Caesarean Delivery in the Second Stage of Labour at a Tertiary Care Hospital

Bhargava, Seema; Hooja, Nupur; Kala, Manisha; Mital, Premlata; Tulani, Kritika; Arora, Surabhi; Kumavat, Bhomraj; Gupta, Shivani

doi:10.1007/s13224-018-1179-4

Cited by 6 publications

(4 citation statements)

References 3 publications

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“…In a study done by Bhargava et al, most common indication of CS (77.34%) in second stage was non-descent of fetal head, out of which 21.87% were with non-reassuring fetal heart rate and 24.21% were with meconium-stained liquor. 12 In our study maximum number of women 27 (55.10%) were in the age group of 20 to 25 years. In a similar study done by Gupta et al 46% women were in the age group of 21 to 30 years.…”

Section: Discussionmentioning

confidence: 47%

Exploring caesarean delivery in the second stage of labour at a tertiary care hospital: a retrospective study

Dabhi²,

Rathod

2021

Int J Reprod Contracept Obstet Gynecol

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Background: Caesarean section (CS) performed in the second stage of labour has many implications for maternal and neonatal morbidity as well as for subsequent pregnancies. The objectives of this study were to determine the rates of CS at full dilatation, their indications, associated maternal and neonatal complications.Methods: This retrospective study assessed all the women with a singleton fetus in cephalic presentation at term (≥37 weeks) who underwent CS in the second stage of labor between 1 August 2019 and 31 March 2020 at a tertiary care hospital. Maternal demographics, labour and delivery details as well as neonatal outcomes were collected.Results: During the study period, 2124 (36%) babies were born by CS. Of these, 49 (2.3%) were performed in the second stage of labour at ≥37 weeks of gestation. The most common indication of CS was non-descent of head in 38 (77.55%) of cases. The majority of women 38 (77.55%) delivered by CS in the second stage of labor were primiparous. The 27 (55.10%) women were in the age group of 20-25 years. Most common intraoperative complication was blood-stained urine in 20 (40.81%) women. Overall transfusion rate was 18.36%. Maximum number of babies born 44 (89.79%) were having birth weight between 2.5-3.5 kg. Out of 65 babies born, 17 (34.69%) were admitted to neonatal intensive care unit.Conclusions: Formulation of an institutional protocol and training and supervision of trainees to improve the skill of operative vaginal delivery and second stage cesarean is needed.

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Section: Discussionmentioning

confidence: 47%

Exploring caesarean delivery in the second stage of labour at a tertiary care hospital: a retrospective study

Dabhi²,

Rathod

2021

Int J Reprod Contracept Obstet Gynecol

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“…In a study done by Bhargava S et al, most common indication of caesarean section (77.34%) in second stage was non descent of fetal head, out of which 21.87% were with non-reassuring fetal heart rate and 24.21% were with meconium stained liquor. 7 In this study 10 cases were anemic, 13 cases were having pregnancy induced hypertension, 3 cases were having previous cesarean section and 1 case was having bad obstetric history.…”

Section: Discussionmentioning

confidence: 72%

A study of caesarean section at full cervical dilatation

Rami

Kaul

Sailor

et al. 2020

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONThe increasing trend of caesarean section at second stage is of major concern in modern obstetrics. According to a data from 150 countries, collected from 1990 to 2014, 18.6% of all births were done under knife, ranging from 6% to 27.2% in the least and most developed regions, respectively. Based on the data from 121 countries, the trend analysis showed that between 1990 and 2014, the global average caesarean section rate increased 12.4% (from 6.7% to 19.1%) with an average annual rate of increase of 4.4%1. Incidence of second stage caesarean section has increased from 0.9 to 2.2%. 2 This increasing trend of caesarean section in second stage of labour is multifactorial, probably a combination of lack of training for junior staff in second stage decision making, lack of expertise in assisted vaginal delivery. 3 Caesarean section at full dilation is technically more challenging procedure than caesarean section in early labour. 4 Maternal morbidity in second stage caesarean section may be in form of extension of uterine angels, post postpartum hemorrhage and prolonged surgical time. 5,6 METHODSA prospective study of cesarean section at full cervical dilatation was carried out in the department of obstetrics and gynecology, at tertiary care hospital for a period of 1 st ABSTRACT Background: Caesarean sections performed in the second stage of labour are difficult and have many implications on both mother and baby. This study was conducted to analyse fetal and maternal outcome in case of caesarean section at full cervical dilatation. Methods: This prospective study was conducted at one of tertiary care teaching institute for period of 1 st August 2019 to 31 st January 2020. It includes all women delivered by caesarean section at full cervical dilatation at study institute during study period. Cases were looked for parity, maternal age, gestational age, baby birth weight, indication of cesarean section and associated factors. Results: Out of total 3657 deliveries 1690 were delivered by caesarean section, out of which 65 (3.8%) caesarean sections were conducted at full cervical dilation. The most common indication of caesarean section was deep transverse arrest in 66.15% of cases. The maximum number of cases (69.23%) were seen between the age group of 20 to 25 years. Majority of second stage cesarean section (70.77%) were performed in primi gravida. 80% of caesarean sections at full cervical dilatation were performed after 37 weeks of gestation. 15.38% of patients had anemia, 20% had hypertension, 4.61% had history of previous caesarean section. Baby weight at time of birth was 2.5 to 3.5 kg in 67.70% of cases. 15.38% of patients required blood transfusion. Conclusions: A skilled obstetrician is required to take timely and proper decision in such cases and also to conduct cesarean section at second stage of labour.

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“…2 AVB can also avoid a second-stage caesarean section (CS) and its associated short-term and long-term morbidity for the mother and baby, especially in low/middle-income countries (LMICs). [3][4][5][6][7][8][9] Compared with secondstage CS, AVB is associated with lower risks of haemorrhage, postoperative infection, faster maternal recovery, shorter hospital stay and cost-savings for health systems. [10][11][12][13] Moreover, women are more likely to have a spontaneous…”

Section: Introductionmentioning

confidence: 99%

Interventions to reintroduce or increase assisted vaginal births: a systematic review of the literature

et al. 2023

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ObjectiveTo synthesise the evidence from studies that implemented interventions to increase/reintroduce the use of assisted vaginal births (AVB).DesignSystematic review.Eligibility criteriaWe included experimental, semi-experimental and observational studies that reported any intervention to reintroduce/increase AVB use.Data sourcesWe searched PubMed, EMBASE, CINAHL, LILACS, Scopus, Cochrane, WHO Library, Web of Science, ClinicalTrials.gov and WHO.int/ictrp through September 2021.Risk of biasFor trials, we used the Cochrane Effective Practice and Organisation of Care tool; for other designs we used Risk of Bias for Non-Randomised Studies of Interventions.Data extraction and synthesisDue to heterogeneity in interventions, we did not conduct meta-analyses. We present data descriptively, grouping studies according to settings: high-income countries (HICs) or low/middle-income countries (LMICs). We classified direction of intervention effects as (a) statistically significant increase or decrease, (b) no statistically significant change or (c) statistical significance not reported in primary study. We provide qualitative syntheses of the main barriers and enablers for success of the intervention.ResultsWe included 16 studies (10 from LMICs), mostly of low or moderate methodological quality, which described interventions with various components (eg, didactic sessions, simulation, hands-on training, guidelines, audit/feedback). All HICs studies described isolated initiatives to increase AVB use; 9/10 LMIC studies tested initiatives to increase AVB use as part of larger multicomponent interventions to improve maternal/perinatal healthcare. No study assessed women’s views or designed interventions using behavioural theories. Overall, interventions were less successful in LMICs than in HICs. Increase in AVB use was not associated with significant increase in adverse maternal or perinatal outcomes. The main barriers to the successful implementation of the initiatives were related to staff and hospital environment.ConclusionsThere is insufficient evidence to indicate which intervention, or combination of interventions, is more effective to safely increase AVB use. More research is needed, especially in LMICs, including studies that design interventions taking into account theories of behaviour change.PROSPERO registration numberCRD42020215224.

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Caesarean Delivery in the Second Stage of Labour at a Tertiary Care Hospital

Cited by 6 publications

References 3 publications

Exploring caesarean delivery in the second stage of labour at a tertiary care hospital: a retrospective study

Exploring caesarean delivery in the second stage of labour at a tertiary care hospital: a retrospective study

A study of caesarean section at full cervical dilatation

Interventions to reintroduce or increase assisted vaginal births: a systematic review of the literature

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