Changing trends in indication of cesarean section in a tertiary care centre of Central India

Patil, Pradeep; Bhardwaj, Malini; Sharma, Pulkit; Chandrakar, Garima

doi:10.18203/2320-1770.ijrcog20172561

Cited by 6 publications

(7 citation statements)

References 6 publications

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“…Contrast to our study, Patil P et al found that they were multigravidas except in 2016 in which the majority were primigravidas. 11 Contrast to our study and similar to study by Patil et al, Gupta M et al found that maximum no. of caesarean sections were in multiparous females (53.82%).…”

Section: Discussioncontrasting

confidence: 78%

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Anesthetic complications in cesarean section

Patil

Upadhye²

2018

Int J Res Med Sci

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Background: Obstetric anesthetists need to face with the unique situation of providing anesthesia for caesarean sections, where they have to provide care for both the mother and the unborn baby. This study was performed in 100 women who underwent cesarean section, either elective or emergency to evaluate type of anesthesia, anesthetic complications and neonatal outcome.Methods: A retrospective study was conducted in 100 women with singleton pregnancy undergoing cesarean section in the department of Anesthesiology in collaboration with department of Obstetrics and gynecology at Dr PDMMC and Hospital, Amravati from January 2017 to March 2018. Detailed information regarding medical and obstetric history, intrapartum course, postpartum complications diagnosed before hospital discharge, and infant outcome were collected directly from maternal and infant charts. Other details like age of the patient, parity, type of cesarean section and type of anesthesia was noted. American Society of Anesthesiologists (ASA) scores and type of anesthesia was noted.Results: In our study, spinal anesthesia was given in 62 (62%) patients, epidural anesthesia was given in 20 (20%) patients, combined spinal-epidural anesthesia was given in 10 (10%) patients while general anesthesia was given in 8 (8%) patients. Anesthetic complications were less. About 10 (10%) patients had spinal headache, 4 (4%) patients had failed regional anesthesia, 2 (2%) patients had failed intubation while 2 (2%) patients had high spinal anesthesia. Babies of 96 (96%) patients had Apgar score at 5 minutes of more than 7 and babies of 4 (4%) patients had Apgar score at 5 minutes of less than 7. Only babies of 2 (2%) patients required intubation for resuscitation.Conclusions: This study provides strong evidence that the guidelines recommending regional block over GA for most cesarean section. It is beneficial for neonates as well as for mothers.

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Section: Discussioncontrasting

confidence: 78%

“…So younger patients were seen in their study. 11 In our study, 68 (68%) patients were primigravida while 32 (32%) patients were multigravida. Contrast to our study, Patil P et al found that they were multigravidas except in 2016 in which the majority were primigravidas.…”

Section: Discussionmentioning

confidence: 45%

Anesthetic complications in cesarean section

Patil

Upadhye²

2018

Int J Res Med Sci

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“…10 Patil P et al in their study also reported 71.1% emergency caesarean section and 28.9% elective caesarean section. 11 Dasari et al, also reported emergency caesarean section rate of 62.5% which is higher than elective caesarean section rate of 37.5%. 12 In our study we observed that, among cases that 70% of first time mothers underwent emergency caesareans and 25% had elective primary caesareans and it was 75% and 30% respectively in a similar study in Karnataka.…”

Section: Discussionmentioning

confidence: 92%

Determinants and outcomes of caesarean delivery: elective versus emergency in a tertiary care teaching institute in Kerala, India

Shenoy¹,

Remash²,

Shenoy³

2019

Int J Reprod Contracept Obstet Gynecol

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Background: Globally, the caesarean delivery rate is rising continuously, making caesarean one of the most common surgical procedures. The purpose was to analyse the determinants and maternofoetal outcomes in elective versus emergency caesarean sections in a tertiary care centre.Methods: All women, who gave birth by Caesarean deliveries done over a period of 1 year (January 2018-December 2018), were studied in Travancore Medical College in Kerala, India. Indications of caesarean, whether emergency or elective, medical morbidities, Gestational age at decision, birthweights and extended hospital stay and new-borns needed to resuscitate were looked into. The data was collected and analysed from the hospital registry.Results: Out of the 378 selected patients, 95 patients in group of elective and 283 emergency caesarean section were studied. The indications of emergency caesarean sections were failed induction, non-progression of labour, CPD, Previous caesarean in labour, foetal distress. The most frequent indicator for elective lower segment caesarean section (LSCS) was patient with previous LSCS not willing for vaginal birth, followed by breech presentation and high risk pregnancy ( BOH and ART). Younger mothers, gestational age remote from term, low-birth weight, and extended hospital stay were statistically significant in mothers undergoing emergency caesarean delivery. Fever, urinary tract infections, need for maternal and neonatal ventilation, blood transfusion, scar dehiscence were more common in the emergency caesarean group.Conclusions: The antenatal morbidity, low birth weights, decision taken preterm for salvaging the baby, postoperative complications and extended stay were more in the emergency caesarean when compared to elective caesarean.

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“…Patil P et al in their study also reported 71.1% emergency cesarean section and 28.9% elective cesarean section. 16 Gayathry D et al also reported emergency cesarean section rate of 62.5% which is higher than elective cesarean section in 37.5%. 17 In our study we observed that, among cases that underwent cesarean section, 68.1% patients underwent primary cesarean section and 67 (31.9%) underwent repeat cesarean section.…”

Section: Discussionmentioning

confidence: 92%

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

Nigar

Aḥmad

Khan

2019

Int J Reprod Contracept Obstet Gynecol

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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.

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Changing trends in indication of cesarean section in a tertiary care centre of Central India

Cited by 6 publications

References 6 publications

Anesthetic complications in cesarean section

Anesthetic complications in cesarean section

Determinants and outcomes of caesarean delivery: elective versus emergency in a tertiary care teaching institute in Kerala, India

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

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