scholarly journals Analysis of repeat LSCS in a tertiary care centre

2018 ◽  
Vol 7 (5) ◽  
pp. 1963
Author(s):  
M. Poovathi ◽  
Suilharsini T. S.
Keyword(s):  
Caesarean Section ◽  
Tamil Nadu ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Management Strategies ◽  
Negative Consequences ◽  
Care Needs ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Set Up

Background: Caesarean section (CS) rates continue to increase worldwide, particularly in middle and high-income countries without evidence indicating substantial maternal and perinatal benefits from the increase and some studies showing negative consequences for maternal and neonatal health. The objective of this study is to analyse the repeat caesarean section rates in a tertiary centre.Methods: This is a retrospective study carried out in the Department of Obstetrics and Gynaecology, Pudhukottai Medical College, Tamil Nadu, India for a 12-month period from January 2017 to December 2017 with the aim to analyse the rate and indications for caesarean section and to identify the measures to decrease its incidence if possible. A total of 2654 cesarean deliveries were conducted in one year, out of which 1380 (51.99%) were primary cesarean sections and 1274(48%) were repeat cesarean sections.Results: Repeat LSCS is more common in age group of 21-30 years (80%) and in second gravida (90.42%). The incidence of caesarean section is 94.6%. Patients who had successful trial of scar were 73. In all these patients, measures were taken to shorten the 2nd stage of labour either by giving episiotomy alone or by application of outlet forceps or vacuum. Out of these 62 (84.9%) patients were delivered by episiotomy alone.Conclusions: Caesarean section has become one of the commonly performed surgeries in obstetric practice. Implementation of standard labour management strategies can reduce primary caesarean section rate without compromising maternal and fetal safety. One important strategy is ROBSON ‘S 10 GROUP classification system for caesarean section needs to be adopted. Targets of care needs to be set up which also depends on the available resources and expertise. With continuous critical review as described and frequent comparison with other delivery units, the caesarean section rate in each individual unit can be reduced to an appropriate level.

scholarly journals A RETROSPECTIVE STUDY ON EVALUATION OF CAESAREAN SECTION RATE USING THE ROBSON’S 10 GROUP CLASSIFICATION IN SARDAR PATEL MEDICAL COLLEGE, BIKANER

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Sudesh Agrawal ◽  
Virendar Singh Rawat
Keyword(s):  
Caesarean Section ◽  
Scientific Evidence ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Group Classification ◽  
Health Concern ◽  
International Studies ◽  
Negative Consequences ◽  
Tertiary Care Centre ◽  
Pregnant Females

Introduction : Despite the lack of scientific evidence indicating any substantial maternal and perinatal benefits from increasing caesarean section rates, most of the studies are showing that higher rates could be linked to negative consequences in maternal and child health, still caesarean rates continues to increase worldwide, particularly in middle and high income countries, and have become a major and controversial public health concern. Therefore, we conducted this study to analyse the LSCS rate in the institute, to classify the indications of LSCS as per RTGCS and to find out strategy to decrease the prevalence of lower segment caesarean section. Material & Methods : This is a retrospective hospital based study at tertiary care centre. Data collection of one thousand pregnant females who delivered by caesarean section from the period of January 2018 onwards was assessed for the study. There are six parameters as per Robson’s classification to classify all pregnant females for caesarean section. Entire information was entered in Microsoft excel sheet and analysis were done to decrease caesarean section rate. Results : In the present study, a total of 1000 pregnant women delivered by caesarean section was taken from January 2018 onwards. The total number of deliveries during this study period was 2919 and the overall caesarean section rate was 34.25%. Most of the patients belonged to Robson’s group 1,2&5 which contributed to 65.6% to total. Conclusion :  The overall CSR in the study is 34.25% which is high as compared to international studies, contribution of repeat CS is high. It is important that efforts to reduce the overall CS rate should focus on reducing the primary CS rate. More analytical studies based on Robson’s 10-group classification system are needed locally, to evaluate the indications of CS within each group.  

Comparison of incidences and indications of multi primary caesarean with primi caesarean mothers in a tertiary care teaching hospital

2017 ◽  
Vol 6 (10) ◽  
pp. 4263
Author(s):  
M. Sujatha Alagesan ◽  
M. Meena
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Teaching Hospital ◽  
Tamil Nadu ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Foetal Distress ◽  
College Hospital ◽  
Medical College ◽  
Clinical Profiles

Background: The incidences and indications of caesarean sections between the primary caesarean multies and caesarean primies were comparable in respect of their demographical and clinical variables of mothers and their foetal outcomes. Aim and objective of the study was to analyze the incidences and indications of primary caesarean multies and caesarean primies. To compare the incidences and indications of mothers between the primary caesarean multies and caesarean primies. To compare the demographic and clinical profiles of the mothers and babies.Methods: During January to June 2016 total of 3583 deliveries were conducted in Tiruneleli Medical College Hospital, Tamil Nadu, India. Among them 89 and 1168 were primary caesarean multies and caesarean primies respectively. They had been compared according to the objectives.Results: The caesarean incidences were 62.5% among the primies and 4.8% among the multies as Primary. The primary caesarean incidences among the multies were statistically significantly lesser in the 15-24 ages than the primi (P<0.05). 25-29 age bracket the incidences were not differed significantly (P>0.05). After 30 years of age, the incidences were statistically significantly increased among the multies (P<0.05). The birth weight of babies did not show any statistically significant indications between the two groups (P>0.05). The indications of Foetal distress, Severe Oligo hydration and others did not show any statistically significantly difference between the groups (P>0.05). Mal presentation and Ante Partum hemorrhage were significantly more among the multies than primies (p<0.05) and Failed indication and CPD were the significantly lesser indication than the primies (P<0.05).Conclusions: Without reducing the caesarean section rate in primi we cannot bring down the overall caesarean rate of delivery.

scholarly journals Assessment of indications of lower section caesarean section at tertiary care centre: a cross sectional study

2017 ◽  
Vol 4 (4) ◽  
pp. 1253
Author(s):  
Vijay L. Badge ◽  
Sumit Suresh Aggarwal ◽  
Deepti D. Ambalkar ◽  
Arun Humne ◽  
Neethika Raghuwanshi
Keyword(s):  
Caesarean Section ◽  
Care Center ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College

Background: Caesarean section is one of the commonly performed surgical procedures in obstetrics and is certainly one of the oldest operations in surgery. One of the most dramatic features of modern obstetrics is the increase in the caesarean section rate. The present study was conducted to estimate proportion of various indications of LSCS and also to assess socio demographic profile of mothers undergoing caesarean section in a tertiary care centre. Methods: The present cross sectional observational study was conducted at Government Medical College & Hospital, Akola in the post natal ward (PNC). Non probability convenient sampling method was used. All patients admitted to PNC ward after LSCS were included in study. For data collection paper based pre tested, semi –structured questionnaire was used. Results: Previous LSCS was indication for LSCS in 32% cases. Eclampsia, preeclampsia and Anaemia were the indications for LSCS in 19.3%, 8.6% and 5.3% cases respectively. Other common indications includes CPD, meconium stained liquor, fetal distress, breech presentations, twin pregnancy and preterm labour. Conclusions: The proportion of LSCS is more than WHO recommended proportion of LSCS. It may be due to present institute acts as tertiary care center. Still this proportion is high, so encouragement should be given to trial of labour in selected low risk cases and in Primi patients whenever possible. 

scholarly journals Analysis of caesarean section rate according to modified Robson’s classification at tertiary care centre in Uttarakhand, India

2019 ◽  
Vol 8 (4) ◽  
pp. 1288
Author(s):  
Kusum Dogra ◽  
Neetu Arora ◽  
Bhawna Sharma ◽  
Meenakshi Tanwar
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Maternal Characteristics ◽  
Robson Classification ◽  
Group 4 ◽  
Spontaneous Labour ◽  
Group 5

Background: High caesarean section rate worldwide including India is matter of concern. The aim of this study is to analyse caesarean section rate at tertiary care centre according to Modified Robson’s classification.Methods: This retrospective study was conducted at Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIMHS) and Shri Mahant Indiresh Hospital at Dehradun from April 2018 to September 2018. All women delivered during this period were classified according to modified Robson’s classification using their maternal characteristics and obstetric history. For each group, authors calculated the caesarean section rate within the group and its contribution to overall caesarean section rate.Results: Out of total 1302 women delivered, 395 underwent CS (30.3%).The major contribution to overall caesarean section rate was 33.4% by group 5 (Previous CS, singleton, cephalic, >37weeks) followed by 16.7% by group 1 (nullipara, singleton, cephalic, >37 weeks, spontaneous labour), 12.4% by group 3 ( multipara, singleton, cephalic, >37 weeks, spontaneous labour ).CS rates among various group ranges from 100% among women with abnormal lie (group 9) to 77.5% in nulliparous breech (group 6), 73.7% in previous CS (group 5) and least 11.2%  in multipara induced or pre labour CS (group 4).Conclusions: Modified Robson classification is simple, systematic, reproducible and can be effectively utilized in analyzing delivering women. Major contribution to overall caesarean section is made by previous CS.

scholarly journals Clinical presentation of autoimmune disorders in pregnancy

2017 ◽  
Vol 6 (12) ◽  
pp. 5401
Author(s):  
Neha Singhal ◽  
Alka S. Gupta ◽  
Madhva Prasad
Keyword(s):  
Tertiary Care ◽  
College Teaching ◽  
Autoimmune Disorders ◽  
Neonatal Outcomes ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Set Up ◽  
In Pregnancy

Background: Autoimmune disorders have a significant impact over the health of an individual. This heterogenous group of disorders affects pregnancy in a multitude of ways. Pregnancies with autoimmune disorders are usually cared for by a multidisciplinary team of doctors.Methods: Pregnancies with autoimmune disorders were studied over a one-year period in one unit of a medical college teaching hospital set up. Obstetric and neonatal outcomes were studied.Results: Ten patients were studied. Average age was 29.9 years. Majority presented in early second trimester. Eight patients were ANA positive. Two patients had antiphospholipid antibody syndrome, for whom low molecular weight heparin was helpful. Hypothyroidism was seen in two patients. Bad obstetric history was seen in most patients. Successful neonatal outcome was seen in six patients. One patient had Evans syndrome. There were no maternal mortalities. There was one perinatal mortality.Conclusions: Autoimmune disorders in pregnancy when managed in a tertiary care centre with multidisciplinary approach can result in good obstetric and neonatal outcomes.

scholarly journals Caesarean section in a tertiary care centre

2020 ◽  
Vol 9 (8) ◽  
pp. 3106
Author(s):  
Rina V. Patel ◽  
Divyanshi J. Shani ◽  
Parul T. Shah ◽  
Dipali Pandey
Keyword(s):  
Caesarean Section ◽  
Surgical Site Infection ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Infectious Complications ◽  
Site Infection ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College

Background: Caesarean section constitutes a major surgical procedure characterized with morbidity even if it is performed a planned procedure. Postoperative infection in obstetrics continues to affect the practice of every surgeon. Infection can cause an increase in patient’s stay in the hospital, create discomfort, cause disfigurement and lead to morbidities to the patient. Thus, preventive measures need to be constantly evaluated and updated and hence authors have to study and analyse prevalence of postoperative infectious morbidities.Methods: The study was conducted in an Urban Based Medical College Hospital in Ahmedabad. It was a retrospective cross-sectional study of 50 cases of patients who suffered infectious complications post caesarean from 1st March 2019 to 31st March 2020.Results: The prevalence rate of surgical site infection in my study is 5.9% whereas of post-operative puerperal sepsis is 0.6%, of post-operative urinary tract infection is 1.09%, of post-operative breast abnormalities is 0.16%. The most common infectious morbidity amongst all was surgical site infection (surgical site) infection and its prevalence was 5.9%.Conclusions: The development of post-operative infection is an important event that can be prevented by taking proper precautions and following prescribed guidelines. There should be specific use of antibiotics in the post-operative period. In the event of early signs of sepsis antibiotics should be administered properly as per culture sensitivity report. The decrease in infection rate also indirectly reduce the health costs involved in treating them post operatively.

scholarly journals Retrospective study of massive obstetric haemorrhage and its materno fetal outcomes in a tertiary care centre

2017 ◽  
Vol 6 (2) ◽  
pp. 554
Author(s):  
Anju Padmasekar ◽  
Shyamala Jothy
Keyword(s):  
Retrospective Study ◽  
Tamil Nadu ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Significant Risk ◽  
Perinatal Outcomes ◽  
Tertiary Care Centre ◽  
Fetal Outcomes ◽  
Medical College ◽  
Obstetric Haemorrhage

Background: Massive obstetric haemorrhage is defined as blood loss of >1500 ml, or a decrease in haemoglobin>4 gm/dl or acute transfusion requirement of >4 units of blood when need for further transfusion is foreseeable. The purpose of this study is to analyse the demographic, medical and obstetric risk factors for massive obstetric haemorrhage and it’s materno fetal outcomes.Methods: Criteria for patient selection was all patients who had an acute obstetric haemorrhage necessitating a transfusion of >4 units of blood at a stretch when there was a need for more. This is a retrospective study conducted for a period of one year January to December 2015. Data regarding all cases under study during this period was obtained from Medical Records Department with prior permission. This study was conducted in the Department of Obstetrics and Gynecology, Government Raja Mirasudhar Teaching Hospital, Thanjavur Medical College, Tamil Nadu. Maternal outcomes like mode of delivery, rate of hysterectomy, postpartum complications, maternal mortality and fetal outcomes like intra uterine death, still birth and preterm birth were analysed.Results: The rate of massive obstetric haemorrhage in our hospital during the study period was 5.7/1000 births. Massive obstetric haemorrhage contributed to 25% of all maternal deaths in 2015. Atonic PPH was the commonest cause. Multiparity and previous caesarean section were identified to be significant risk factors.Conclusions: We found an increased association of massive obstetric haemorrhage with multiparity, caesarean sections and pre-eclampsia. Atonic PPH was the commonest cause. Massive obstetric haemorrhage had contributed significantly to adverse maternal and perinatal outcomes.

scholarly journals A clinical study of effect of standard labour protocols on rates of primary caesarean section at a tertiary care centre, Madurai, India

2018 ◽  
Vol 7 (9) ◽  
pp. 3766
Author(s):  
Shanthi C. ◽  
Mahalakshmi N. K.
Keyword(s):  
Clinical Study ◽  
Caesarean Section ◽  
Comparative Study ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
The World ◽  
Before And After ◽  
Failed Induction

Background: Caesarean section rates are on the rise all over the world. Primary caesarean section usually determines the future obstetric course of any woman and therefore should be avoided whenever possible. WHO recommended that caesarean rates should not be more than 15 %. In this view we started our study on how to reduce the rate of Primary caesarean section in Tertiary Care Centre, Madurai, India. The objective of the present study was to evaluate how the implementation of universally acceptable standards affects rates of primary caesarean section rates without compromising maternal and foetal safetyMethods: This a comparative study on the effect of standard labour protocols and guidelines devised after audit of cases from January 2017 to June 2017, on the rate of primary caesarean section rates, induction of labour, failed induction, maternal and fetal outcomes before and after the implementation of the guidelines.Results: Primary caesarean section rates from 52.85% to 45.02% noted in the induced cases. There were no significant adverse maternal and perinatal outcomes.Conclusions: Implementation of standard labour protocols can reduce primary caesarean section rate without compromising maternal or foetal safety.

scholarly journals Study of sociodemographic factors of women undergoing caesarean section in tertiary care centre of rural area of central India

2019 ◽  
Vol 8 (12) ◽  
pp. 4757
Author(s):  
Shuchi M. Jain ◽  
Ketki Thool ◽  
Poonam V. Shivkumar ◽  
Manish A. Jain
Keyword(s):  
Caesarean Section ◽  
Rural Women ◽  
Caesarean Section Rate ◽  
Health Centre ◽  
Tertiary Care ◽  
Central India ◽  
Demographic Characteristics ◽  
Health Facilities ◽  
Population Characteristics ◽  
Tertiary Care Centre

Background: Many studies have attempted to examine and evaluate the changes in population characteristics that may have contributed to the observed increase in CS rate. The aim of this study was to determine the caesarean section rate and demographic characteristics of women undergoing caesarean section in our rural tertiary health centre of central India.Methods: This prospective study was conducted in department of obstetrics and gynecology. The study instrument comprised a pre-structured data collection proforma which had various sections; social demographic characteristics, obstetric history and gestation details.Results: The overall caesarean section rate (CSR) was 36.88%. Maximum women (39.62%) who underwent Caesarean section were of age group 25-29 years. 58.05% from rural while 41.95% from urban area. CS was more in women of lower middle (22.80%) and upper lower (20.80%) class. Majority of women who had caesarean section were educated till higher school (31.87%) or were graduate (22.61%), 5.85% were illiterate. Majority of women (56.40%) were housewives. CSR was 70.83% in referred and 28.31% in booked. 52.86% women were nulliparous. Caesarean section was maximum (83%) in term, 16.92% preterm women and 0.08% post term women. 38.69% were referred from other health facilities. Maximum referrals 43.21% were from the district hospital.Conclusions: It was noted that the preference for caesarean section is more in women of 25-29 years, lower middle and upper middle class, rural women, educated upto high school and housewives at our centre. This hospital also serves as referral centre from surrounding health facilities increasing the caesarean section rate of the institute.

scholarly journals A randomised single blind control study to assess the effect of intrapartum amnioinfusion on maternal caesarean section rate and fetal outcome in a tertiary care centre

2017 ◽  
Vol 6 (10) ◽  
pp. 4347
Author(s):  
Michelle Fonseca ◽  
Jyotsna S. Dwivedi
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Meconium Aspiration Syndrome ◽  
Control Group ◽  
Study Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Meconium Stained Amniotic Fluid

Background: The procedure of instilling normal saline/Ringer’s lactate into the uterine cavity is called amnioinfusion. Objective of present study was to assess the effect of intrapartum amnioinfusion on maternal caesarean section rate and fetal outcome in a tertiary care centre in cases of meconium stained amniotic fluid.Methods: A total of 160 women at term in labor with meconium stained amniotic fluid were randomized into two groups: study and control group. The study group received transcervical amnioinfusion at detection of MSAF. The control group was given the routine obstetric care. Both groups were started on O2 and intrapartum monitoring. The outcomes in both groups were analyzed statistically.Results: The control group had caesarean section rate of 45% and in the study group it was 31.25%. The difference was statistically significant. The outcome in the neonate was assessed on the parameters such as respiratory distress, neonatal intensive care unit admission, meconium aspiration syndrome, neonatal deaths.Conclusions: Amnioinfusion in cases of meconium stained amniotic fluid cases significantly reduces the risk of meconium aspiration syndrome. It also decreases the need for operative intervention thus reducing the risk of maternal morbidity and mortality.

Sign in / Sign up

Export Citation Format

Share Document