scholarly journals An appraisal of computed tomography pelvimetry in patients with previous caesarean section

2000 ◽  
Vol 6 (2-3) ◽  
pp. 260-264
Author(s):  
Y. M. Abou Ghazzeh ◽  
R. Barqawi
Keyword(s):  
Computed Tomography ◽  
Birth Weight ◽  
Caesarean Section ◽  
Caesarean Delivery ◽  
Elective Caesarean Section ◽  
Emergency Caesarean Section ◽  
Control Group ◽  
Previous Caesarean Section ◽  
Apgar Scores ◽  
Emergency Caesarean

This study was conducted to determine the value of computed tomography [CT] pelvimetry in patients with previous caesarean section. Of 219 pregnant women with one previous caesarean section, 100 had antenatal CT pelvimetry and a control group of 119 women had no CT pelvimetry. In the CT pelvimetry group, 51.0% delivered by caesarean section, 28.0% underwent elective caesarean section for contracted pelvis based on the findings of CT pelvimetry and 23% underwent emergency caesarean section after a trial labour. In the control group, 21.8% underwent emergency caesarean section. The differences in birth weight and Apgar scores between the groups were not statistically significant. CT pelvimetry increased the rate of caesarean delivery, suggesting that CT pelvimetry before a vaginal birth after a previous caesarean delivery is of limited value

STUDY OF OBSTETRIC OUTCOMES IN ELECTIVE AND EMERGENCY CAESAREAN SECTION IN PATIENTS WITH PRIOR LOWER SEGMENT CAESAREAN SECTION

2021 ◽  
pp. 57-60
Author(s):  
Dipak S. Kolate ◽  
Meenal M. Patvekar ◽  
Shriraj Katakdhond ◽  
Yogesh Thawal ◽  
Kale DhanaLaxmi ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Perinatal Outcome ◽  
Maternal Morbidity ◽  
Caesarean Delivery ◽  
Emergency Caesarean Section ◽  
Obstetric Outcomes ◽  
Fetal Outcomes ◽  
Emergency Caesarean ◽  
Management Protocol ◽  
History Of

Background:Acomprehensive study of maternal morbidity and mortality with perinatal outcome in patients with prior LSCS undergoing elective or emergency caesarean section was carried out. With the sky rocketing caesarean section rates worldwide an increasing number of women face the issue of mode of delivery in their current pregnancy. There are conicting reports regarding the safety of a trial for vaginal birth after caesarean delivery (VBAC) in terms of uterine rupture, maternal and perinatal morbidity. The purpose of this study was to evaluate the obstetric and fetal outcomes of patients presenting at term with a history of previous one or more LSCS. Methods:Asix months prospective, observational study was conducted where all patients who had a term pregnancy with a history of previous one or more LSCS were included after obtaining their consent for participation. The obstetric and fetal outcomes of these patients with elective or emergency LSCS in the present pregnancy were noted and tabulated. Adescriptive analysis of these outcomes was carried out. Results: 100 Patients at term, with a history of previous one or more LSCS were studied. 38 patients underwent an elective repeat caesarean delivery and 62 in emergency.Scar dehiscence was seen in 35.5 % of the patients who were presented in emergency with uterine contractions or lower abdominal pain and those were not candidate for a trial for VBAC.All of the complications were signicantly higher in emergency group in terms of both maternal (83.9 % Vs 31.6%) and perinatal outcome (6.5% Vs 0 %). Conclusion:With an increase in the proportion of patients with a history of previous LSCS, it is essential for health care institutions to have proper antenatal counseling regarding plan of delivery and vigilance while operating patients with prior history of LSCS , especially in emergency situation. There should be a well dened management protocol in an effort to decrease the number of complications and bring down the overall maternal morbidity & mortality .

scholarly journals Profile of Caesarean Section at Kathmandu Medical College

2017 ◽  
Vol 15 (2) ◽  
pp. 110-113
Author(s):  
Apurwa Prasad ◽  
Garima Bhandari ◽  
Rachana Saha
Keyword(s):  
Caesarean Section ◽  
Demographic Data ◽  
Elective Caesarean Section ◽  
Emergency Caesarean Section ◽  
Medical College ◽  
Emergency Caesarean ◽  
Clinical Indications ◽  
Depth Study ◽  
Elective Procedure ◽  
Failed Induction

Background: There is a world-wide rise in caesarean section rateduring the last three decades and has been a cause of alarm and needs an in-depth study. The objective of this study was to determine the rate and clinical indications of Caesarean Section.Methods: A hospital based study was carried out from 15th June 2015 to 15th January 2016 in Department of Obstetrics and Gynecology at Kathmandu Medical College, Sinamangal, Nepal. Patients who delivered by caesarean section were included in the study. Basic demographic data and clinical indications were noted.

Results: A total of 1172 deliveries were carried out during the study period. Total number of caesarean section was 537 accounting to 45.81%. Most of the patients were of the age group of 25-29 years (42.8%). Most of the patients were primigravida (n=274; 51%). Emergency caesarean section was 411 (76.5%) and elective caesarean section was 126 (23.4%). Multigravida (71%) underwent more elective procedure than primigravida (25. 39%).The most frequent indication was fetal distress19.55% (n=105), failed induction 19.73%(n=106), and previous caesarean section 21.3% (n=115).Conclusions: The rate of cesarean section is quite high than that recommended by WHO which is (10-15%). Most of the caesarean sections were emergency caesarean section with previous caesarean being the leading cause.

scholarly journals Maternal and foetal outcome in elective versus emergency caesarean sections

2017 ◽  
Vol 6 (4) ◽  
pp. 1222
Author(s):  
Amit A. Gurunule ◽  
Himangi S. Warke
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
Breech Presentation ◽  
Emergency Caesarean Section ◽  
Tertiary Care Centre ◽  
Emergency Caesarean ◽  
Significant Difference ◽  
Foetal Outcome ◽  
Tract Infections

Background: Caesarean delivery is defined as the birth of the foetus through an incision in the abdominal wall (i.e. laparotomy) and the uterine wall (hysterotomy). The purpose was to analyze the maternal and foetal outcome in elective versus emergency caesarean sections retrospectively in a tertiary care centre and to analyze the indications of elective versus emergency caesarean sections.Methods: A retrospective observational study of the cases undergoing caesarean sections in KEM hospital, Mumbai, India was carried out during the period of September 2013 to September 2015. Maternal and foetal outcome was studied. The data was collected and analyzed from the maternal medical records. The neonatology records were also examined.Results: Out of the 600 selected patients, 300 patients in each group of elective and emergency caesarean section were studied. The usual indications of emergency caesarean sections were foetal distress, followed by meconium stained amniotic fluid (MSAF) and cephalopelvic disproportion (CPD). 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 previous multiple LSCS. There was a significant difference seen in the occurrence of fever, urinary tract infections and wound infections in the two groups. These were more common in the emergency caesarean section group. Significant difference was also seen in the incidence of postpartum haemorrhage in the two groups, which was more in the elective caesarean section group.Conclusions: The maternal morbidity, intra operative and postoperative complications were more in the emergency LSCS group as compared to patients who underwent elective LSCS.

scholarly journals Elective versus emergency caesarean section: differences in maternal outcome

2019 ◽  
Vol 8 (8) ◽  
pp. 3207
Author(s):  
Anshu Sharma ◽  
Rajiv Acharya ◽  
Yashika Pehal ◽  
Bhawna Sharma
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Fetal Distress ◽  
Emergency Caesarean Section ◽  
Maternal Outcome ◽  
Common Indication ◽  
Emergency Caesarean ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Caesarean section is a life-saving surgical procedure when certain complications arise during pregnancy or labour. The use of CS worldwide has increased worldwide unprecedented levels although the gap between higher- and lower-resource settings remains. The present study evaluates the difference in maternal outcome in elective versus emergency caesarean sections in our institute.Methods: The study included first 65 cases of emergency caesarean section (group A) and during the study period, first 65 elective caesarean section (group B) if they fulfilled the inclusion criteria. Various intra operative and postoperative events were recorded which included intra operative complications, postpartum haemorrhage and transfusion indices.Results: The most common indication of caesarean section in group A was fetal distress (27.7%). In group B most caesarean sections were classified under 5 followed by class 6, the most common indication being previous caesarean section (27.6%). It was observed that pre-operative mean haemoglobin in group A was 10.6 g/dl and in group B was 11.2g/dl. A drop of 1.36 g/dl in group A and 1.10 g/dl in group B was observed in the post-op period. Cross match / transfusion ratio 1.5 in group A and  2 in group B, transfusion probability ratio was 60 % in group A and  66.7%  in group B and transfusion index was 1 in group A and  group B. There was significantly higher contraception acceptance in group B compared to group A.Conclusions: Elective caesarean section has more favourable maternal outcome as compared to emergency caesarean section as the former is done under controlled and planned circumstances.  However, there should be stringent audit to scrutinise indication of caesarean section, outcome of caesarean and blood transfusion practices.

scholarly journals Post-operative Experience following Caesarean Section in a Nigerian Obstetric Population

2021 ◽  
Vol 2 (1) ◽  
pp. 60-65
Author(s):  
Jamila A Garba ◽  
Abubakar A Panti ◽  
Ahmed Yakubu ◽  
Eze A Ukwu ◽  
Ahmed T Burodo ◽  
...  
Keyword(s):  
Pain Relief ◽  
Caesarean Section ◽  
Outcome Measures ◽  
Elective Caesarean Section ◽  
Cross Sectional Study ◽  
Emergency Caesarean Section ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Patient’S Satisfaction ◽  
Emergency Caesarean

Background: Caesarean section is the most significant obstetrics operative intervention globally. Good postoperative experience after caesarean section is important because there is need for the mother to recover from surgery and take care of her baby. The aim of this study was to assess the experience of women that had caesarean section in the first 24 hours postoperatively. Materials/methods: This was a cross-sectional study conducted among women that had elective and emergency caesarean section. They were followed up to 24 hours post-operative. The primary outcome measures were pain score and satisfaction. Secondary outcome measures were time of mobilization, time of commencement of oral feeds and time of initiation of breastfeeding. Data analysis was carried out using Statistical Package for Social Sciences version 22. Results: The median pain scores among those that had emergency and elective caesarean section ranged between 2 and 3 at all points of pain assessment. The satisfaction was good among 66.1% that had emergency caesarean section and 71.2% among those that had elective caesarean section. However, the difference was not statistically significant (χ2 = 0.546, p = 0.761). More than 90% of the participants that had either emergency or elective caesarean section did not ambulate within the first 24 hours after caesarean section and there was no association between the time of ambulation and the type of caesarean section (χ2 = 0.005, p = 0.941). Conclusion: The participants had adequate pain relief and majority were satisfied with the pain relief. However, the optimum satisfaction was not achieved. The participants did not ambulate early and did not initiate breast-feeding early. Recommendation: Further research is recommended to assess other factors that affect patient's satisfaction and ambulation so as to improve on patient's postoperative care.

In pregnant bitches, is elective caesarean section more effective than vaginal delivery at improving puppy survival?

2020 ◽  
Vol 5 (3) ◽  
Author(s):  
Mullika Borisoot
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Research Question ◽  
Elective Caesarean Section ◽  
Emergency Caesarean Section ◽  
Clinical Expertise ◽  
Bottom Line ◽  
Safe Delivery ◽  
Definitive Answer ◽  
Emergency Caesarean

PICO question In pregnant bitches due to whelp, is elective caesarean section more effective than vaginal delivery to improve puppy survival?   Clinical bottom line Category of research question The category of the research question is regarding the incidence of puppy mortalities as a result of vaginal delivery, emergency caesarean section and elective caesarean section. The number and type of study designs reviewed Two retrospective articles were reviewed and critically appraised; one retrospective study with high single canine breed bias and one study on different canine breeds but limited support in directly answering the PICO question. Strength of evidence The studies selected both had strong uses of experimental designs but together provided weak evidence to determine a definitive answer to the PICO question. Outcomes reported The outcomes from both retrospective studies suggests that the mortality rates of newborn puppies can be reduced if pregnant bitches are scheduled ahead for elective caesareans, in comparison to undergoing an emergency caesarean section when complications develop, particularly in breeds with higher risks of dystocia. Therefore, there is some evidence to support that it may be advantageous to consider the breed, age and overall health of the bitch during pregnancy to determine whether elective caesarean sections, for the safe delivery of puppies, should be considered. Conclusion There are currently insufficient studies, literatures and evidence in veterinary medicine for caesarean sections to become a routine procedure in first opinion practices. Future prospective studies should be conducted and include the optimum anaesthetic protocols with the lowest associated risks for the pregnant bitch and puppies.   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

scholarly journals Maternal and Fetal Outcome in Emergency versus Elective Caesarean Section

2020 ◽  
Vol 18 (2) ◽  
pp. 186-189
Author(s):  
Naveen Darnal ◽  
Ganesh Dangal
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Elective Caesarean Section ◽  
Fetal Outcome ◽  
Emergency Caesarean Section ◽  
P Value ◽  
Age Group ◽  
Common Indication ◽  
Emergency Caesarean ◽  
Emergency Cesarean

Background: Caesarean section is one of the most performed surgical procedures all over the world. It is associated with high morbidity and mortality as compared to vaginal delivery. The present study was carried out to evaluate the maternal and neonatal outcome and complications in two groups of pregnant women who underwent elective and emergency cesarean section, so that measures can be taken to reduce morbidity and mortality in near future.Methods: It was hospital based descriptive cross-sectional study carried out at Paropakar Maternity and Women’s Hospital from October to December 2018. There were 340 patients enrolled in the study 170 in elective and 170 in emergency caesareans selected randomly. Ethical approval was obtained from the Institutional Review Board and informed consent was taken from the patients and patients’ guardians. Data were collected daily from the Operation Theater. Results: The rate of caesarean section in the hospital was 30.7%. Proportion of emergency caesarean section was 1324 (74.4%) and elective caesarean section was 456 (25.6%). Emergency Caesarean section was more common in younger age group and in primigravida while elective Caesarean section was more common in advanced age group and in multigravida. The most common indication for emergency Caesarean section was Fetal Distress and the most common indication for elective Caesarean section was previous cesarean with refused vaginal delivery after cesarean section. The maternal outcome in terms of post-operative wound infection, (post-partum hemorrhage, urinary tract infection need for blood transfusion, fever and need for maternal intensive care unit admission was significantly (p- value <0.05) higher in emergency Caesarean section than in elective Caesarean section .The fetal outcome in terms of birth asphyxia, meconium stained liquor and need for Neonatal ICU admission were significantly (p – value <0.05) higher in emergency Caesarean section than in elective Caesarean section. Conclusions: Maternal and fetal complications were significantly higher in the emergency caesarean section as compared to elective caesarean section group.Keywords: Fetal outcome; emergency cesarean section; elective cesarean section; maternal outcome.

scholarly journals Acid Aspiration Prophylaxis in Australian Obstetric Hospitals — A Survey

1989 ◽  
Vol 17 (4) ◽  
pp. 492-495 ◽  
Author(s):  
R. W. Burgess ◽  
J. A. Crowhurst
Keyword(s):  
Caesarean Section ◽  
Sodium Citrate ◽  
Elective Caesarean Section ◽  
Emergency Caesarean Section ◽  
Aspiration Pneumonitis ◽  
Magnesium Trisilicate ◽  
Acid Aspiration ◽  
Emergency Caesarean ◽  
Obstetric Services

During 1987 a confidential survey of all hospitals in Australia providing obstetric services was undertaken to determine the antacid medications used routinely as prophylaxis against acid aspiration pneumonitis. Of the 567 hospitals surveyed, 379 (67%) responded. Of these, 243 hospitals provide an obstetric service which includes caesarean section, and 67% of these perform less than 500 deliveries per annum. Aspiration prophylaxis during labour was used in 22.4% of responding hospitals. Prior to elective caesarean section, 11.5% used no prophylaxis, and 39.4% used particulate antacids such as magnesium trisilicate mixture (33.3%) or Mylanta® (6.1%). Sodium citrate mixture was the most popular therapy (37%). Results were similar in the emergency caesarean section group. The use of cimetidine or ranitidine was uncommon in all groups. Results of this survey suggest marked differences in attitudes towards acid aspiration prophylaxis between Australian and British obstetric anaesthetic practices.

Respiratory adaptation in term infants following elective caesarean section

2017 ◽  
Vol 103 (5) ◽  
pp. F417-F421 ◽  
Author(s):  
Daragh Finn ◽  
Julie De Meulemeester ◽  
Lisa Dann ◽  
Ita Herlihy ◽  
Vicki Livingstone ◽  
...  
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Maternity Hospital ◽  
Neonatal Unit ◽  
Term Infants ◽  
Apgar Scores ◽  
Mean Values ◽  
End Tidal Carbon Dioxide ◽  
End Tidal

ObjectiveTo determine respiratory rate (RR), tidal volume (TV) and end-tidal carbon dioxide (EtCO2) values in full-term infants immediately after caesarean section, and to assess whether infants that develop transient tachypnoea of the newborn (TTN) follow the same physiological patterns.Design and patientsA Respironics NM3 Monitor (Philips, Netherlands) continuously measured RR, TV and EtCO2 for 7 min in infants >37 weeks’ gestation following elective caesarean section (ECS). Monitoring was repeated at 2 hours of age for 2 min. Gestation, birth weight, Apgar scores and admissions to neonatal unit were documented.SettingThe operative delivery theatre of Cork University Maternity Hospital, Ireland.ResultsThere were 95 term infants born by ECS included. Median (IQR) gestation was 39 weeks (38.2–39.1) and median (IQR) birth weight 3420 g (3155–3740). Median age at initiation of monitoring was 26.5 s (range: 20–39). Data were analysed for the first 7 min of life. Mean breaths per minute (bpm) increased over the first 7 min of life (44.31–61.62). TV and EtCO2 values were correlated and increased from 1 min until maximum mean values were recorded at 3 min after delivery (5.18 mL/kg–6.44 mL/kg, and 4.32 kPa–5.64 kPa, respectively). Infants admitted to the neonatal unit with TTN had significantly lower RRs from 2 min of age compared with infants not admitted for TTN.ConclusionsTV and EtCO2 values are correlated and increase significantly over the first few minutes following ECS. RR increases gradually from birth, and rates were lower in infants that develop TTN.

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