INDICATIONS OF ELECTIVE AND OUTCOMES OF EMERGENCY CAESAREAN SECTION - A CASE STUDY OF RANDLE GENERAL HOSPITAL, LAGOS, NIGERIA (original) (raw)
Related papers
Maternal Morbidity Associated with Emergency Versus Elective Caesarean Section
Journal of Postgraduate Medical Institute, 2012
Caesarean section is a major obstetric operation. Caesarean section (C-section) involves The modern caesarean operation was th making an incision in the woman's abdomen and developed between the late 19 century and the th cutting through the uterine muscles. The baby is first three decades of the 20 century. During this 1 then delivered through that incision. It is usually period, three developments accounted for the performed when a vaginal delivery would put the reduction in maternal mortality from caesarean baby's or mother's life or health at risk, although delivery from close to 100% to 2%. These three in recent times it has been also performed upon developments were the adoption of the use of uterine sutures to arrest hemorrhage, the adoption of aseptic technique, and changes in operative technique from the classical to lower-segment 3 operations. Compared to a vaginal delivery, maternal mortality and especially morbidity is increased with caesarean delivery. The overall maternal mortality rate is 6-22 deaths per 100,000 live births, with approximately one third to one half of maternal deaths after caesarean delivery directly attributed to a surgical procedure and, in part,
Journal of Gynecology and Obstetrics
Background: The pattern of Caesarean section rate is on the rise with emergency surpassing elective caesarean deliveries. This could not be unconnected to the safety of anaesthesia in modern obstetrics. Method: Data on Caesarean deliveries conducted from January, 2005 to December, 2009 was analyzed using Epi Info Statistical Software. Results: The Caesarean section rate was 18.75%. The mean age was 28.02±5.86 years. Emergency Caesarean section was the majority (59.4%) while the remaining (40.6%) were elective. General anaesthesia was used for the majority (66.68 %) of the cases, while 33.32% had subarachnoid block. Univariate analysis, shows statistically significant association between the type of surgery and anaesthetic technique used (χ 2 =22.741, df = 1, p = 0.000). A statistically significant association was also established between age group of the patients and the anaesthetic technique (χ 2 =10.878, df = 2, p = 0.004). However, there was no statistically significant association between age group of the patients and the type of Caesarean section (χ 2 =0.224, df = 2, p = 0.894). Conclusion: The high rate of emergency caesarean intervention has been a persistent denominator in several studies. The root cause of these anomalies such as dearth of expertise at secondary facilities should be addressed. With effective pregnancy supervision, obstetric cases that would end with emergency intervention can be handled electively.
Elective versus emergency caesarean section: differences in maternal outcome
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2019
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%). I...
Caesarean delivery: An experience from a tertiary institution in north western Nigeria
Objective: To assess the overall caesarean section (CS) rate, indications and outcomes in a tertiary hospital in Northwestern Nigeria. Materials and Methods: A cross-sectional study carried out over a period of two years. All patients who had caesarean section at any time within the day were noted and followed up till discharge. The socio-demographic data, types of CS, anaesthesia, indications, abdominal wall and uterine incisions, cadre of surgeon and feto-maternal outcomes were documented in a proforma. Statistical analysis was carried out using the EPI INFO 3.5.1 (CDC Atlanta Georgia, USA). Result: The caesarean section rate was 11.3% (504/4462) of total deliveries. The highest rate of 44.6% (225/504) was among the primipara. The most common age group involved was 25 to 29 years. The emergency rate was 57.1% (288/504), while elective CS constituted 42.9% (216/504) of cases. The most common indication for emergency CS was obstructed labour 25.7% (30/288) and previous CS 39.8% (86/216) for elective CS. The complication rate was 13.3% (67/504) and the main complication was haemorrhage 59.7% (40/67). Complications were more with emergency CS compared to elective surgery (χ 2 = 6.633, df = 1, P < 0.01) and with junior residents (χ 2 = 15.9, df = 1, P < 0.001). There were 10 maternal and 60 perinatal deaths. Conclusions: The rate of caesarean section has been increasing gradually. There is need to improve on facilities and manpower in order to reduce morbidity and mortality.
Obstetrics & Gynecology International Journal, 2023
Background: Cesarean Section on Maternal Request (CSMR) is a growing phenomenon whose literature needs to be appraised, and it is exemplified by a steady increase in the world neck and neck by high percentage of births by CS. It is even more luckless that giving birth by elective CS based on the pregnant woman's choice has become the first place among the justifications, notwithstanding its direct and long-term complications. Methods: This retrospective study reviewed data of all CS deliveries during the year 2022 at our hospital using electronic medical records in the hospital information system. Retrieved data include baseline demographic characteristics, mode of delivery, indications, and the type of CS, aiming to clarify the reason for CS to challenge the percentage of CS based on the yearning of the pregnant woman without a medical reason; to identify, analyze and try to solve the ethical problem raised up by the pregnant woman's request for CS. Results: The results revealed two significant facts; a sturdy noteworthy increase in the percentage of pregnant women delivering by CS compared to vaginal delivery at 54% versus 45.6%, and a sharp increase in the CS deliveries on maternal requests at 22.78%. The main reason for this shifting practice is the previous one CS followed by a decision that was taken on personal and family convictions. These harvested results revealed a significant increase in the percentage of pregnant women not receiving proper antenatal counseling about the appropriate method of delivery, with improper justification to jump over nature. Conclusion: Cesarean section should be signposted when on earth there is any indication or menace of detriment to the maternal and fetal binomial. If in earlier times "labor death" was a fact of life, nowadays it is astonishing and disgraceful the death of a mother due to pregnancy-delivery-postpartum. The proclamation that vaginal delivery is better because it is "natural" cannot and should not be taken to the last consequences under the risk of bad luck. The best form of birth is the safe one. To provide every pregnant woman with the right to choose her child's mode of delivery is to arbitrate for her sovereignty, yielding her respect and pride, nonetheless, it should be minimalistic and not absolute under this banner. Minimizing the rate of primary CS carries the secret key to ideal obstetrical care.
The Professional Medical Journal
To evaluate the common reasons for C/section done at tertiary care hospital and to look into their major determinants, in order to reduce the rate of C/section delivery and its associated mortality and morbidity. Study design: Retrospective, descriptive study. Place and duration of study: At Ibn-E-Siena Hospital, the duration of study was 1 year from November 2016 to October 2017. Material methods: The study included 250 patients who were delivered by Caesarean delivery. All the patients who were delivered abdominally after 28 weeks of gestation were included in this study. The women delivered abdominally before 28 weeks gestation were excluded from study. Results: The common indications for C/section in this study were previous C/section delivery in 37.6%, oligohydramnios 36%, fetal distress 12%, hypertensive disorders of pregnancy 7.2%, multiple pregnancy 5.6%, preterm labour 5.6%, failed progress of labour and bad obstetrical history 4.8% each, placenta previa 3.2% and cardiac disease 0.8%. Conclusion: Repeat C-section has become the commonest indications for C-section effort should be put in to reduce the rate of C/section in primigravidas, proper trial of labour should be given, and fetal distress should be properly diagnosed before going for C/section.
A Three-Year Review of Caesarean Delivery at a Secondary Health Facility in North-Western Nigeria
BORNO MEDICAL JOURNAL
Background: Caesarean section is today one of the commonest surgical operations performed on women. The increased refinement in anaesthetics and surgical skills has reduced the morbidity and mortality associated with the procedures. Most of the studies on caesarean rates in Nigeria are from tertiary centres in the main cities. They may not reflect the situation in secondary facilities in rural and suburban areas which do not have the adequate number of staff, equipment and logistic support. Objectives: To determine the rates of caesarean section, indications and outcome in the general hospital located in Dutse, Jigawa, NorthWestern Nigeria. Methods: It was a retrospective review of records of women that had caesarean delivery between January 2013 and December 2015. Socio-demographic and obstetric information were extracted and analysed using SPSS statistical software. Analysis of the data was done using descriptive statistics. Ethical approval was obtained from the state ministry of health research ethics committee. Results: There were a total of 9,362 deliveries of which 543 were caesarean births giving a caesarean section rate of 5.8%. Majority of the procedures were emergency (90%). More than half of the women had prolonged obstructed labour as the indication. Mean age (±SD) of the women was 25.5 ±7.21 years. There were 69 stillbirths and 4 maternal deaths. The main complication was wound breakdown seen among 9.8% of patients. Conclusion: The rate of caesarean section was lower compared to other secondary and tertiary facilities in Nigeria. Nine out of every 10 caesarean sections were emergency and were associated with high perinatal and maternal morbidity.
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.