). The complications in our study were about 47 cases and were less accounted for (20.79%), like, postpartum and intraoperative hemorrhage, and anesthetic complications, which represented 5.75%, and 10.62% respectively. In conclusion: The cesarean delivery rate in this study was higher than the WHO recommendation, and elective repeat cesarean delivery was a major common indicator. Keywords: C-section; Indication; Complication of C- section

Probability of severe postpartum hemorrhage in repeat cesarean deliveries: a multicenter retrospective study in China

To determine the factors predicting the probability of severe postpartum hemorrhage (SPPH) in women undergoing repeat cesarean delivery (RCD). This multicenter, retrospective cohort study involved women who underwent RCD from January 2017 to December 2017, in 11 public tertiary hospitals within 7 provinces of China. The all-variables model and the multivariable logistic regression model (pre-operative, operative and simple model) were developed to estimate the probability of SPPH in development data and external validated in validation data. Discrimination and calibration were evaluated and clinical impact was determined by decision curve analysis. The study consisted of 11,074 women undergoing RCD. 278 (2.5%) women experienced SPPH. The pre-operative simple model including 9 pre-operative features, the operative simple model including 4 pre-operative and 2 intraoperative features and simple model including only 4 closely related pre-operative features showed AUC 0.888, 0.864 and 0.858 in development data and 0.921, 0.928 and 0.925 in validation data, respectively. Nomograms were developed based on predictive models for SPPH. Predictive tools based on clinical characteristics can be used to estimate the probability of SPPH in patients undergoing RCD and help to allow better preparation and management of these patients by using a multidisciplinary approach of cesarean delivery for obstetrician.