Worldwide rise in caesarean section rate during the last three decades, has been the cause of alarm and needs an in depth study. Caesarean section is one of the most common major surgical procedure performed now a days. The procedure is not benign and should be performed only when circumstances distinctly require it. Public perception of caesarean sections has seen a swing from a "failure of obstetric care" to being "safe for mother and child." There have been occasions where an obstetrician has been manhandled for a poor outcome and blamed needlessly for not having performed a caesarean section. At the same time media glare has fallen unfavorably on the rise in rates of these procedures. Why have the rates increased and what are the strategies to reduce the rates of Caesarean sections? In this context, this study intends to find out the prevalence of caesarean section and also to identify the maternal, institutional and physician related determinants of caesarean section. Objectives To find out prevalence of caesarean section in Trivandrum district during the year 2010. To find out maternal, hospital and physician related determinants of caesarean section in Trivandrum district Materials and Methods: Our study was a Descriptive study from four maternity care hospitals in Trivandrum district. Duration of our study was 6 months and sample size was 800. Results: Our study shows that the prevalence of caesarean section in private institutions in Trivandrum district is higher in private hospitals when compared to public sector. The primary caesarean sections in the public and private health institutions were found to be 38.50% and 47.90% respectively. The mean age of women who underwent caesarean section was found to be 27. Our study shows that there is an increasing trend for caesarean section as maternal age increases. The association between age and type of delivery was found to be significant. Analysis also shows that as level of education increases, the chance for caesarean section increases. The association between educational status and type of delivery was found to be highly significant. It was observed that 52.2% of the upper strata, which constitutes 50.4% of the study population, underwent caesarean section. Among the middle strata, 50.9% underwent caesarean
Aim: To study the incidence of metabolic syndrome in postnatal women with history of gestational diabetes mellitus in the index pregnancy when compared to a women without the history of gestational diabetes mellitus To study the socio-demographic factors affecting the development of metabolic syndrome in postnatal women with history of gestational diabetes mellitus in the index pregnancy Materials and Methods: The recruitment of the postnatal women to the study was started after obtaining clearance from the Ethical committee conducted in Sree Avittom Thirunal Hospital, Government Medical College, Thiruvananthapuram and study period was for one year. This was a Prospective cohort study Results: In our study we included only women >19 years and <35 years and majority of the women in the GDM group belonged to the age group 26-30 and women in the non GDM group who belonged to 25. In the present study 49.7% of the women in the GDM group belonged to Class IV when compared to 64.6% in the non GDM group also belonged to the same socioeconomic status. Majority of the women belonged to the Hindu religion both in the GDM and the non GDM group.60% of the multipara belonged to the GDM group when compared to 40% of the primipara belonged to the GDM group.24.6% of the patients in the GDM group had a history of gestational hypertension, when compared to 8% of the non GDM group.20% of the women in the GDM group had a past history of GDM in their previous pregnancies.23.4% of the women in the GDM group had a family history of diabetes in father when compared to 5.1% of the non GDM group. Majority of the women in the study did not have any family history of diabetes in the siblings.45.1% of the women belonging to the GDM group had a birth weight between 2.6 to 3.5kg.28% of the women belonging to the GDM group had a pre pregnancy BMI > = 25 when compared to 13.1% of the women in the non GDM group.69% of the women belonging to the GDM group had BMI >= 25 when compared to 48% of the women belonging to the non GDM group. In our study, we included only women >19 yrs and <35 yrs and the percentage of metabolic syndrome was higher in either ends of the range that is 55.6% and 44% respectively. Majority of the subjects were booked at our hospital but the percentage of metabolic syndrome was found to be slightly higher in the referral subjects, p value was 0.4 and it was not
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