Background: Time to perform elective LSCS is a relevant issue related to mother and foetus. LSCS can be done from 37 weeks onwards because foetal lungs mature by then. But foetuses born at 37 weeks of gestation have more risk of developing respiratory problems, transient tachypnoea of new born, hypothermia, hypoglycaemia and NICU admission.The purpose of this study is to find out appropriate gestational age at which elective LSCS can be performed without adverse maternal and neonatal outcome.Methods: This is an observational comparative study done on 209 antenatal women who underwent elective caesarean section from December 2014 to January 2016.Patients were divided into two groups after taking consent. Maternal parameters like formation of lower uterine segment need for blood transfusion. Neonatal parameters like Apgar score, respiratory distress syndrome and NICU admission with indication and duration were analyzed by chi-square test. Gestational Age and Pre-Op Hb and Post-Op Hb were analyzed by independent ‘t’test.Results: In this study 55% of the pregnant women belong to 38 weeks,45% belongs to 39 weeks. The formation of lower uterine segment was statistically significant and the need for blood transfusion was slightly increased at 39 weeks. But there was no significant difference in Apgar score, Respiratory distress, NICU admission comparing both study groups.Conclusions: Elective caesarean section can be done safely at 38 weeks without affecting maternal and perinatal outcome.
Background: The most performed surgical procedure in obstetrics is cesarean section. Purpose of this study is to establish the maternal and neonatal outcome after emergency and elective cesarean section, and identifying preventable risk factors wherever possible.Methods This is n observational comparative study done at Al Azhar medical college Thodupuzha, Kerala, India on 185 pregnant women who underwent cesarean section and who fulfilled the inclusion criteria in the department of obstetrics and gynecology. After taking consent patients were identified into two groups based on type of cesarean section that is elective or emergency. In elective cesarean section group 79 women were studied whereas emergency cesarean section group 106 women were studied. Maternal parameters like indication of cesarean section, intra operative and post-operative complications were analyzed. Neonatal parameters like respiratory distress syndrome, NICU admissions, APGAR score were analyzed.Results: Most number of cases in elective cesarean section group underwent cesarean section for prior cesarean section for maternal request (89%) and for emergency cesarean section for fetal distress (32%). Intraoperative, post-operative complications and adverse neonatal outcome were more with emergency CS group.Conclusions: Adverse maternal and neonatal outcome was found to be more in emergency cesarean section compared to elective cesarean section. Inducing labor with proper indication, assessment of cephalopelvic disproportion and intrapartum monitoring using partogram are some of the preventable factors identified to reduce adverse outcome.
Background: Oligohydramnios and its outcome is a relevant issue related to mother and fetus. Purpose of this study is to establish the obstetric and perinatal outcome in pregnancy associated with ‘isolated oligohydramnios as compared to women with normal liquor.Methods: This is an observational comparative study done at Al Azhar Medical College, Thodupuzha, Kerala, India on 50 pregnant women of 37 weeks of gestation or more and diagnosed to have oligohydramnios without any high-risk factors. Age, parity, gestational age matched patients without any high-risk factors and AFI >5 cm attending the OPD /ward were taken as controls. In each group there were 25 subjects. After getting informed consent those who fulfilled inclusion criteria were followed through the delivery and immediate neonatal outcome were assessed. Parameters like age, parity, amniotic fluid volume, gestational age at delivery, mode of onset of labor, indication of induction, methods of induction, need for augmentation of labor, CTG patterns, color of liquor, mode of delivery, indications of caesarean section., distribution of APGAR score were analyzed.Results: There were significant difference in maternal outcomes in patients with isolated oligohydramnios in the form of increased rates of induction of labor, augmentation of labor, meconium-stained liquor, non-reassuring fetal heart pattern, caesarean section rates without any significant effects on neonatal outcome.Conclusions: Isolated oligohydramnios has increased rate of induction of labor, meconium-stained liquor, CTG abnormalities and caesarean section rates without significant increase in neonatal morbidity and mortality.
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