scholarly journals A study of rate, indications and maternal morbidity associated with cesarean delivery in a tertiary care hospital

2019 ◽  
Vol 8 (7) ◽  
pp. 2810
Author(s):  
Asma Nigar ◽  
Ausaf Ahmad ◽  
Khashia Khan
Keyword(s):  
Cesarean Section ◽  
Maternal Morbidity ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
Morbidity And Mortality ◽  
Obstetrics And Gynecology ◽  
Care Hospital ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Previous Cesarean

Background: Cesarean section is one of the most commonly performed surgical procedures in obstetrics worldwide. Over  the last three decades, a tremendous increase in cesarean section rates has been observed globally, which is a cause for concern as procedure is associated with higher morbidity and mortality compared to vaginal delivery. This study was done to analyze the rate and indications for cesarean section and associated maternal morbidity and mortality.Methods: This retrospective study was conducted over a period of 6 months from 1st October 2017 to 31st March 2018 in the department of Obstetrics and Gynecology, Integral Institute of Medical Sciences and Research, Lucknow, India. Data of patients who were admitted for delivery in department of Obstetrics and Gynecology in OPD or emergency were recorded. Statistical analysis of various parameters namely, the cesarean section rates, its indications, the patient’s morbidity and mortality was done.Results: The total numbers of women delivered over the study period were 577, out of which 210 patients underwent cesarean sections. The overall cesarean section rate in our study was 36.39%. Previous cesarean section was the leading indication of cesarean section (31.9%) followed by arrest of labor (18.1%), CPD (14.2%), and fetal distress (12.9%). Breech presentation (5.2%), failed induction of labor (4.8%), pregnancy induced hypertension (PIH) (3.8%), oligohydramnios (3.3%), obstructed labor (2.4%), APH (1.4%), multiple pregnancy and BOH accounted for 0.95% of cesarean sections. 9% patients had few complications mainly minor wound infection (2.4%) and postpartum hemorrhage (2%). There was no mortality during this period.Conclusions: Previous cesarean section has been found to be the main indication for cesarean section. So primary cesarean section should be reduced to decrease the overall cesarean rates. A comprehensive, evidence based approach needs to be introduced to monitor indication of all cesarean section.

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.

Safety of Scar on Repeat Second Cesarean Section in Patients with Previous One Cesarean Section

2009 ◽  
Vol 1 (2) ◽  
pp. 26-28
Author(s):  
Shahnaz Kouser ◽  
Shaheen Kouser ◽  
Bushra Anwar
Keyword(s):  
Cesarean Section ◽  
Tertiary Care ◽  
Teaching Hospitals ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Medical Disorders ◽  
Elective Cesarean ◽  
One Year ◽  
Operative Findings ◽  
Previous Cesarean

ABSTRACT Objective To evaluate the safety and integrity of scar at repeat cesarean section, in patients with previous one cesarean section performed at different settings. Study design A reterospective study in a tertiary care obstetric unit over a period of one year (2006). Material and methods All patients with previous one cesarean section, undergoing emergency and elective cesarean sections were enrolled at our institution. The variables noted were age, parity, residential area, location of previous cesarean section and associated complaints, e.g uterine contractions, vaginal leaking/ bleeding and comorbid medical disorders. Outcome measures Operative findings in terms of thinning of scar, dehiscence or rupture were recorded. The effects of skill level of surgeon and set-up of previous cesarean section were analyzed. Results Two hundred and seventy cesarean sections were performed for different indications in patients with previous one cesarean section over a period of one year. Out of all patients, extreme thinning of scar was noted in 36 (13.3%) patients. Seven patients(2.6%) had scar dehiscence. Only 3 (42.8%) patients with scar dehiscence had associated complaint of scar tenderness, while 22 (61%)of 36 cases of scar thinning were having scar tenderness. All 7 cases of scar dehiscence had their previous cesarean sections at teaching hospitals. No patient underwent hysterectomy and all patients with scar dehiscence had successful repair. Conclusion The study concludes relatively inadequate scar thickness rate but at the same time relatively acceptable scar dehiscence rate. Thus it will still be safe to subject the patients to trial of labor after meticulous scrutinization and individualization. At the same time adequate surgical training of doctors (trainees and community doctors) through different formats is recommended.

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.

scholarly journals Is emergency cesarean section more risky than elective cesarean section in women with previous cesarean section?

2018 ◽  
Vol 7 (5) ◽  
pp. 1880
Author(s):  
Balwan Singh Dhillon ◽  
Nomita Chandhiok ◽  
M. Vishnu Vardhana Rao
Keyword(s):  
Cesarean Section ◽  
Maternal Morbidity ◽  
Morbidity And Mortality ◽  
Previous Cesarean Section ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Maternal Morbidity And Mortality ◽  
Repeat Cesarean Section ◽  
Elective Repeat Cesarean ◽  
Previous Cesarean

Background: Cesarean section is one of the most performed surgical procedures all over the world, but unfortunately cesarean sections are associated with a great deal of maternal morbidity and mortality. In the past the rate of cesarean section has increased for many avoidable and unavoidable indications both in developed and developing countries. The objective of this study was to compare maternal morbidity and mortality in elective repeat cesarean section (El-RCS) and emergency repeat cesarean section Em-RCS.Methods: Prospective data was recorded on management practices, associated complications and morbidity and mortality on 15664 consecutive cases of previous cesarean section reporting at 30 medical colleges/teaching hospitals for delivery.Results: Of the 15664 women with a previous cesarean section, 5399 (34.5%) women underwent elective repeat cesarean section, 7752 (49.5%) women who underwent emergency repeat cesarean section and 2513 (16.0%) had successful trial of labor (S-TOL). There was    failed trial of labor (F-TOL) in 1522 cases and requiring an emergency cesarean section for delivery of baby. Therefore, total no. of 7752 women had an emergency cesarean section. The overall maternal morbidity was 22.5%, 20.7% in Em-RCS and El-RCS respectively. Blood loss was more than 1000ml in 7.2% of Em-RCS where as in El-RCS it was 8.8%, blood transfusion was 7.5% in Em-RCS where as it was 6.5% in El-RCS, dehiscence of scar in Em-RCS was 4.7% as compared to 2.2% in El-RCS, uterine rupture was 1.2% in Em-RCS as compared to 0.7 % in El-RCS found statistically significant. Post-operative complication was 5.9% cases in Em-RCS where as in El-RCS was 5.8% (p=0.79 non-significant). Maternal mortality was reported in 12 (0.2%) cases of Em-RCS as compared to 5 (0.1%) cases in El-RCS (p=0.37) which was not statistically significant.  Conclusions: Maternal morbidity was found more in emergency repeat cesarean section than in elective repeat cesarean section. Complications and referral of women who are likely to undergo cesarean section should be diagnosed at an early stage so that the maternal   morbidity and mortality can be prevented. 

scholarly journals Evaluation of Uterine Scar on Repeat Second Cesarean Section in Patients with Previous Cesarean Section

1970 ◽  
Vol 3 (1) ◽  
pp. 16-19
Author(s):  
N Nargis ◽  
AK Al-Mahmood ◽  
D Akhter
Keyword(s):  
Cesarean Section ◽  
Tertiary Care ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
History Of ◽  
Uterine Scar ◽  
One Year ◽  
Operative Findings ◽  
A Prospective Study ◽  
Previous Cesarean

To evaluate the safety and integrity of uterine scar at repeat cesarean section in patients with previous one cesarean section (C/S). A prospective study was Carried out in a tertiary care, obstetric unit over a period of one year, 2010. All pregnant mothers who underwent cesarean section either emergency or elective with history of previous one cesarean sections were included in this study. The variables noted were age, parity, socioeconomic status, residential area, location of previous cesarean section, previous wound infection and associated complaints. Data was analyzed on SPSS 11 Operative findings during cesarean sections were recorded in terms of thinning of scar, dehiscence or rupture. One hundred and twenty cesarean section patients were included in the study. Out of all patients, extreme thinning of scar was noted in 28 (23.33%) patients. Four patients (3.33%) had scar dehiscence,only 3( 2.5%) patients with scar dehiscence had associated complaint of scar tenderness, while 17 (14.16%) of 120 cases of scar thinning were having scar tenderness. All 4 cases of scar dehiscence had their previous c/s at peripheral hospitals. No patient underwent hysterectomy and all patients with scar dehiscence had successful repair. Our findings shows relatively inadequate scar thickness rate but at the same time relatively acceptable scar dehiscence rate. Thus it seems to be a safe approach to make trial of labour after meticulous scrutinization and individualization. DOI: http://dx.doi.org/10.3329/akmmcj.v3i1.10108 AKMMCJ 2012; 3(1): 16-19

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 Study of feto-maternal outcome in previous cesarean section

2018 ◽  
Vol 7 (9) ◽  
pp. 3848
Author(s):  
Mahantappa A. Chiniwar
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Maternal Morbidity ◽  
Mode Of Delivery ◽  
Previous History ◽  
Clinical Findings ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Emergency Cesarean ◽  
Previous Cesarean

Background: There is increase in number of primary cesarean sections, leading to more number of women facing the issue of mode of delivery in the current pregnancy. There are reports about success of vaginal birth after cesarean section as well as complications such as scar dehiscence, rupture of uterus, poor maternal and fetal outcome.Methods: A prospective study was done for a period of 1 yr and 9 months at Cheluvamba Hospital attached to Govt Medical College Mysore from October 99 to June 2000. Data regarding previous cesarean section was collected, clinical findings during the present pregnancy were noted.Results: During the study period there were 942 women admitted with previous history of cesarean section. Elective repeat cesarean section was done for 530 cases and trial of labour after cesarean section was planned for 412 cases. Successful vaginal delivery was conducted in 311 cases. Repeat emergency cesarean section was done for 96 cases due to failed trial of labour. Maternal morbidity such as adhesions was seen in 11.25% and obliteration of U V fold in 7.92% of cases. Maternal mortality was seen in 0.15%. Perinatal morbidity was seen in 3.32%, perinatal mortality in 3.96%.Conclusions: With increasing proportion of women with previous cesarean sections, it is essential to counsel these women during trial of vaginal delivery in well equipped hospitals. It is worth to reduce primary cesarean section to avoid complications in consequent pregnancies. Proper and timely decision for repeat cesarean sections will reduce fetal and maternal morbidity and mortality.

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