The Significance of the Second Cesarean Delivery in the Reduction of Institutional Cesarean Delivery Rates [13] (original) (raw)
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Medical principles and practice : international journal of the Kuwait University, Health Science Centre, 2018
The cesarean delivery rate has increased worldwide. The aim of our study was to assess the events associated with the second cesarean deliveries in our institution. All the cesarean deliveries at Maternity Hospital, Kuwait, from January 1 to December 31, 2013, were identified. A comparative study was undertaken on patients having their first and second cesarean deliveries. The social and clinical characteristics of these patients were extracted from our records and the antenatal, intra-partum, and postpartum course of the pregnancies and their outcomes documented. During the study period, 10,586 deliveries were recorded, including 3,676 cesarean deliveries, a cesarean delivery rate of 34.7%. 840 of these patients were undergoing their first cesarean delivery (group A), and 607 patients were undergoing their second (group B); 484 patients from group A and 341 patients from group B with complete records were analyzed. Mean age (30.89 ± 4.93 vs 29.94 ± 5.56 years, p = 0.008), parity (1...
2014
Background: The increase in the prevalence of cesarean section (C-section) in recent decades has become a public health problem worldwide. Studies of cesarean section in order to identify the causes and form policies and interventions to reduce the incidence of this health problem are necessary. This study was conducted with the aim to investigate the causes of C-sections performed at Niknafs and Ali-Ibn Abi Talib Hospitals in Rafsanjan, Iran, in the second trimester of 2014. Materials and Methods: In this cross-sectional study, 560 pregnant women were selected from among those referred to Niknafs and Ali-Ibn Abi Talib Hospitals in the second trimester of 2014 for cesarean delivery. Information was collected using a researcher-made checklist through interviews with patients and reviewing medical records. Data were analyzed using chi-square or Fisher's exact tests, as required. Results: The mean and standard deviation of age of women was 29.46 ± 5.08 years and most of them (65.0%) were in the age range of 26-36 years and had a diploma (40.7%). Considering delivery history, the highest percentage of women had had a single delivery (38.9%) and over half of the subjects (52.9%) had experienced a previous C-section. The most common causes were repeated C-section (52.9%), elective C-section (on maternal request) (7.5%), meconial stained (6.1%), fetal distress (5.0%), and breech presentation (4.5%). Statistically significant associations were observed between C-section reasons, and age (P < 0.001), number of previous pregnancies (P < 0.001), and previous delivery method (P = 0.010). Conclusions: Repeated C-section, as the most common cause of cesarean, has had a major role in increasing cesarean. Vaginal delivery after cesarean, taking into account the clinical and legal circumstances and providing training programs to acquaint women to the negative consequences of C-section and vaginal delivery benefits would be effective in the choice of delivery and might help in reducing cesarean.
FREQUENCY AND INDICATIONS OF CESAREAN SECTION IN A TERTIARY CARE HOSPITAL
Objective: To determine the frequency of cesarean section and to analyze the indications, so as to introduce measures to control the cesarean section rate. Methodology: This descriptive study was conducted in obstetric and gynecology department of Isra university hospital Hyderabad Sindh from 1 st Jan 2007 to 31 st Dce 2007.In this study clinical record of all the patients who underwent cesarean section was analyzed. It included all the pregnant ladies booked in the antenatal clinic and unbooked patients admitted in early labour for whom cesarean section was indicated later. It also included all those cases coming in emergency at any time for which cesarean section was indicated. Clinically diagnosed cases of ruptured uterus proved on laparotomy were not included in the study. Data was analyzed on SPSS version 11 and frequencies as wall as percentages were calculated. Results: During one year study period, 380 cesarean section were performed. The rate of cesarean section was 64.7%. Emergency cesarean section was performed in 225 (59.2%) patients and elective cesarean section in 155 (40.7%). Among 380 patients, 167 (43.9%) were booked while 213 (56.0%) were unbooked. Repeat cesarean section was the commonest indication seen in 73 (19.2%) patients followed by dystocia in 51 (13.4%) patients, fetal distress in 48 (12.6%) and ante partum hemorrhage in 45 (11.8%) patients. Miscellaneous indications contributed to 16 (4.2%) of the cases. Conclusion: Majority of patients who underwent cesarean section was unbooked and had an emergency cesarean section. The commonest indication was repeat cesarean section.
Indications for cesarean deliveries during a 7-year period in a tertiary hospital
Acta médica portuguesa
To analyze the cesarean section rate evolution in a tertiary hospital and the main indications for cesarean section. A retrospective study was conducted at a major academic hospital and included 5 751 women who had a cesarean section from 2005 to 2011. The rates of overall, primary and repeat cesarean sections were analyzed. A linear regression and adjusted R-square were used to access the relative contribution of each indication to the variation in primary cesarean section. During the 7-year period of the study the cesarean section rate decreased from 30.9% to 27.6%. This was due to a decrease in primary cesarean section (21.9% to 18.2%), although an increase in repeat cesarean section was observed (9.0% to 9.4%). Among the indications for primary cesarean section, maternal-fetal indications and malpresentation were the ones that decreased the most with adjusted R-square of 0.70 and 0.55, respectively. The collected data identified that the decrease in the cesarean section rate at ...
The effect of increased number of cesarean on maternal and fetal outcomes
Ginekologia polska, 2017
The aim of this study was to evaluate the effects of multiple cesarean deliveries (CDs) on maternal-fetal mor-bidity and mortality rates. This retrospective study included a total of 1,506 patients who underwent multiple CDs between January 2006 and May 2014. The patients were divided into two groups. One group consisted of patients with four or more CDs (n = 444) and a control group of patients with three CDs (n=1,062). Both groups were analyzed for demographics, complications from multiple cesarean deliveries and perinatal outcomes. The mean age was higher in the study group (p < 0.001). Dense adhesion (p < 0.001), demand for tubal ligation (p < 0.001), the requirement of pelvic drainage (p < 0.001), duration of hospitalization (p < 0.001) and the requirement for blood transfusion (p=0.03) was also significantly higher in the study group. Hemoglobin levels (p = 0.002) were signifi-cantly higher in the control group on the second postoperative day. Regarding perinata...
Multiple Cesarean Section Outcomes and Complications: A Retrospective Study in Jazan, Saudi Arabia
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Background: Given the increase in the rate of cesarean sections (CSs) globally and in Saudi Arabia, this study was conducted to assess the maternal and perinatal complications after repeat cesarean sections in the studied population. Methods: This retrospective study was conducted by reviewing the records of all women who underwent CSs between January and July 2023 in three hospitals in the Jazan region of Saudi Arabia. Results: Of the 268 women studied, 195 (72.7%) had a CS for the first or second time and 73 (27.3%) had two, three, or four previous CSs (repeat CS). The most common maternal intra-operative complications reported by the repeat CS group were intra-peritoneal adhesions (7.5%) and fused abdominal layers (7.1%) while the most common postoperative complications were the need for blood transfusion (22%) and UTIs (3%). The most common neonatal complications were a low Apgar score (19%), needing neonatal resuscitation (2.6%), and intensive care admission. In addition, 3.7% ...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
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 w...
Journal of Saidu Medical College, Swat
Background: Caesarean section is a time honoured approach that evolved to save maternal lives in the times of difficult deliveries. The rise in the rates of caesarean section is a matter of concern as being a major surgery, it is associated with risks that can extend for years and affect the health and future pregnancies of women.Objective: This study is carried out to analyses changing trends in the rates and indications of caesarean sections in the last six years in a Tertiary Care Hospital of Peshawar.Materials and Methods: This retrospective study is carried out by collecting record of all deliveries including indications of caesarean sections of the years 2014,2016 and 2018 of the unit. Results: The caesarean rate was 174/1000 total births for year 2014.It was 143 and 176 per 1000 total births for the year 2016 and 2018. The commonest indication for primary caesarean section was fetal malpresentations with rates as 31.5,30.2 and 29.9 per 1000 total births for 2014,2016 and 2018...
Prevalence of Cesarean Section and Its Indications in A Tertiary Care Hospital
Journal of Nepal Medical Association
Introduction: Cesarean section is a surgical procedure performed to deliver fetus through abdominal route. Increasing rate of cesarean section worldwide is an alarming concern for public health and obstetricians due to increase in financial burden and risk to health of the mother in comparison to vaginal delivery. The aim of the study was to find the prevalence of cesarean section and its most common indication in a tertiary care hospital. Methods: This descriptive cross-sectional study was done in a tertiary care hospital, from July 2016 to June 2018 after taking ethical clearance from institutional review board. Convenience sampling was done to reach the sample size. Data was collected and entry was done in microsoft excel, point estimate at 95% CI was calculated along with frequency and proportion for binary data and analysis was done. Results: Out of total deliveries conducted, 862 (36.8%) were CS deliveries, 1477 (63.1%) were vaginal deliveries, and 12 (0.51%) were instrumental...
Analysis of repeat cesarean delivery indications: Implications of heterogeneity
American Journal of Obstetrics and Gynecology, 1996
Our purpose was to describe the relative contributions and characteristics of various subgroups of patients to the overall repeat cesarean delivery rate and to determine modifiable practice patterns that might lead to fewer repeat cesarean deliveries. STUDY DESIGN: Hospital records of all women with a previous cesarean section who were delivered between Jan. 1 and June 30, 1994, at St. Peter's Medical Center in New Brunswick, New Jersey, were reviewed. Four groups were identified: (1) elective repeat cesarean, (2) "indicated" repeat cesarean, (3) failed vaginal birth after cesarean, and (4) successful vaginal birth after cesarean. Descriptive and outcome data were collected. RESULTS: There were 406 patients, 376 of whom had complete records available for review. Of these, 235 had a repeat cesarean delivery because of the following reasons: elective (107, 45%), "indicated" (66, 24%), and failed vaginal birth after cesarean (72, 31%). The remaining 141 patients had a vaginal birth after cesarean. Patients with private or health maintenance organization insurance were nearly seven times more likely to have a repeat cesarean delivery as an elective procedure as compared with Medicaid or self-pay patients (odds ratio 6.88, 95% confidence interval 2.33 to 20.38). The failed vaginal birth after cesarean group was characterized by more frequent inductions of labor, less use of amniotomy, and very early epidural placement. CONCLUSIONS; Examination of patient characteristics is required to identify population-specific strategies to reduce repeat cesarean delivery rates. Modifiable practice patterns exist that may lead to interventions to reduce repeat cesarean delivery rates. (Am J Obstet Gynecol 1996;175:883-8.)