Introduction: With increased safety of operative deliveries the caesarean section rates have been increasing steadily all over the world. Analysis of the caesarean section rate of a centre would allow insight into preventable causes of the rising problem. Objective: This retrospective study was undertaken to analyse the indications of caesarean deliveries in one year period from 18 Jun 2017 to 17 Jun 2018 using Robson's Ten Group Classification System and to find out the preventable causes of caesarean section. Method: All patients who delivered during this period were identified based on labour room delivery register. Their records were analysed on basis of age, parity, risk factors, mode of delivery, intra partum events and indication of caesarean section. Data was entered in Excel sheet and classified as per Robson's Ten Group Classification System. Results: Caesarean section rate was 52.7% during the study period. Caesarean section was lowest in Group 3(10.31%) and highest in Group 6(92.68%). Group 2 made the highest contribution to overall Caesarean section rate (23.93%). Analysis of indications in Group 2 showed that Oligohydramnious and Post ART pregnancies were the two modifiable indications where decision towards Caesarean section was much liberal. Conclusion: Strategies to reduce the caesarean section rate should concentrate on Primigravida who are getting admission to the Hospital for safe confinement i.e not in labour. Hospital needs to review its policy regarding intervention in oligohydramnious and post ART pregnancies. Strict Policy guidelines on Induction of labour protocols and trial of labour in the previous caesarean cases will improve the situation.
Introduction: Adnexal masses are a common entity in gynaecological practice. These masses may be benign or malignant, tubal or ovarian or both. Clinician must be aware of their differential diagnosis to triage the patients and ensure optimum therapeutic approach. Objective: The objective of this study were to analyse the diverse clinical spectrum of adnexal masses and to correlate the preoperative diagnosis based on clinical examination and ultrasonography with histopathological examination. Method: This was a cross sectional observational study on 189 patients with a diagnosis of adnexal mass who underwent laparoscopy or laparotomy. All the patients were were evaluated by a complete history, general, abdominal and pelvic examination, followed by ultrasonography. These preoperative findings were then correlated with histopathological diagnosis. Results: 41.26 % of the patients were in the age group 21-30 years .46.03 % of all cases were benign ovarian tumor. There were 5 ovarian malignancies. Preoperative ultrasonography correlate well with histopathological diagnosis. Conclusion:A systematic approach consisting of a proper history, clinical examination, imaging studies and accurate interpretation of diagnostic preocedure is necessary for the triage and optimum management of adnexal masses in women.
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