Lower Segment Caesarean Section Audit Is a Promising Tool to Improve the Quality of a Standard Care at a Tertiary Hospital in Kuwait “Cross-Section Study” (original) (raw)

Determinates of Caesarean Section in Tertiary Care Hospital

Scholars Journal of Applied Medical Sciences, 2016

Caesarean Section is the second commonest surgery done in India after tubectomy and has great impact on maternal and neonatal health. Increasing Caesarean rates have raised the need to study its influencing factors. The objective is to analyse the different indications and frequency of caesarean sections in order to reduce such deliveries in a tertiary hospital. This retrospective study was conducted at the Department of Obstetrics and Gynaecology, Mahatma Gandhi Medical College, Jaipur, from October 1 to December 31, 2015. It comprised review of clinical records of all patients who underwent caesarean section during this period. This included booked, un-booked or referred cases and data regarding the indications, type of caesarean deliveries and demographic features. During the study period, there were 792 deliveries out of which 261 (32.95%) were caesarean. Emergency caesarean section was performed on 150(57.5 %%) and elective caesarean section was performed on 111(42.5%) patients. Overall, 122(46.6 %%) cases were booked and 139(53.3 %%) were un-booked or referred cases. Most of the caesarean sections were carried out due to previous caesarean sections 58(22.2%) followed by foetal distress 49(18.7%), non-progress of labour 32(12.2%), Pregnancy induced hypertension 17(6.51%), breech 15(5.75%), oligohydramnios 16(6.13%), intra uterine growth retardation 10(3.83%), placental abruption 4(1.53%) and placenta previa 5(1.91%). Audit and feedback is the best way to judge clinical practice and to reduce the frequency of caesarean section in any tertiary setup. Previous caesareans were the most common indication of repeat procedure in the study.

A review of caesarean section techniques and postoperative thromboprophylaxis at a tertiary hospital

Singapore medical journal, 2016

Although caesarean sections are among the most commonly undertaken procedures in the world, there are wide variations in the surgical techniques used for this procedure. This study aimed to: (a) review the surgical techniques used for caesarean sections by obstetricians working in a tertiary hospital in Singapore; (b) compare the techniques used by these surgeons with those recommended in evidence-based guidelines; and (c) examine the relationship between the technique used and the level of seniority of the surgeons. Data on 490 caesarean sections performed in Singapore General Hospital (SGH) between 1 August 2013 and 30 June 2014 was collected from the Delivery Suite database and reviewed. The surgical techniques studied were closure of the visceral and parietal peritoneum, closure of the uterine layer, use of surgical drains, and use of postoperative thromboprophylaxis. A total of 486 caesarean sections were analysed (4 of the 490 caesarean sections reviewed were excluded due to m...

Analysis of current trends in caesarean section in a tertiary care hospital

IP Innovative Publication Pvt. Ltd, 2017

In the background of increasing rates of caesarean sections, this study was done to find the current trends of the surgery. Aim: To study 500 consecutive caesarean sections in a tertiary referral maternity hospital in South India to understand the current trends in caesarean. Objective: 1. To find out the incidence of caesarean sections and the pattern of the indications 2. To find the pattern of age distribution, parity, period of gestation, intra operative & post operative complications, fetal & maternal outcome in caesarean sections & 3. To compare elective and emergency caesarean sections Method: This was a prospective study carried out in a District Maternity hospital in South India. We included 500 consecutive caesarean sections from the time of commencement of the study. The various characteristics of the patient & newborn profile, the surgical indications & complications were noted and compared in elective & emergency caesarean sections & the statistical significance was noted by applying Chi square test. Results: The incidence of caesarean section was found to be 30.1% in our study. Of the total 500 cases studies, 68.2% were emergency sections. Most elective cases were in parous women (69.1%); whereas most emergency cases were in nulliparous women (68.03%). Commonest indication for caesarean section was previous caesarean section in the elective group; while in the emergency group, it was meconium and fetal distress. Intra operative complications and perinatal mortality were significantly more in emergency cases. Post operative morbidity was seen in 16.2% cases. Conclusion: There is a need to avoid unwarranted surgeries, mainly primary caesarean section and also the need to give trial of scar in carefully selected cases so that the caesarean rate stabilizes with good maternal and fetal outcome.

Audit of Caesarean Sections in a Single Centre: Analysis of its Frequency and Indications

Journal of Sheikh Zayed Medical College, 2021

Background: Caesarean section serves a substantial parameter of comprehensive emergency obstetric and neonatal care and it is a package of care that groups together basic emergency obstetric care as well. Objective: To evaluate the frequency and indications of caesarean section in a tertiary care hospital. Methodology: This cross-sectional study was conducted in the department of Obstetrics and Gynaecology, Bahawal Victoria Hospital, Bahawalpur from June to November 2018. The records of all the women delivering either vaginally or by caesarean section during the study period were retrieved. Age, socioeconomic status, parity, type of delivery, and indications for which caesarean sections were noted. Data was analyzed by SPSS version 20. Results: A total of 4575 deliveries were conducted during the study period. Out of these, 2605 (57%) had caesarean sections, and 1970 (43%) delivered vaginally. Maternal age ranged from 20 to 40 years. The most common reason for caesarean section was ...

Caesarean Sections -Are we doing right ?

International Journal of Biomedical Research, 2012

Introduction-Caesarean section is the most commonly performed major emergency surgical procedure in Obstetrics. With the improved caesarean skill of the obstetrician and techniques of anaesthesia, the caesarean section has become a safe surgical procedure .The rate of caesarean section has shown progressive rise in last three decades in most part of the world .The immediate operative morbidity and the likelihood of complications in subsequent pregnancies, raise question marks regarding rising caesarean section rates. Material and methods-Retrospective analysis of 3980 caesarean sections performed at tertiary care teaching hospital over six years period, was undertaken to find out the rate of caesarean sections, indications and associated maternal morbidity and mortality . Results-The rate of caesarean section was in between 20 and 22 percent, during the study period .The rate has been fairly constant throughout the study period. The common indications were previous caesarean section, fetal distress, cephalopelvic disproportion, pre-eclampsia or antepartum haemorrhage. Anaemia and urinary infections resulted in postoperative febrile morbidity. Incidence of wound related complications were not significant .There were twelve maternal deaths, of which six were due to severe uncontrolled hemorrhage from placental bed during caesarean section. Conclusion-Caesarean section rate can be maintained at acceptable limits by judicious selection of cases, allowing vaginal births after caesarean sections, external cephalic versions, assisted vaginal breech deliveries in selected cases and proper interpretation of results of electronic fetal monitors. Pain relief by epidural analgesia can reduce the fear of labour and rate of elective caesarean sections.

Analysis of caesarean sections at a tertiary care centre according to Robson’s criteria

International journal of reproduction, contraception, obstetrics and gynecology, 2020

So there arose a necessity for standardized classification of caesarean sections. M. S. Robson proposed a ten-group classification of caesarean sections in year 2001 which was appreciated by WHO in 2014 and FIGO in 2016. 3,4 This classification has been praised as it is simple, robust, reproducible and flexible. The categories in the Robson's criteria are mutually exclusive and are based on 5 basic obstetric characteristics: obstetric history (parity and previous mode of delivery), onset of labour (spontaneous, induced or CS before onset of labour), gestational age, ABSTRACT Background: There has been a considerable increase in the rate of caesarean sections in the past few decades. Some demographers have argued that this increase is largely affected by the uprising trend of new medically indicated caesarean sections. M. S. Robson proposed a ten-group classification of caesarean sections in year 2001 which was appreciated by WHO in 2014 and FIGO in 2016. This classification is known as Robson's classification which has ten groups. Methods: This is a retrospective study which was carried out at Civil Hospital, Karimnagar. The study group included all live births and still births of at least 500 gm birth weight or at least 28 weeks of gestation at Civil Hospital, Karimnagar during the period from October 2019 to December 2019. The data collected was analysed using simple statistical methods like percentage and proportion. The data was grouped according to the Robson's 10 group classification system. The overall caesarean section rate, size of each group and the relative contribution of each group to the overall CS rate were calculated. Results: The total number of deliveries during the study period was 2493. Out of these, the number of caesarean deliveries was 1345. The caesarean section rate was calculated to be 53.95%. The group 5 (multiparous with at least one previous uterine scar with single cephalic pregnancy ≥37 weeks of gestation) contributed to 38.07% of the total caesarean section rate which is the highest. Conclusions: A regular audit into the number and indications of caesarean sections will definitely help in decreasing the primary and repeat caesarean sections.

Analysis of caesarean section in a district hospital

Journal of Medical Science And clinical Research, 2020

Background: Caesarean section is a surgical operation to deliver a baby or babies by means of an incision through the abdomen and uterus. The World Health Organization (WHO) has recommended an ideal caesarean section (CS) rate as 10-15%. Methods: This is a retrospective study of all the caesarean deliveries performed between 1 st