Journal articles on the topic 'Caesarean births'
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Willis, Angela. "Optimising Medical Births 4. Positive Caesarean Births." Practising Midwife 25, no. 03 (April 1, 2022): 15–18. http://dx.doi.org/10.55975/jygg7011.
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In the UK, one in every three to four births is now a caesarean birth. More women and birthing people are choosing maternally requested caesarean births. This is for a number of reasons including increased knowledge of birth modes, fear of vaginal childbirth, the societal perception of birth in the media, previous trauma, and concerns with medicalisation or induction of labour, which is also on the rise with 30–40% of women choosing a vaginal birth having their labour medically induced. Whilst midwives have always been the supporters of physiological birth, we need to support all women and birthing people to have a safe and positive birth being ‘with woman’.
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Daniel, Lincia. "Caesarean births increase." British Journal of Midwifery 17, no. 1 (January 2009): 57. http://dx.doi.org/10.12968/bjom.2009.17.1.37667.
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Webster, Linda A., Janet R. Daling, Carmen McFarlane, Deanna Ashley, and Charles W. Warren. "Prevalence and determinants of caesarean section in Jamaica." Journal of Biosocial Science 24, no. 4 (October 1992): 515–25. http://dx.doi.org/10.1017/s0021932000020071.
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SummaryThe prevalence and determinants of primary caesarean section in Jamaica were estimated from a survey of women aged 14–49 years. Among 2328 women reporting 2395 live hospital births during the period January 1984 to May 1989, the prevalence of caesarean section was 4·1%. Repeat caesarean sections accounted for 1·3% of the hospital births during that period. Of the medical complications studied, prolonged labour and/or cephalopelvic disproportion carried the highest risks of primary caesarean section, followed by breech presentation, maternal diabetes, a high birth-weight baby, maternal hypertension, and a low birth-weight baby. The risk of primary caesarean section increased with maternal age, decreased with parity, was higher for urban than for rural residents, and was higher for births in private versus government hospitals.
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Che, Weng Ian, Karin Hellgren, Olof Stephansson, Ingrid E. Lundberg, and Marie Holmqvist. "Pregnancy outcomes in women with idiopathic inflammatory myopathy, before and after diagnosis—a population-based study." Rheumatology 59, no. 9 (January 30, 2020): 2572–80. http://dx.doi.org/10.1093/rheumatology/kez666.
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Abstract Objectives To examine pregnancy outcomes among births to women with idiopathic inflammatory myopathy (IIM) in relation to time of IIM diagnosis using population-based data. Methods This study used Swedish nationwide registers to identify all singleton births that occurred between 1973 and 2016 among women diagnosed with IIM between 1998 and 2016 and among women unexposed to IIM. We classified births according to the IIM status of the mother at time of delivery: post-IIM (n = 68), 1–3 years pre-IIM (n = 23), >3 years pre-IIM (n = 710) and unexposed to IIM (n = 4101). Multivariate regression models were used to estimate relative risks of adverse pregnancy outcomes in post-IIM births and pre-IIM births separately, in comparison with their non-IIM comparators. Results We found that post-IIM births had increased risks of caesarean section [adjusted relative risk (aRR) = 1.98; 95% CI: 1.08, 3.64], preterm birth (aRR = 3.35; 95% CI: 1.28, 8.73) and low birth weight (aRR = 5.69; 95% CI: 1.84, 17.55) compared with non-IIM comparators. We also noticed higher frequencies of caesarean section and instrumental delivery in 1–3 years pre-IIM births than in the non-IIM comparators. Conclusion Women who gave birth after IIM diagnosis had higher risks of caesarean section, preterm birth and low birth weight. These results further underline the importance of special care and close monitoring of women with IIM. Higher frequencies of caesarean section and instrumental delivery in pre-IIM births highlight the need for future research on the influence of subclinical features of IIM on pregnancy outcomes.
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Alonso, Bruna Dias, Flora Maria Barbosa da Silva, Maria do Rosário Dias de Oliveira Latorre, Carmen Simone Grilo Diniz, and Debra Bick. "Caesarean birth rates in public and privately funded hospitals: a cross-sectional study." Revista de Saúde Pública 51 (November 27, 2017): 101. http://dx.doi.org/10.11606/s1518-8787.2017051007054.
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OBJECTIVE: To examine maternal and obstetric factors influencing births by cesarean section according to health care funding. METHODS: A cross-sectional study with data from Southeastern Brazil. Caesarean section births from February 2011 to July 2012 were included. Data were obtained from interviews with women whose care was publicly or privately funded, and from their obstetric and neonatal records. Univariate and multivariate analyses were conducted to generate crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI) for caesarean section births. RESULTS: The overall caesarean section rate was 53% among 9,828 women for whom data were available, with the highest rates among women whose maternity care was privately funded. Reasons for performing a c-section were infrequently documented in women’s maternity records. The variables that increased the likelihood of c-section regardless of health care funding were the following: paid employment, previous c-section, primiparity, antenatal and labor complications. Older maternal age, university education, and higher socioeconomic status were only associated with c-section in the public system. CONCLUSIONS: Higher maternal socioeconomic status was associated with greater likelihood of a caesarean section birth in publicly funded settings, but not in the private sector, where funding source alone determined the mode of birth rather than maternal or obstetric characteristics. Maternal socioeconomic status and private healthcare funding continue to drive high rates of caesarean section births in Brazil, with women who have a higher socioeconomic status more likely to have a caesarean section birth in all birth settings.
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Hjorth, Sarah, Helene Kirkegaard, Jørn Olsen, Jim G. Thornton, and Ellen A. Nohr. "Mode of birth and long-term sexual health: a follow-up study of mothers in the Danish National Birth Cohort." BMJ Open 9, no. 11 (November 2019): e029517. http://dx.doi.org/10.1136/bmjopen-2019-029517.
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ObjectivesTo investigate the relation between mode of birth and women’s long-term sexual health.DesignMaternal follow-up of the Danish National Birth Cohort (1996–2002) in 2013–2014 including questions on sexual health. Logistic regression was used to relate registry-based information about mode of birth and perineal tears with data on sexual problems.SettingDenmark.ParticipantsOf 82 569 eligible mothers in the Danish National Birth Cohort, 43 639 (53%) completed the follow-up. Of these, 37 417 women had a partner, and answered at least one question on sexual health.Main outcome measuresSelf-reported sexual health.ResultsParticipants were on average 44 years old, and 16 years after their first birth. The frequency of sexual problems among women with only spontaneous vaginal births, the reference group, was 37%. For women who only had caesarean sections, more problems were reported (OR 1.18; 95% CI 1.09 to 1.28). For women who had a spontaneous vaginal birth subsequent to a caesarean, and for women with only vaginal births who had experienced one or more instrumental vaginal births, the odds of sexual problems did not differ from women with only spontaneous vaginal births (OR 1.00; 95% CI 0.91 to 1.11) and (OR 1.01; 95% CI 0.95 to 1.08), respectively.ConclusionsThese findings indicate that caesarean section does not protect against long-term sexual problems. Rather, vaginal birth, even after caesarean section, was associated with fewer long-term sexual problems.
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Geçer, Türkan. "Investigation of Women Employees in Family Health Centers of Eskişehir Province about Normal Birth and Caesarean Birth." JURNAL INFO KESEHATAN 18, no. 1 (June 30, 2020): 80–95. http://dx.doi.org/10.31965/infokes.vol18.iss1.429.
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The rate of caesarean delivery has been rising both in developed countries and developing countries, while there is no benefit evidence of caesarean section when it done with no clinical indication which is normally linked with caesarean delivery. Education and information about normal births can significantly reduce caesarean rates and switch women's preferences in giving birth to normal and physiological delivery. This study aimed to learn the opinions of female employees in Eskişehir family health centers about normal and caesarean births, to determine important points and develop suggestions for these methods. The population of the study was 170 working women. Factor analysis, 16 items normal birth, and caesarean delivery scale were gathered under one factor, and this single factor explained 36.775% of the total variance. Results showed that when item-total correlation values of normal birth and caesarean section were examined, it was found that item-total correlation values of 16 items in the scale were between 0.407 and 0.759. When item scores were examined, it was determined that there was consistency between the items. This research has shown that the majority of female workers prefer to giving births by caesarean section, while there is no clinical indication and they are suggested to normal delivery. As a result of the established DFA model, the fit indexes of the model were found to be among the perfect fit values (x2/df=65.26/25≤3).
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Saa Sita, Chantal Kanyere, Augustin Kadiata Bukasa, and Valentin Boya Bwembola. "Daily Experience of Caesarean Deliveries on Their Care in the Maternities of the City of Kinshasa." International Journal of Health Sciences and Research 12, no. 4 (April 7, 2022): 150–59. http://dx.doi.org/10.52403/ijhsr.20220419.
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Objective: This study aims to understand the daily experience of caesarean births on their care in the maternities of the city of Kinshasa. Materials and Methods: Our study is descriptive, opted for a qualitative estimate of the phenomenological type to study the daily experience of caesarean births on their care . The direction chosen for this study is inspired by a phenomenological approach which aims to describe and understand phenomena based on the person's experience. The phenomenological survey method was used for data collection and the face-to-face semi-structured interview technique. Results: After the analyses, in relation to the experience, the women who gave birth before the caesarean have a Feeling of comfort after psychological preparation; Caesarean section is perceived as a dangerous practice that exposes to death; the caesarean represents a test of strength, binding but an act of rescue; During their care, the midwives say that they had noticed a relaxation in the care following financial demotivation. Conclusions: With regard to the expectation vis-à-vis the nursing staff, those who have given birth to caesarean sections want access to be given to their husbands for support during the caesarean section. Key words: Daily life, Births, Cesarean section, Support.
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Cavallaro, Francesca L., Charles P. Kabore, Rachel Pearson, Ruth M. Blackburn, Soha Sobhy, Ana Pilar Betran, Carine Ronsmans, and Alexandre Dumont. "Does hospital variation in intrapartum-related perinatal mortality among caesarean births reflect differences in quality of care? Cross-sectional study in 21 hospitals in Burkina Faso." BMJ Open 12, no. 10 (October 2022): e055241. http://dx.doi.org/10.1136/bmjopen-2021-055241.
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ObjectivesTo examine hospital variation in crude and risk-adjusted rates of intrapartum-related perinatal mortality among caesarean births.DesignSecondary analysis of data from the DECIDE (DECIsion for caesarean DElivery) cluster randomised trial postintervention phase.Setting21 district and regional hospitals in Burkina Faso.ParticipantsAll 5134 women giving birth by caesarean section in a 6-month period in 2016.Primary outcome measureIntrapartum-related perinatal mortality (fresh stillbirth or neonatal death within 24 hours of birth).ResultsAlmost 1 in 10 of 5134 women giving birth by caesarean experienced an intrapartum-related perinatal death. Crude mortality rates varied substantially from 21 to 189 per 1000 between hospitals. Variation was markedly reduced after adjusting for case mix differences (the median OR decreased from 1.9 (95% CI 1.5 to 2.5) to 1.3 (95% CI 1.2 to 1.7)). However, higher and more variable adjusted mortality persisted among hospitals performing fewer caesareans per month. Additionally, adjusting for caesarean care components did not further reduce variation (median OR=1.4 (95% CI 1.2 to 1.8)).ConclusionsThere is a high burden of intrapartum-related perinatal deaths among caesarean births in Burkina Faso and sub-Saharan Africa more widely. Variation in adjusted mortality rates indicates likely differences in quality of caesarean care between hospitals, particularly lower volume hospitals. Improving access to and quality of emergency obstetric and newborn care is an important priority for improving survival of babies at birth.Trial registration numberISRCTN48510263.
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MAGADI, MONICA, NYOVANI MADISE, and IAN DIAMOND. "FACTORS ASSOCIATED WITH UNFAVOURABLE BIRTH OUTCOMES IN KENYA." Journal of Biosocial Science 33, no. 2 (April 2001): 199–225. http://dx.doi.org/10.1017/s0021932001001997.
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Studies addressing factors associated with adverse birth outcomes have almost exclusively been based on hospital statistics. This is a serious limitation in developing countries where the majority of births do not occur within health facilities. This paper examines factors associated with premature deliveries, small baby’s size at birth and Caesarean section deliveries in Kenya based on the 1993 Kenya Demographic and Health Survey data. Due to the hierarchical nature of the data, the analysis uses multilevel logistic regression models to take into account the family and community effects. The results show that the odds of unfavourable birth outcomes are significantly higher for first births than for higher order births. Furthermore, antenatal care (measured by frequency of antenatal care visits and tetanus toxoid injection) is observed to have a negative association with the incidence of premature births. For the baby’s size at birth, maternal nutritional status is observed to be a predominant factor. Short maternal stature is confirmed as a significant risk factor for Caesarean section deliveries. The observed higher odds of Caesarean section deliveries among women from households of high socioeconomic status are attributed to the expected association between socioeconomic status and the use of appropriate maternal health care services. The odds of unfavourable birth outcomes vary significantly between women. In addition, the odds of Caesarean section deliveries vary between districts, after taking into account the individual-level characteristics of the woman.
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Lennon, Roisin. "To weigh or not to weigh in pregnancy: a retrospective study." British Journal of Midwifery 30, no. 11 (November 2, 2022): 608–14. http://dx.doi.org/10.12968/bjom.2022.30.11.608.
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Introduction A rise in the number of caesarean sections and the rate of birth weight over 4kg prompted an advanced midwife practitioner service to introduce routine weighing for all service users and target weight gain based on Institute of Medicine guidelines. The study's aims were to ascertain if maintaining weight gain reduced pre-eclampsia, caesarean section births, birth weight over 4kg and neonatal intensive care unit admissions. Methods A retrospective study of weight gain and outcomes for 53 pre- and 46 post-routine weighing service users was conducted. Results Over a third (40%) of participants gained excess weight, with a 22% caesarean section rate and 22% of babies weighed over 4kg at birth. There was an overall 6% reduction in caesarean section births and a 22% reduction in babies weighing over 4kg. Conclusions Routine weighing and health promotion techniques have the potential to maximise health and wellbeing and could be a long-term investment in the health and wellbeing of mothers and babies.
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Olaru, Octavian, Anca Stanescu, Cristina Raduta, Liana Ples, Adriana Vasilache, Nicolae Bacalbasa, Andrei Vasilache, and Oana Balalau. "Caesarean section versus vaginal birth in the perception of woman who gave birth by both methods." Journal of Mind and Medical Sciences 8, no. 1 (April 15, 2021): 127–32. http://dx.doi.org/10.22543/7674.81.p127132.
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The increase in the number of births by Caesarean section is a phenomenon whose global expansion is generated by numerous factors and especially by the contemporary perceptions of women regarding childbirth meeting the interests of the professionals in the field. However, the opinion of many women towards the benefits of Caesarean delivery is often not based on the experience or information from reliable sources. This study aimed at sharing the experience of women who gave birth both vaginally and by Caesarean section, focusing on their perception of these events. The study included 26 women and the conclusion of the vast majority (77%) was that natural birth is preferable and they would recommend it as the first option to future mothers. In addition, the analysis of the cases in which, on the contrary, they would recommend birth by Caesarean section (23%) revealed that they objectively had births that had not been optimally managed and hence, the recommendation for careful, professional evaluation of the conditions of birth for each case. Reaching an optimal rate of Caesarean sections is an objective that can be achieved through correct information, health education and the correct management of the cases.
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Fiems, L. O., S. de Campeneere, W. van Caelenbergh, and Ch V. Boucqué. "Relationship between dam and calf characteristics with regard to dystocia in Belgian Blue double-muscled cows." Animal Science 72, no. 2 (January 2001): 389–94. http://dx.doi.org/10.1017/s1357729800055880.
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AbstractInformation concerning 493 single calvings of the double-muscled beef cow herd of the institute was collected to investigate the relationship between the characteristics of dams and calves with regard to dystocia. Factors affecting dystocia are similar in double-muscled cattle to those in non-double-muscled cattle but the occurrence of dystocia is greatly increased in double-muscled cows. Incidence of caesarean section was significantly correlated with parity (–0·243), age of dam (–0·232), post-partum dam weight (–0·185), and calf birth weight (0·164). Caesarean deliveries were required for 89·5% of the parturitions. Calvings without caesarean section were characterized by higher means for post-partum dam live weight (634·7 kg), age (1675·5 days), parity (3·1) and the ratio of post-partum dam weight to calf birth weight (14·4), compared with 580·2 kg, 1251·1 days, 2·1, and 11·8, respectively for births with caesarean setion, while calf birth weight was lower in non-caesarean calvings (45·8 v. 49·9 kg). Caesarean births involved more male calves than females (55 v. 45%). Even when calf birth weight was 30 kg or lower, and also in multiparous cows, 40 and 86% of the deliveries, respectively, still occurred with a caesarean section.Incidence of caesarean section could not be accurately predicted from pre-partum characteristics such as pre-partum dam weight, age and parity.
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Cavallaro, Francesca L., Andrea B. Pembe, Oona Campbell, Claudia Hanson, Vandana Tripathi, Kerry LM Wong, Emma Radovich, and Lenka Benova. "Caesarean section provision and readiness in Tanzania: analysis of cross-sectional surveys of women and health facilities over time." BMJ Open 8, no. 9 (September 2018): e024216. http://dx.doi.org/10.1136/bmjopen-2018-024216.
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ObjectivesTo describe trends in caesarean sections and facilities performing caesareans over time in Tanzania and examine the readiness of such facilities in terms of infrastructure, equipment and staffing.DesignNationally representative, repeated cross-sectional surveys of women and health facilities.SettingTanzania.ParticipantsWomen of reproductive age and health facility staff.Main outcome measuresPopulation-based caesarean rate, absolute annual number of caesareans, percentage of facilities reporting to perform caesareans and three readiness indicators for safe caesarean care: availability of consistent electricity, 24 hour schedule for caesarean and anaesthesia providers, and availability of all general anaesthesia equipment.ResultsThe caesarean rate in Tanzania increased threefold from 2% in 1996 to 6% in 2015–16, while the total number of births increased by 60%. As a result, the absolute number of caesareans increased almost fivefold to 120 000 caesareans per year. The main mechanism sustaining the increase in caesareans was the doubling of median caesarean volume among public hospitals, from 17 caesareans per month in 2006 to 35 in 2014–15. The number of facilities performing caesareans increased only modestly over the same period. Less than half (43%) of caesareans in Tanzania in 2014–15 were performed in facilities meeting the three readiness indicators. Consistent electricity was widely available, and 24 hour schedules for caesarean and (less systematically) anaesthesia providers were observed in most facilities; however, the availability of all general anaesthesia equipment was the least commonly reported indicator, present in only 44% of all facilities (34% of public hospitals).ConclusionsGiven the rising trend in numbers of caesareans, urgent improvements in the availability of general anaesthesia equipment and trained anaesthesia staff should be made to ensure the safety of caesareans. Initial efforts should focus on improving anaesthesia provision in public and faith-based organisation hospitals, which together perform more than 90% of all caesareans in Tanzania.
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Odent, Michel Robert Fortuné. "Three kinds of caesarean sections: the foetal/neonatal perspective." Journal of Perinatal Medicine 49, no. 7 (July 13, 2021): 763–66. http://dx.doi.org/10.1515/jpm-2021-0319.
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Abstract In the age of hospital births, it is commonplace to contrast the vaginal route and the abdominal route as the basic classification. From the “point of view” of the foetus/neonate, we provide reasons to contrast “birth without labour” (that is birth by pre-labour caesarean section) and all the other vaginal and abdominal modes of birth. From a great diversity of theoretical reasons, one can anticipate that babies born by pre-labour caesarean sections are different from the others. We also provide reasons to popularize the concepts of “in labour non-emergency caesarean sections” and “planned in-labour caesarean sections”.
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Yitambe, Andre, Rucha Kenneth Kibaara, and Peterson Warutere. "SOCIO-ETHICAL ISSUES SURROUNDING CAESAREAN SECTION BIRTHS IN AFRICA." International Journal of Research -GRANTHAALAYAH 6, no. 11 (November 30, 2018): 272–82. http://dx.doi.org/10.29121/granthaalayah.v6.i11.2018.1128.
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In the last decade, a number of studies have questioned the practice of caesarean section birth in obstetrical practices in Africa. Medical sociologists and anthropologists have considered caesarean section as a medicalization of social events. We are not assuming that it is true of false. The transformation of social events into medical indications rises ethical issues in the provision of healthcare in Africa. In this paper, we especially used the case of caesarean section birth to explore the transformation of social events into medical indications in Africa. Caesarean sections by choice interrogates the obstetrical practices. This paper examines the socio-ethical issues in caesarean section in Africa. We considered some underlying factors: medicalization of the society, informed consent, biotechnology, demand inducement, consumer-inducement demand and the health market-driven economy. This was desk-based study. A review of secondary data and literatures relative to caesarean section births in Africa were used for discussion. Findings from literatures revealed that a number of considerations have to be taken such as: demand inducement and information asymmetry, defensive and corporate medicine, medical power, consumer induced demand and health market driven economy. The findings informed health regulators on demand and supply sides of caesarean sections.
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Kruit, Heidi, Mika Gissler, Seppo Heinonen, and Leena Rahkonen. "Breaking the myth: the association between the increasing incidence of labour induction and the rate of caesarean delivery in Finland - a nationwide Medical Birth Register study." BMJ Open 12, no. 7 (July 2022): e060161. http://dx.doi.org/10.1136/bmjopen-2021-060161.
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ObjectivesTo determine the association between the rate of labour induction and caesarean delivery.DesignMedical Birth Register-based study. We used data from the nationwide Medical Birth Register collecting data on delivery outcomes on all births from 22+0 weeks and/or birth weight of at least 500 g.SettingFinland.Participants663 024 live births in Finland from 2008 to 2019.Main outcome measuresThe rates of labour induction and caesarean delivery.ResultsThe rate of labour induction increased from 17.8% to 30.3%; p<0.001, during the study. The total caesarean delivery rate was 16.5% (n=109 178). An increase of approximately 0.5% in the caesarean delivery rate occurred during the study period. The rate of caesarean delivery following labour induction slightly decreased (15.41% vs 15.35%; p<0.001). In multivariate logistic regression analysis, induction of labour was associated with a reduced risk for caesarean delivery (OR 0.72, 95% CI 0.71 to 0.74). The frequency of advanced maternal age (18.0% vs 23.5%; p<0.001), obesity (11.4% vs 15.1%; p<0.001) and gestational diabetes (9.8% vs 23.3%; p<0.001) increased during the study.ConclusionsThe 70% increase in the rate of labour induction in Finland has not led to a significant increase in the rate of caesarean delivery, which has remained one of the lowest in the world. Pregnant women in Finland are more frequently obese, older and diagnosed with gestational diabetes, which may partly explain the increase in the rate of labour induction.
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Rahmatika, Vina, Musa Ghufron, Nenny Triastuti, and Syaiful Rochman. "Hubungan Pemberian Anestesi Regional Dengan Kelancaran ASI Pada Ibu Post Partum Sectio Caesarea Di Rumah Sakit Muhammadiyah Gresik." MAGNA MEDICA: Berkala Ilmiah Kedokteran dan Kesehatan 7, no. 2 (December 21, 2020): 42. http://dx.doi.org/10.26714/magnamed.7.2.2020.42-48.
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Background: The birth rate by caesarean section method is getting higher. Risk data for 2013 shows the method of birth with the operation method of 9.8 percent of the total 49,603 births during 2010 to 2013. Being in practice the mother must be given anesthetic before the surgery begins. This anesthesia will later affect the pain that will occur after SC. Purpose: The purpose of this study was to determine the correlation between regional anesthetic drugs and the smoothness of breast milk in women born in sectio caesarea at Muhammadiyah Gresik Hospital. Method: Method with Cross Sectional approach. The population in this study mothers who gave birth in a caesarean section at Muhammadiyah Hospital Gresik in December 2019 to January 2020. The sampling technique in this study is probability / random simple sampling. The sample in this study was a portion of mothers who gave birth in a caesarean section at Muhammadiyah Gresik Hospital. The instrument used was primary data collection in the form of questionnaires and secondary data in the form of patient medical records. Result: The data obtained in this study were processed using spearman correlation statistics. From the statistical test the Correlation coefficient value was 0.807, and obtained P-Value equal to 0,000 this value is less than 0.05. Conclusion: The conclusion of this study is that there is a correlation between the administration of a regional anesthetics and the smoothness of breast milk in mothers of post partum caesarea at Muhammadiyah Gresik Hospital.
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Br Tarigan, Herri Novita, Megawati Sinambela, and Reka Novrina. "PENGARUH PEMBERIAN TERAPI MUSIK TERHADAP PENURUNAN INTENSITAS NYERI PADA PASIEN POST SECTIO CAESAREA." Jurnal Penelitian Keperawatan Medik 2, no. 2 (April 30, 2020): 27–33. http://dx.doi.org/10.36656/jpkm.v2i2.210.
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The World Health Organization (WHO) sets the average standard of sectio caesarean delivery in a country to be around 5-15 percent per 1000 births in the world.In Indonesia, the results of Basic Health Research in 2013 showed births with a caesarean section of 9.8% out of a total of 49,603 births from 2010 to 2013. Nursing problems that often arise in cases of post sectio caesarea are pain caused by trauma to the tissue due to tissue damage and direct irritation to the receptors. The nurse's independent action to control the pain felt by the patient is to do pain management with non-pharmacological techniques, namely music therapy. The purpose of this study was to determine the effect of music therapy on pain intensity reduction in post sectio caesarea patients. This study used a quasi-experimental design method with a non equivalent control group design. The sampling technique uses accidental sampling technique with a total sample of 32 respondents, 16 experimental groups and 16 control groups. This study used the Wilcoxon non-parametric test. The results of this study indicate the P-value (0.001) <α (0.05). The conclusion of this study is that there is an effect of music therapy on the decrease in pain intensity in post-sectio caesarea patients in the hybrid room Sembiring General Hospital.
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Panigrahi, Namrata, Nivedita Karmee, R. M. Tripathy, and Monali Kar. "Caesarean section and its determinants: a hospital based cross-sectional study." International Journal Of Community Medicine And Public Health 4, no. 4 (March 28, 2017): 1183. http://dx.doi.org/10.18203/2394-6040.ijcmph20171346.
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Background: The rapid rise in CS rate has become a serious public health issue now-a-days because unnecessary caesareans generate higher expenditure at individual and national levels and have the potential to divert human and financial resources from higher priority intervention. Therefore the present study was carried out to know the indications and determinants of caesarean births in a tertiary hospital of Odisha.Methods: A hospital based cross-sectional study was conducted among women who delivered by caesarean section in O and G department of MKCG Medical College Hospital, Berhampur from July to October 2016 using a pretested semi-structured questionnaire. The data was analysed using appropriate statistical tests such as proportion, chi square test using SPSS software. P value of less than 0.05 is considered as statistically significant.Results: Premature rupture of membrane with oligohydramnias was the major indication in 31.4% cases followed by previous CS in 20.1% cases. Out of socio-demographic factors age (P value = 0.001) and educational status of women (P value= 0.042) were significantly associated with type of CS. Foetal presentation (P value= 0.003), interval between labour and CS (P value <0.01) and type of admission (P value = 0.05) were major obstetric determinants of CS.Conclusions: In order to safeguard the health of mother and child from effects of unnecessary caesarean births, regular antenatal checkups, proper birth preparedness along with timely diagnosis and management of complications is necessary.
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Schnapp, Carlos, and Waldo Sepulveda. "Rise in caesarean births in Chile." Lancet 349, no. 9057 (April 1997): 1029. http://dx.doi.org/10.1016/s0140-6736(05)62933-9.
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Weisshaupt, Karen, Wolfgang Henrich, Jörg Neymeyer, and Alexander Weichert. "Mode of delivery of women with Swyer syndrome in a German case series." Journal of Perinatal Medicine 49, no. 6 (March 17, 2021): 725–32. http://dx.doi.org/10.1515/jpm-2020-0562.
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Abstract Objectives For women with Swyer Syndrome, a 46,XY gonadal dysgenesis, full term pregnancies are possible after oocyte donation. According to literature, mode of delivery is almost always by Caesarean section for various reasons. Medical indications are multiple pregnancies and related complications, preeclampsia, an androgynous shaped pelvis and failed induction of labor. Elective Caesarean sections were performed based on maternal request and medical recommendation. Methods Following careful examination and shared decision making, we planned a spontaneous delivery with a patient with Swyer syndrome and tested the different hypotheses regarding anatomical and functional features according to literature. In addition, deliveries of women with Swyer Syndrome were analyzed in a German multicenter case series. Results A total of seven women with Swyer syndrome with a total of 10 pregnancies were identified, who later gave birth to twelve live-born children. Seven out of 10 births were performed by elective and non-elective Caesarean section, three births took place vaginally. Conclusions In summary, the risk of Caesarean section delivery has increased, but spontaneous delivery can be attempted in the event of inconspicuous findings.
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Mohapatra, Ipsita, Subha Ranjan Samantaray, Achanta Vivekanand, Anandala Manjula, and Buyyani Priyanka. "Analysis of caesarean sections at a tertiary care centre according to Robson’s criteria." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 8 (July 23, 2020): 3445. http://dx.doi.org/10.18203/2320-1770.ijrcog20203339.
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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.
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Varea, Carlos, Cristina Bernis, and Antonio González González. "Maternal Characteristics and Temporal Trends in Birth Outcomes: Comparison between Spanish and Migrant Mothers." International Journal of Population Research 2012 (May 29, 2012): 1–8. http://dx.doi.org/10.1155/2012/412680.
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Low birth weight and preterm babies have been increasing in Spain since 1980, coinciding with important changes in the social and demographic structure of childbearing populations—including the contribution of a 25% of foreign mothers—and with increasing medical intervention in births. This study, based on 5,990,613 births, compares the temporary trends in reproductive patterns and birth outcomes in Spanish and foreign mothers during the period 1996–2009 and evaluates for the years 2007 to 2009 the relative contribution of mother's origin and Caesarean section to birth weight variability. Foreign mothers maintain their own reproductive pattern, whereas negative birth outcomes increase in all groups. Results from logistic regression analysis show that besides late maternity and primiparity also Caesarean section increases the risk for low birth weight. The reduction in Caesarean section rates between 2007 and 2009 might explain the reduction of low birth weight detected. A change of tendency simultaneously appears in most maternal and newborn characteristics, and in the mode of delivery in all ethnic groups since 2008. Coincidence in the timing of the change of trends points to a common factor. We suggest that the current world financial crisis could be this common cause, a hypothesis to be contrasted in future research.
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Basha, Sara, Alex Socarras, Mohammed Waseem Akhter, Mohamed Hamze, Ahmad Albaik, Imad Hussein, Ahmad Tarakji, et al. "Protracted armed conflict and maternal health: a scoping review of literature and a retrospective analysis of primary data from northwest Syria." BMJ Global Health 7, no. 8 (August 2022): e008001. http://dx.doi.org/10.1136/bmjgh-2021-008001.
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IntroductionSyria’s protracted conflict has devastated the health system reversing progress made on maternal health preconflict. Our aim is to understand the state of maternal health in Syria focused on underage pregnancy and caesarean sections using a scoping review and quantitative analysis; the latter draws on data from the Syrian American Medical Society’s (SAMS) maternal health facilities in northwest Syria.MethodsWe performed a scoping review of academic and grey literature on the state of maternal health across Syria since the onset of conflict (taken as March 2011). Identified articles were screened using pre-established criteria and themes identified. We also performed a retrospective quantitative analysis of maternal health data from SAMS’ facilities in a microcontext in north-west Syria between March 2017 and July 2020, analysing the trends in the proportion of births by caesarean section and age at pregnancy.ResultsScoping review: of 2824 articles, 21 remained after screening. Main themes related to maternal mortality rates, caesarean sections, maternal age and perinatal care. 12 studies reported caesarean section rates; these varied from 16% to 64% of all births: northern Syria (19%–45%,) Damascus (16%–54%,) Lattakia (64%) and Tartous (59%.) Quantitative analysis: Of 77 746 births across 17 facilities, trend data for caesarean sections showed a decrease from 35% in March 2017 to 23% in July 2020 across SAMS facilities. Girls under 18 years accounted for 10% of births and had a lower proportion of caesarean section births. There was notable geographical and interfacility variation in the findings.ConclusionThe quality of available literature was poor with country-level generalisations. Research which explores microcontexts in Syria is important given the different effects of conflict across the country and the fragmented health system. Our quantitative analysis provides some evidence around the changes to caesarean section rates in northwest Syria. Despite limitations, this study adds to sparse literature on this important topic.
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Hoxha, Ilir, Alban Fejza, Mrika Aliu, Peter Jüni, and David C. Goodman. "Health system factors and caesarean sections in Kosovo: a cross-sectional study." BMJ Open 9, no. 4 (April 2019): e026702. http://dx.doi.org/10.1136/bmjopen-2018-026702.
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ObjectiveTo investigate the association of caesarean section rates with the health system characteristics in the public hospitals of Kosovo.DesignCross-sectional survey.SettingFive largest public hospitals in Kosovo.Participants859 women with low-risk deliveries who delivered from April to May 2015 in five public hospitals in Kosovo.Outcome measuresThe prespecified outcomes were the crude and adjusted OR of births delivered with caesarean section by health system characteristics such as delivery by the physician who provided antenatal care, health insurance status and other. Additional prespecified outcomes were caesarean section rates and crude ORs for delivery with caesarean in each public hospital.ResultsWomen with personal monthly income had increased odds for caesarean (OR 1.55, 95% CI 1.06 to 2.27), as did women with private health insurance coverage (OR 3.44, 95% CI 1.20 to 9.85). Women instructed by a midwife on preparation for delivery had decreasing odds (OR 0.32, 95% CI 0.19 to 0.51) while women having preference for a caesarean had increasing odds for delivery with caesarean (OR 3.84, 95% CI 1.96 to 7.51). The odds for caesarean increased also in the case of delivery by a physician who provided antenatal care (OR 2.06, 95% CI 1.16 to 3.67) and delivery during office hours (OR 2.36, 95% CI 1.37 to 4.05), while delivery at the University Clinical Centre of Kosovo decreased the odds for caesarean (OR 0.46, 95% CI 0.24 to 0.90).ConclusionsWe found that several health system characteristics are associated with the increase of caesarean sections in a low-risk population of delivering women in public hospitals of Kosovo. These findings should be explored further and addressed via policy measures that would tackle provision of unnecessary caesareans. The study findings could assist Kosovo to develop corrective policies in addressing overuse of caesareans and may provide useful information for other middle-income countries.
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McIntyre, Meredith J., Ysanne Chapman, and Karen Francis. "Hidden costs associated with the universal application of risk management in maternity care." Australian Health Review 35, no. 2 (2011): 211. http://dx.doi.org/10.1071/ah10919.
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This paper presents a critical analysis of risk management in maternity care and the hidden costs associated with the practice in healthy women. Issues of quality and safety are driving an increased emphasis by health services on risk management in maternity care. Medical risk in pregnancy is known to benefit 15% or less of all pregnancies. Risk management applied to the remaining 85% of healthy women results in the management of risk in the absence of risk. The health cost to mothers and babies and the economic burden on the overall health system of serious morbidity has been omitted from calculations comparing costs of uncomplicated caesarean birth and uncomplicated vaginal birth. The understanding that elective caesarean birth is cost-neutral when compared to a normal vaginal birth has misled practitioners and contributed to over use of the practice. For the purpose of informing the direction of maternity service policy it is necessary to expose the effect the overuse of medical intervention has on the overall capacity of the healthcare system to absorb the increasing demand for operating theatre resources in the absence of clinical need. What is known about this topic? Australia is experiencing an increase in unexplained caesarean section births in healthy populations of women at a time when risk management is an accepted practice in maternity care irrespective of clinical need. The effect of this increase on health services has been cushioned in the belief that caesarean section is cost neutral when compared with uncomplicated vaginal birth. What does this paper add? This article shows that caesarean section is not cost neutral when compared with uncomplicated vaginal birth. Hidden costs in terms of serious morbidity affecting women’s future health and fertility associated with caesarean delivery in the absence of medical risk need to be calculated into the overall cost burden. Practitioners have been misled in this regard, thereby contributing to overuse of the practice. What are the implications for practitioners? The importance of changing the index measurement of safety and quality of maternity care to include serious morbidity following unexplained caesarean section birth rates and normal births.
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Kadivnik, Mirta, Kristina Kralik, Gordana Lončar, Andrea Teodosić, Maja Košuta Petrović, and Iva Milić Vranješ. "Utjecaj majčinih i fetalnih faktora na uspješnost medikamentozne indukcije poroda." Medicina Fluminensis 57, no. 3 (September 1, 2021): 275–82. http://dx.doi.org/10.21860/medflum2021_261189.
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Labour induction is the process in which labour is induced mechanically or pharmacologically. The percentage of induced labours is between 1.4% and 32% of the total number of births in the world. The aim of this research is to present the number of medically induced labours from 2012 to 2019 at the Clinic for Gynaecology and Obstetrics of the Clinical Hospital Center in Osijek and to present the success rate of medically induced labour and factors, both maternal and/or foetal which may affect it. Materials and methods: In the study 2361 subjects were included whose births were induced by medication regardless of the indication for medically induced labour, gestational age or mother’s age. χ2 test, Mann Whitney U test, Fisher’s exact test, Kruskal Wallis test (Pot Hoc Conover), and the univariate and multivariate logistic regression model were used. Results: The percentage of inductions was 13.8%. 81% of the child births was completed vaginally , while 19% was completed by the caesarean section. The univariate regression analysis found that meconium amniotic fluid increases the risk of the caesarean section after the labour has been induced. Factors decreasing the possibility of the caesarean section after induced labour include multiparity, women age between 25 and 35 years and women bearing female children. The multivariate statistical regression model found that women over the age of 36 are 1.58 times more likely to have the caesarean section. Women with meconium amniotic fluid are 1.47 times more likely to have the caesarean section. Multiparity in the mother and the female sex of the child reduce the probability of the caesarean section after induced labour (odds ratio (OR) 0.20, P=0.02 and OR 0.84, P=0.09, respectively). Conclusion: The study indicates that multiparity and female gender of child increase the probability of the vaginal birth after the induction, while the mother’s age over 36 and meconium amniotic fluid after the induction increase the risk of the caesarean section.
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Casteleiro, Ana, M. Santibanez, Paula Paras-Bravo, Amada Pellico-Lopez, and María Paz-Zulueta. "Clinical practice outcomes and differential results in maternal and neonatal morbidity among pregnant women in Spain who are candidates for a normal birth: a cross-sectional study." BMJ Open 9, no. 8 (August 2019): e026899. http://dx.doi.org/10.1136/bmjopen-2018-026899.
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ObjectiveTo determine the percentage of pregnant women who are potential candidates for a normal birth in the region of Cantabria, Spain. Also, to compare the main clinical practice outcome indicators and the rates of maternal and neonatal morbidity among the group of candidate women versus non-candidates.DesignA cross-sectional study.SettingA tertiary Hospital in Cantabria (Northern region of Spain).ParticipantsThe study population comprised the total number of hospital births that took place between 1 January 2014 and 31 December 2014 (n=3315).ResultsSecondary registers were accessed to review the main indicators of care and the outcome of births. The χ2 test or the Student’s t-test were used to compare both groups for the categorical and continuous variables, respectively. In total, 1863 births (56.20%) were candidates for applying the strategy of care for a normal birth. In 50.86% of these candidate births, an episiotomy was performed, compared with 60.96% in the group of non-candidates (p<0.001). Regarding caesarean sections, these were carried out in 19.32% of the candidate births, compared with 26.79% of non-candidate births (p<0.001). Furthermore, there were statistically significant differences between the groups according to the type of birth, the need for instrumental birthing methods, the existence of perineal tears, Apgar scores and the requirement for the infant to be admitted to the neonatal intensive care unit.ConclusionsOur results suggest a differential clinical practice, in line with the recommendations of the Clinical Practice Guidelines for Care of Normal Birth. Nonetheless, improvements are necessary regarding the care provided to women and infants, as the percentages of episiotomies and caesarean sections are still high when compared with current standards and compared with other reports.
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McDonnell, Sian, and Edwin Chandraharan. "Determinants and Outcomes of Emergency Caesarean Section following Failed Instrumental Delivery: 5-Year Observational Review at a Tertiary Referral Centre in London." Journal of Pregnancy 2015 (2015): 1–6. http://dx.doi.org/10.1155/2015/627810.
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Objectives. To review the determinants for a failed operative vaginal delivery and to examine associated fetal and maternal morbidity.Design. Retrospective observational study.Setting. Large London Teaching Hospital.Method. A retrospective review of case notes during a 5-year period was carried out.Results. Overall 119 women (0.44%) out of 26,856 births had a caesarean section following a failed instrumental delivery, which comprised 5.1% of all operative vaginal births. 73% had a spontaneous onset of labour and 63% required syntocinon at some time prior to delivery. 71.5% of deliveries were complicated by malposition. Only 20% of deliveries were attended by a consultant obstetrician. Almost 50% of women and 8.4% of neonates sustained trauma at the time of either their failed instrumental delivery or the caesarean section.Conclusions. Emergency caesarean section during the second stage of labour is associated with maternal and fetal complications. A ‘failed instrumental delivery score’ (FIDS) may aid practitioners in predicting an increased likelihood of a failed operative vaginal birth and therefore to consider a trial of operative vaginal delivery in the theatre. Senior input should also be sought because a failed operative vaginal birth is associated with increased maternal and fetal morbidity.
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Ibrahimou, Boubakari, Sireesha Kodali, and Hamisu Salihu. "Survival of Preterm Singleton Deliveries: A Population-Based Retrospective Study." Advances in Epidemiology 2015 (September 28, 2015): 1–6. http://dx.doi.org/10.1155/2015/858274.
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Aim. To identify sociodemographic and medical characteristics associated with preterm birth survival. Methods. A retrospective study of singleton births was performed using Missouri linked data for the years 1978 to 2005. We computed hazard ratios (HR) and 95% confidence intervals (CI) using Cox proportional hazards model. Results. High rates of infant, neonatal, and postneonatal mortality were observed among preterm as compared to term births. White are at low risk for postneonatal (HR = 0.77, CI: 0.65, 0.90) and infant mortality (HR = 0.90, CI: 0.81, 0.99) compared to blacks. We observed increased risks of all mortality types for preterm deliveries by caesarean section (neonatal HR = 1.53, CI: 1.40, 1.68; postneonatal HR = 1.39, CI: 1.22, 1.58; infant HR = 1.37, CI: 1.27, 1.48). As compared to nonsmokers, preterm singletons born to smoking mothers are 69% more likely to experience postneonatal mortality and have a 17% increased risk for infant death. Conclusions. Caesarean section is associated with increased risk of all types of mortality. Racial disparity is still a concern. Further research is required to identify the detailed differences in structure and procedures that result in the disadvantage associated with preterm birth especially with respect to caesarean section and race.
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Yuhana, Yuhana, Tuti Farida, and Turiyani Turiyani. "Hubungan Ketuban Pecah Dini, Partus Lama, dan Gawat Janin dengan Tindakan Persalinan Sectio Caesarea di Rumah Sakit TK. IV DR. Noesmir Baturaja Tahun 2020." Jurnal Ilmiah Universitas Batanghari Jambi 22, no. 1 (February 19, 2022): 78. http://dx.doi.org/10.33087/jiubj.v22i1.1735.
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Sectio Caesarea is an artificial birth, in which the fetus is born through an incision in the abdominal wall and uterine wall with the condition that the uterus is intact and the fetal weight is above 500 grams. According to WHO, national rate of cesarean delivery does not exceed 10% of all births. The mortality rate due to Sectio Caesarea delivery ranges from 40-80 people per 100,000 live births. This study aimed to determine the relationship between premature rupture of membranes (PROM), Prolonged labor, and fetal distress with Sectio Caesarea delivery at Level IV hospital of Dr. Noesmir Hospital, Baturaja in 2020. It was an analytic survey with cross sectional approach. The population in this study was all mothers giving birth at Level IV Hospital of Dr. Noesmir Hospital, Baturaja in 2020 with a total of 332 people. 77 samples were selected using Systematic Random sampling technique. The data were analyzed using Chi Square statistical test. The results showed that the factors associated with caesarean section delivery were premature rupture of membranes with a p-value = 0.028 (≤ 0,05), fetal distress with a p-value = 0.029 (≤ 0,05), whereas the factor that is not related to it was prolonged labor a p-value = 1.000 ( > 0.05). This study can be used as a reference to add insight and skills for readers and a reference to improve the quality of services in hospitals.
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Agrawal, Ajay, S. Chhetri, A. Thakur, S. Agrawal, and P. Basnet. "Outcome of Women with Previous Cesaerian Section At A Tertiary Care Hospital in Eastern Nepal." Health Renaissance 12, no. 1 (January 27, 2015): 18–23. http://dx.doi.org/10.3126/hren.v12i1.11980.
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Background: Pregnant women with previous caesarean section are increasing due to the liberal use of caesarean section in first pregnancy due to multifactorial reason. The risks, benefits, and relative safety of vaginal birth after caesarean (VBAC) have been subject of interest for well over 100 years. Thus mutual understanding between the treating obstetrician and patient herself is a core towards achieving good maternal and perinatal outcome considering all the risk and benefit in women with previous caesarean section. Objective: The aim was to analyze the maternal and perinatal outcome in pregnant women with previous caesarean section. Methods: In this prospective observational study, 300 women with singleton pregnancy in cephalic presentation with previous one lower segment caesarean section (LSCS) having inter pregnancy interval ≥ 18 months presenting at ≥ 37-41 week period of gestation admitted for delivery were enrolled and various maternal and perinatal outcome were noted. Results: Caesarean delivery rate during the study period was 26.95%. Eighty percent of eligible women opted for trial of labor. Successful vaginal birth after caesarean section was 29%. Elective repeat caesarean delivery was 19.66%. The rate of failed VBAC was 51%. Failed VBAC increased with increasing weight of baby. There was no difference in mean birth weight among patient who had successful VBAC, who refused VBAC and who had failed VBAC. Mode of delivery had no significant effect on the number of neonatal intensive care unit admission and number of still births. DOI: http://dx.doi.org/10.3126/hren.v12i1.11980Health Renaissance 2014;12(1):18-23
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Shorten, Allison, Donald E. Lewis, and Brett Shorten. "Trial of labour versus elective repeat caesarean section:A cost-effectiveness analysis." Australian Health Review 21, no. 1 (1998): 8. http://dx.doi.org/10.1071/ah980008.
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For subsequent births, women who have experienced previous caesarean section facea choice between elective caesarean section and trial of labour. The study reported inthis paper utilises Australian hospital data to compare birth outcomes and healthsystem costs of these two options. Although trial of labour is more expensive if the resultis an emergency caesarean section, high rates of successful vaginal delivery mean that,overall, trial of labour is found to be 30- per cent less expensive than elective caesareansection. It is estimated that trial of labour remains the most cost-effective option aslong as less than 68- per cent of women require emergency caesarean section. This studyhighlights the potential importance of more accurate information about a broaderrange of costs and outcomes in order for stronger conclusions to be drawn.
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Barros, Fernando C., Cesar G. Victora, Alicia Matijasevich, Iná S. Santos, Bernardo L. Horta, Mariângela F. Silveira, and Aluísio J. D. Barros. "Preterm births, low birth weight, and intrauterine growth restriction in three birth cohorts in Southern Brazil: 1982, 1993 and 2004." Cadernos de Saúde Pública 24, suppl 3 (2008): s390—s398. http://dx.doi.org/10.1590/s0102-311x2008001500004.
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Three birth cohort studies from 1982, 1993 and 2004, in Pelotas, Southern Brazil provided the data for this study of trends in preterm births, low birth weight, and intrauterine growth restriction. We found a slight increase in the period in the low birth weight prevalence from 9% to 10%. Intrauterine growth restriction decreased from 14.8% in 1982 to 9.4% in 1993, and subsequently increased to 12% in 2004, whereas preterm births increased markedly, from 6.3% in 1982 to 14.7% in 2004. This striking increment could not be explained by changes in maternal characteristics, as mothers in 2004 were heavier, smoked less during pregnancy and attended antenatal clinics more often and earlier than those of previous cohorts. However, pregnancy interruptions due either to caesarean sections or to inductions significantly increased. Caesareans increased from 28% in 1982 to 45% in 2004, and inductions were 2.5% in 1982 but 11.1% in 2004. The increase in preterms could be partially explained by the growing number of pregnancy interruptions, but there must be other causes since this increase was also observed among babies born by non-induced vaginal deliveries.
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Devabhaktuni, Pratibha, Padmaja Allani, and Maheen F. "Changing trends in uterine rupture audit, from the Institute of obstetrics and gynecology, modern government maternity hospital, Osmania medical college." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 9 (August 27, 2020): 3631. http://dx.doi.org/10.18203/2320-1770.ijrcog20203832.
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Background: Between January 2001 to September 2003, 46,171 deliveries were recorded, the number of caesarean deliveries during this period of two years and nine months were 16,182 (35.04%). Methods: An Audit from the Institute of obstetrics and gynecology, of uterine ruptures.Results: Total 81 cases of uterine rupture were managed at the Institute. Total number of scar ruptures managed were, 48/81 uterine ruptures. Five women had previous classical upper segment caesarean, and in previous lower segment caesarean section (LSCS), there were 43 cases of rupture uterus. In two cases following forceps delivery, traumatic uterine ruptures were recorded. Spontaneous ruptures were 31 during the study period. Bladder rupture occurred in 13 cases, 16.04% of uterine ruptures. The fetal outcome in uterine ruptures 81 cases, live births were 19-23.45%. The number of vaginal births after caesarean section were 261, 215, 186 in the years 2001, 2002 and 2003 at the Institute of obstetrics and gynecology. The number of scar ruptures were 7/261, 9/215, 2/186 in the respective years. Hysterectomy was done in 43/81=53.08%. Rent repair of the uterine rupture was done in 38/81.Conclusions: An Audit from the Institute of obstetrics and gynecology, of uterine ruptures has provided the following data that gives an insight into the practice of obstetrics during the decade 2000 to 2010 in the teaching Institute. Caesarean deliveries accounted for 35.04% of the total deliveries. Repeat caesarean sections were 7105, 43.9%. The number of vaginal births after caesarean section (VBAC) were 662. Scar ruptures in VBAC were 18 /662-2.71%. The maternal mortality in MGMH study was 3/81 uterine ruptures-3.7%. Scar ruptures constituted, 48/81-59.25% of uterine ruptures. Trial of labor after caesarean (TOLAC) and VBAC are practiced in the teaching Institute.
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Bobik, Yuriy Y., Valeriy V. Korsak, and Irina І. Packan. "OPTIMIZATION OF THE FREQUENCY AND STRUCTURE OF CESAREAN SECTIONS BASED ON ROBSON’S QUALIFICATION SYSTEM." Wiadomości Lekarskie 75, no. 10 (2022): 2486–90. http://dx.doi.org/10.36740/wlek202210132.
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The aim: Analyze the frequency and structure of indications for cesarean section in municipal non-profit enterprise “Uzhgorod city maternity hospital” of Uzhgorod city council to determine promising ways to optimize the tactics of childbirth. Materials and methods: A comparative clinical and statistical analysis of the frequency and indications for caesarean section for 2011-2015 (first group) and 2016-2020 (second group) years according to the Robson system classification was conducted. Results: The increase in caesarean section had no effect on overall perinatal mortality. The main reserve for reducing the incidence of cesarean section is the primi- and se¬cundipara women with full-term singleton pregnancy, the cephalic presentation of the fetus. Increasing the proportion of vaginal births in women with a scar on the uterus is possible through careful selection of patients for vaginal birth. The high frequency of cesarean section in groups of women with premature births, multiple pregnancies, pelvic preterm births or abnormal preterm births is justified by modern obstetric approaches and does not significantly affect the overall frequency of cesarean section due to the small number of these groups. Conclusions: The reserve for reducing the frequency of cesarean sections is the standardization of medical care in obstetrics and also in social and legal protection of an obstetrician and gynecologist.
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Kothiyal, Shivani, Anjoo Agarwal, Vinita Das, Amita Pandey, and Smriti Agarwal. "High rate of caesarean section in cases of intrauterine fetal demise in a low resource setting: Why?" International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 9 (August 27, 2018): 3748. http://dx.doi.org/10.18203/2320-1770.ijrcog20183788.
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Background: Stillbirth as an obstetric complication is emotionally devastating for the women as well as the clinician and having a caesarean section for stillbirth is even more catastrophic. The aim of the present research was to study the indications of caesarean section in women with intrauterine fetal demise in a low resource setting.Methods: This was an observational study for assessing the indication of caesarean section among 222/ 550 stillbirths from June 2013 to May 2014 in a tertiary care teaching hospital of North India. 7024 births occurred in the institution over a period of 1 year out of which 550 were stillbirths. Stillbirths which weighed over 500 grams were included in the study. Details of women with intrauterine fetal demise in which caesarian section was done were noted and analyzed.Results: Out of 550 stillbirths, 222 women underwent caesarean section. Rate of caesarean section among women with stillbirth was 40.36%. Placenta previa (23.87%), Rupture uterus (22.1%), obstructed labour (10.8%), transverse lie (9.45%), failed induction (7.20%), massive abruption (5.86%), non-progress of labour (5.40%), eclampsia/pre-eclampsia related causes (4.95%), acute fetal distress (4.95%), were leading indications of caesarean sections. Out of 222 women, 162 (73%) women had anaemia (Hb <11g%). Severe anaemia (haemoglobin less then 7gm/dl) was present in 51 cases (23%).Conclusions: Caesarean section done for intrauterine death in present study were mostly inevitable. Reducing intrapartum stillbirths by improving essential obstetric services will ultimately result in reducing caesarean section rates in stillbirths in developing countries. Further studies are needed both in developing and developed countries to strategize the management of intrauterine dead fetus to prevent such high rate of caesarean section.
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Bibi, Safia, Khanda Gul, Fozia Mohammad Bukhsh, and Palwasha Gul. "Assessment Of Perinatal Outcome Of Breech Presentation At A Tertiary Care Hospital, Quetta." Journal of Bahria University Medical and Dental College 09, no. 03 (September 4, 2019): 218–21. http://dx.doi.org/10.51985/jbumdc2018098.
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Objective: To review the mode of delivery and perinatal outcome in breech presentation in a tertiary care hospital. Study Design and Setting: Retrospective Analytical Study. Department of Obstetrics and Gynecology Unit-4, Bolan Medical Complex Hospital, Quetta, from 1st January 2012 to 31st December, 2016. Methodology: This retrospective analytical study included review of clinical records of all patients who delivered either vaginally or via caesarean section with breech presentation. Results: During the study period, 806 patients presented with breech (2.4%). Vaginal breech delivery was carried out in 71.8% patients and caesarean section was done in 28.2% patients. In vaginal breech group 30.7% patients were primigravida and 69.3% patients were multigravida. In caesarean section group 50.3% patients were primigravida and 49.7% were multigravida. Most common birth weight was between 2.5-3.5 kg in both group. Most common indication for cesarean section was breech with previous one LSCS. Conclusion: Like all vaginal births, vaginal breech delivery is not only beneficial in the chance of having a vaginal birth in future but also prevents from the complications of caesarean delivery.
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Zimmo, Mohammed Walid, Katariina Laine, Sahar Hassan, Bettina Bottcher, Erik Fosse, Hadil Ali-Masri, Kaled Zimmo, Ragnhild Sørum Falk, Marit Lieng, and Åse Vikanes. "Caesarean section in Palestine using the Robson Ten Group Classification System: a population-based birth cohort study." BMJ Open 8, no. 10 (October 2018): e022875. http://dx.doi.org/10.1136/bmjopen-2018-022875.
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ObjectiveTo analyse the current situation of caesarean section in Palestine using the Robson Ten Group Classification System (TGCS).DesignA population-based birth cohort study.SettingObstetrical departments in three governmental hospitals in Gaza.ParticipantsAll women (18 908) who gave birth between 1 January 2016 and 30 April 2017.MethodsThe contributions of each group to the study population and to the overall rate of caesarean section were calculated, as well as the rate of caesarean section in each TGCS group. Differences in proportions between study hospitals were assessed by χ2test.Main outcome measuresThe main outcome was the contributions of each group to the overall caesarean section rate.ResultsThe overall rate of caesarean section was 22.9% (4337 of 18 908), ranging from 20.6% in hospital 1 to 24.6% in hospital 3. The largest contributors to the overall caesarean section rate were multiparous women with single cephalic full-term pregnancy who had undergone at least one caesarean section (group 5, 42.6%), women with multiple pregnancies (group 8, 11.6%) and those with single cephalic preterm labour (group 10, 8.1%). Statistically significant differences in caesarean section rates between the study hospitals were observed in group 1 (nulliparous women with single cephalic full-term pregnancy and spontaneous labour), group 4 (multiparous with single cephalic full-term pregnancy with induced labour or prelabour caesarean section), group 5 (multiparous with single cephalic full-term pregnancy with previous caesarean section) and in group 7 (multiparous with breech presentation).ConclusionWomen in groups 5, 8 and 10 were the largest contributors to the overall caesarean section rate in the study hospitals. Efforts to reduce the differences in obstetrical care between hospitals need to be directed towards increasing the proportion of vaginal births after caesarean section and by reducing primary caesarean section in multiple pregnancies and preterm labour.
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Bin Amer, Dr Waseela, A. sahilat Biwaeamar, and A. Kawther Ebrahimi. "The Psychosocial Trends Of Neonatal Mothers Towards The Treatment Of Doctors And Midwives In The Hospital Field Study On A Sample Of Newborn Mothers In Biskra Cit." ALUSTATH JOURNAL FOR HUMAN AND SOCIAL SCIENCES 227, no. 3 (December 5, 2018): 441–64. http://dx.doi.org/10.36473/ujhss.v227i3.791.
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This study aimed to detect the psychosocial trends of the newly born mothers towards the treatment of the doctors and the midwives in the hospital institution in Biskra and to detect any statistically significant differences in this according to the variables (type of birth: normal / caesarean, number of births, number of days spent in hospital, state of the newborn: alive / dead, educational level, job). In order to achieve the objectives of the study, we used the descriptive method in its comparative method, and the measure was built on the five-year Likert method to measure the psychosocial trends of the newly born mothers (19 mothers).
- The newly born mothers have a negative psychosocial attitudes towards the treatment of midwives, and a positive treatment of the doctors in the hospital.
- There are no statistically significant differences in the psychosocial trends of the newly born mothers towards the treatment of the midwives in the hospital institution due to the variable (type of birth: normal / caesarean). Where there are statistically significant differences in the treatment of the doctors due to the variable of birth type and Caesarean section.
- There are no statistically significant differences in the psychosocial trends of newly born mothers towards the treatment of the midwives and the doctors due to the variable (number of births, number of days spent in hospital, state of the newborn: alive / dead, educational level, job
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Bignall, John. "Why are caesarean births in the UK increasing?" Lancet 344, no. 8938 (December 1994): 1694. http://dx.doi.org/10.1016/s0140-6736(94)90469-3.
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Stone, C., J. Halliday, J. Lumley, and S. Brennecke. "Vaginal births after Caesarean (VBAC): a population study." Paediatric and Perinatal Epidemiology 14, no. 4 (October 2000): 340–48. http://dx.doi.org/10.1046/j.1365-3016.2000.00299.x.
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Gundersen, Tina Djernis, Lone Krebs, Ellen Christine Leth Loekkegaard, Steen Christian Rasmussen, Julie Glavind, and Tine Dalsgaard Clausen. "Postpartum urinary tract infection by mode of delivery: a Danish nationwide cohort study." BMJ Open 8, no. 3 (March 2018): e018479. http://dx.doi.org/10.1136/bmjopen-2017-018479.
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ObjectivesTo examine the association between postpartum urinary tract infection and intended mode of delivery as well as actual mode of delivery.DesignRetrospective cohort study.Setting and participantsAll live births in Denmark between 2004 and 2010 (n=450 856). Births were classified by intended caesarean delivery (n=45 053) or intended vaginal delivery (n=405 803), and by actual mode of delivery: spontaneous vaginal delivery, operative vaginal delivery, emergency or planned caesarean delivery in labour or prelabour.Primary and secondary outcome measuresThe primary outcome measure was postpartum urinary tract infection (n=16 295) within 30 days post partum, defined as either a diagnosis of urinary tract infection in the National Patient Registry or redemption of urinary tract infection-specific antibiotics recorded in the Register of Medicinal Product Statistics.ResultsWe found that 4.6% of women with intended caesarean delivery and 3.5% of women with intended vaginal delivery were treated for postpartum urinary tract infection.Women with intended caesarean delivery had a significantly increased risk of postpartum urinary tract infection compared with women with intended vaginal delivery (OR 1.33, 95% CI 1.27 to 1.40), after adjustment for age at delivery, smoking, body mass index, educational level, gestational diabetes mellitus, infection during pregnancy, birth weight, preterm delivery, preterm prelabour rupture of membranes, pre-eclampsia, parity and previous caesarean delivery (adjusted OR 1.24, 95% CI 1.17 to 1.46).Using actual mode of delivery as exposure, all types of operative delivery had an equally increased risk of postpartum urinary tract infection compared with spontaneous vaginal delivery.ConclusionsCompared with intended vaginal delivery, intended caesarean delivery was significantly associated with a higher risk of postpartum urinary tract infection. Future studies should focus on reducing routine catheterisation prior to operative vaginal delivery as well as improving procedures related to catheterisation.
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D.P., Pană, Georgescu Carmen, Mitran M., and Mitran Loredana. "Postpartum Hemorrhage after Cesarean Delivery - Causes and Management Statistics of „Prof. Dr. Panait Sîrbu „ Hospital- Bucharest." ARS Medica Tomitana 20, no. 1 (February 1, 2014): 30–34. http://dx.doi.org/10.2478/arsm-2014-0006.
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ABSTRACT Postpartum hemorrhages represent a major cause of maternal mortality everywhere in the world and in Romania obstetrical hemorrhages are directly incriminated in 47.85% from the cases reported between 1975 -2010. This retrospective study over a period of five years (2008 - 2012) includes the clinical-statistical analysis of postpartum hemorrhages (PPH) registered in “Prof. Dr. Panait Sîrbu” Clinical Hospital of Obstetrics and Gynecology in Bucharest. During the period under analysis there were 20204 births, out of which 13012 were vaginal and 7192 by caesarean section. There were 853 cases of postpartum hemorrhage with significant clinical manifestations, which required medical management, 4.22% of all births. In 459 cases there were reported hemorrhagic complications after caesarean section (6.368% of caesarean sections), representing 53.81% of postpartum hemorrhage. The severity of intra-operative and post-cesarean bleeding is due to its association to anesthetic risk, which is more important in cesarean, as well as to the associated pathology that indicated the caesarean section in the first place
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Hui, Lisa, Melvin B. Marzan, Stephanie Potenza, Daniel L. Rolnik, Joanne M. Said, Kirsten R. Palmer, Clare L. Whitehead, et al. "Collaborative maternity and newborn dashboard (CoMaND) for the COVID-19 pandemic: a protocol for timely, adaptive monitoring of perinatal outcomes in Melbourne, Australia." BMJ Open 11, no. 11 (November 2021): e055902. http://dx.doi.org/10.1136/bmjopen-2021-055902.
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BackgroundThe COVID-19 pandemic has resulted in a range of unprecedented disruptions to maternity care with documented impacts on perinatal outcomes such as stillbirth and preterm birth. Metropolitan Melbourne has endured one of the longest and most stringent lockdowns in globally. This paper presents the protocol for a multicentre study to monitor perinatal outcomes in Melbourne, Australia, during the COVID-19 pandemic.MethodsMulticentre observational study analysing monthly deidentified maternal and newborn outcomes from births >20 weeks at all 12 public maternity services in Melbourne. Data will be merged centrally to analyse outcomes and create run charts according to established methods for detecting non-random ‘signals’ in healthcare. Perinatal outcomes will include weekly rates of total births, stillbirths, preterm births, neonatal intensive care admissions, low Apgar scores and fetal growth restriction. Maternal outcomes will include weekly rates of: induced labour, caesarean section, births before arrival to hospital, postpartum haemorrhage, length of stay, general anaesthesia for caesarean birth, influenza and COVID-19 vaccination status, and gestation at first antenatal visit. A prepandemic median for all outcomes will be calculated for the period of January 2018 to March 2020. A significant shift is defined as ≥6 consecutive weeks, all above or below the prepandemic median. Additional statistical analyses such as regression, time series and survival analyses will be performed for an in-depth examination of maternal and perinatal outcomes of interests.Ethics and disseminationEthics approval for the collaborative maternity and newborn dashboard project has been obtained from the Austin Health (HREC/64722/Austin-2020) and Mercy Health (ref. 2020-031).Trial registration numberACTRN12620000878976; Pre-results.
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Hoque, Humaira, Chowdhury Shamima Sultana, Hoshneara Laizu, Md Wareshuzzaman, and Farhat Hossain. "Outcome of Planned Vaginal Birth at Term after One Previous Caesarean Section." Ibrahim Cardiac Medical Journal 11, no. 1 (March 14, 2022): 54–61. http://dx.doi.org/10.3329/icmj.v11i1.58707.
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Background & objective: Pregnant women with a previous caesarian section may be offered either vaginal birth or elective repeat caesarian section (ERCS). Detailed antenatal counseling and methodical intrapartum management of women are the key factors for success of planned vaginal birth after caesarean (VBAC). The present study was undertaken to determine the incidence of successful vaginal birth and the maternal and perinatal complications in patients undergoing planned vaginal birth after one previous caesarean section.
Methods: This prospective observational study was carried out in the Department of Obstetrics and Gynaecology, Sir Salimullah Medical College & Mitford Hospital (SSMC & MH), Dhaka over a period of one year between January to December 2016. A total of 96 term pregnant women, aged 20 – 35 years, having previous experience of one lower uterine caesarean section with spontaneous onset of labour, vertex presentation of the fetus and adequate pelvis were consecutively included in the study. The main primary outcome variable was fate of trial VBAC (successful vaginal delivery either spontaneous or assisted or ERCS). The secondary outcome variables were maternal and perinatal complications (morbidity and mortality).
Result: Over 55% of the women under trial VBAC were 25 – 30 years old with mean age of the women being 26.8 ± 3.7 years. Nearly three-fifths (58.3%) of the women were of normal BMI, 40.6% were overweight. None of the women was obese. Only 15% women had gestational age 40 weeks. The mean interval between the current and the previous births was almost 3 years. In terms of primary outcome, over 60% of the planed VBAC were successfully delivered (52.2% spontaneously and 9.3% with the aid of forceps and vacuum extraction). While maternal complications were uterine rupture (6.2%), hysterectomy (6.2%) and haemorrhage needing transfusion (14.6%), neonatal complications were respiratory distress syndrome (17.7%), perinatal death (10.4%), hypoxic ischemic encephalopathy (4.2%) and sepsis (8.3%).
Conclusion: The study concluded that planned VBAC is appropriate for majority of women with a singleton pregnancy of cephalic presentation who have had a single previous lower segment caesarean section (LSCS). However, as the maternal complications (like hysterectomy, haemorrhage etc.) and the perinatal complications including death were much high, utmost caution is advised in selecting the right candidate for VBAC so that the incidence of successful VB could be maximized and complications minimized.
Ibrahim Card Med J 2021; 11 (1): 54-61
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Mendis, Ramali, Christopher Flatley, and Sailesh Kumar. "Maternal demographic factors associated with emergency caesarean section for non-reassuring foetal status." Journal of Perinatal Medicine 46, no. 6 (August 28, 2018): 641–47. http://dx.doi.org/10.1515/jpm-2017-0142.
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Abstract Objectives: This study aimed to determine maternal and obstetric factors associated with emergency caesarean section (CS) for non-reassuring foetal status (NRFS). Materials and methods: This was a retrospective analysis of term singleton births between January 2007 and December 2015 at the Mater Mother’s Hospital in Brisbane. The study group comprised all cases of emergency CS for NRFS, and the control cohort comprised all other births meeting the inclusion criteria but excluding those in the study cohort. Results: Over the study period, there were 74,177 births fulfilling the inclusion criteria. The overall rate of emergency CS for NRFS was 4.2% (3132/74,177). Multivariate analysis showed that being overweight and obese, Indian and “other” ethnicity, artificial reproductive techniques, smoking, induction of labour and gestation at 39–42 weeks were associated with an increased risk, whereas being underweight, female sex, hypertension and birth without labour conferred a lower risk. Conclusion: Many maternal and obstetric factors were associated with emergency CS for NRFS and influenced adverse perinatal outcomes. Recognition of these risk factors could help risk stratify women prior to labour.
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Pek, Eren, and Fatma Beyazit. "Characteristics of deliveries at a tertiary care hospital in Turkey: results from a retrospective analysis (2012-2016)." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 5 (April 28, 2018): 1687. http://dx.doi.org/10.18203/2320-1770.ijrcog20181896.
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Background: Although the choice of a particular method of birth delivery by the pregnant woman is a modern, complex and controversial subject all over the world, the rate of caesarean delivery has risen to nearly 50% in western countries. Apart from medical reasons, several non-medical factors are also involved in this choice, and they comprise the socioeconomic conditions, ethical/legal concerns and psychological and cultural characteristics of the patients and doctors. In this study, we aimed to evaluate the demographic and clinical characteristics of pregnant women who gave birth in a tertiary care hospital between October 2012 and June 2016.Methods: The patients’ charts of pregnant women who presented to the Canakkale Onsekiz Mart University hospital between October 2012 and June 2016 and who gave birth through either vaginal or caesarean delivery were retrospectively analysed. The patients’ age, delivery type, weeks of pregnancy at delivery, number of pregnancies and caesarean indications were recorded.Results: In this study, we retrospectively analysed 2012 pregnant women. The mean age of the pregnant women was 28.9 ±5.4 years. The mean gravida and parity of pregnant women were 1.9±1.0 and 1.5±0.7, respectively. Regardless of the delivery type, the mean pregnancy weeks were found to be 38.6±1.9 weeks. The mean pregnancy weeks of patients undergoing caesarean delivery were 38.4±1.8 weeks. The primary caesarean rates were 52.81%. The most common caesarean delivery indications were foetal distress, cephalopelvic disproportion and presentation anomalies.Conclusions: The steady increase in caesarean delivery rates has become a major cause of concern worldwide. The reasons for this phenomenon are mostly related to advanced age; foetal distress, especially one that is detected in continuous foetal monitoring; intrauterine growth retardation; presentation anomalies and multiple gestation. To avoid unnecessary caesarean births, mothers, especially nulliparous mothers, should be persuaded to undergo vaginal delivery.
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Souza, Cecilia De Mello E. "C-sections as Ideal Births: The Cultural Constructions of Beneficence and Patients' Rights in Brazil." Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 358–66. http://dx.doi.org/10.1017/s096318010000517x.
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The culture of giving birth in Brazil has changed drastically since 1970. The caesarean section, once known as a life-saving medical procedure to be used under extraordinary circumstances, is now perceived by the medical profession and their female patients as a safe, painless, modern, and ideal form of birth for any pregnant woman. Brazil has the world's highest percentage of caesarean deliveries. The widespread use of C-sections has become a cultural phenomenon whose boundaries extend far beyond the medical arena. Medical practitioners have appropriated cultural values regarding the female body and sexuality, rein-forced a blind fascination with technology, and medicalized women's fear of labor to justify their preference for surgical births. By narrowing ethical concerns to the doctor-patient relationship and drawing on the notion of the patient's best Interest, physicians defend their practice as appropriate and even desirable.