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MUSSARAT, NAZIA, SAIMA QURASHI, and MAHNAZ ROOHI. "LOWER SEGMENT CESAREAN SECTION (LSCS);." Professional Medical Journal 20, no. 06 (2013): 916–23. http://dx.doi.org/10.29309/tpmj/2013.20.06.1737.
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Introduction: Caesarean section is one of the commonly performed surgical procedures in obstetric and is certainly one ofthe oldest operations in surgery. Recently there has been a dramatic rise in the caesarean section rate world wide especially in thedeveloped countries. As primary caesarean deliveries contributed most to the overall caesarean section rate (CSR). So this is clear thatprimary caesarean section is an important target for reduction because it leads to an increased risk for repeat caesarean delivery.Objectives: To have an overview of fetomaternal indications for LSCS at a teaching hospital And to review intra-operative and postoperativecomplications of LSCS at tertiary care centre. Material And Methods: All caesarean sections performed at Obstetrics andGynecology Unit Independent University Hospital Faisalabad from January 2009 to December 2010 were reviewed. Information wasobtained from operation theater and labor ward records. Results: During the study period 100 patients undergone caesarean section. Outof 100 patients, 58(58%) had emergency and 42(42%) had elective caesarean section. The leading maternal indications were previouscaesarean section 34 (34%), severe pre- eclampsia 6(6%),post date& failed induction of labor6 (6%), placenta previa 6(6%), and failureof progression of labor 5(5%), PROM3(3%), Pre-PROM3(3%)and cephalopelvic disproportion2 (2%).Major fetal indications include fetaldistress9 (9%), malpresentation 6(6%), cord prolapse 3(3%),IUGR 5(5%) and pregnancy complicated by multiple fetuses 7 (7%). Intraoperativesurgical and anesthetic complications were observed in very few patients. Nine babies had perinatal deaths in this study, 8belonged to emergency and only one baby died in elective group due to aspiration pneumonia. Conclusions: Majority of cesarean sectionare done in emergency situations and previous CS is the most frequent indication of cesarean section. The most effective mean to controlCS is the prevention of first caesarean section which could be achieved by adopting the policy of trial of vaginal birth after previous Csection,selective vaginal breech delivery and regular audit of C-section as well as early detection of at risk cases and proper referral intime is the key factor in decreasing the cesarean section rate and complications.
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Chavda, Dolly, Kamal Goswam, and Kavita Dudhrejiya. "A cross sectional study of 1000 lower segment cesarean section in obstetrics and gynecology department of P. D. U Medical College, Rajkot, Gujarat, India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 4 (2017): 1186. http://dx.doi.org/10.18203/2320-1770.ijrcog20170916.
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Background: Though WHO recommends a rate of 10-15% caesarean section for a given hospital, there has been a rising trend worldwide. We estimated the recent incidence of caesarean section in Obstetrics and Gynecology Department, P.D.U. Medical College, Rajkot (Gujarat and correlated these rates with the socioeconomic, demographic, and health variables.Methods: We have studied 1000 cases of lower segment caesarean section (cross sectional study) at Obstetrics and Gynecology Department, P.D.U Medical College, Rajkot (Gujarat) to find out rate of caesarean section, common maternal and fetal indication and complications of lower segment caesarean section.Results: Caesarean section rate of the present study is 19.9%. Most common indication of LSCS was scarred uterus 39.9%.followed by fetal distress 19.1%, malpresentation 18.6%, and failed induction 7.3%. Maternal morbidities and mortalities in emergency LSCS in compare to elective LSCS. Analysis based on Robson’s ten-group showed that group 5 (Previous CS, single cephalic,>37 weeks) made the greatest contribution to total CS rate.Conclusions: Scientific advances, social and cultural changes, and medico legal considerations seem to be the main reasons for the increased acceptability of caesarean sections. The decision to perform a C-section delivery must be chosen carefully and should not be profit oriented. There is a possibility of keeping the rate to minimum by reducing number of primary caesarean sections, by proper counseling of the patients, proper monitoring and patience.
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Agrawal, Grishma P. "Primary lower segment caesarean section in multipara: materno-fetal outcomes." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 1 (2018): 279. http://dx.doi.org/10.18203/2320-1770.ijrcog20185439.
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Background: All-natural birth has a purpose and a plan; who would think of tearing open the chrysalis as the butterfly is emerging? Who would break the shell to pull the chick out?” ~ Marie Mongon. It is of particular interest, in light of increased incidence of abdominal delivery throughout the country and in the world, to judge the validity of this procedure when used for the first time in the multipara.Methods: All the cases of Primary caesarean delivery in multipara over a period of 18 months were studied with regards to the indication, associated risks factors, and perinatal morbidity and mortality. The primary objective of the study was to find out the status of primary Lower Segment Caesarean Section (LSCS) in multipara in tertiary care center.Results: The overall incidence of LSCS was 30.7%. The incidence of Primary LSCS in multipara was 23.4%. The most common indication of LSCS was Foetal Distress i.e. 40.8%. Almost all caesarean sections were done in Emergency (99.2%). 12.3% of patients underwent PPH intra-operatively with 0.7% patient requiring Obstetric hysterectomy. Majority of the neonates were admitted in NICU for Respiratory Distress (30%). Major cause of Post-operative morbidity was wound gape seen in 10.8% patients.Conclusions: The fact that a multipara has had one or more vaginal deliveries should be regarded as an optimistic historical fact, not as diagnostic criteria for spontaneous delivery of the pregnancy at hand. Hence a multiparous woman in labour requires the same attention as that of primigravida and may still require a caesarean section for safe delivery. Good antenatal and intrapartum care and early referral will help reduce the maternal and perinatal morbidity.
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Sailakshmi, M. P. A., and Vidhyadhare G. S. "Retrospective study of maternal and neonatal outcome in second stage lower segment caesarean section in a tertiary hospital." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 12 (2020): 4924. http://dx.doi.org/10.18203/2320-1770.ijrcog20205222.
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Background: Caesarean section at second stage are increasing and are associated with significant maternal morbidity. The overall caesarean section rates are also increasing from last two decades.Methods: A retrospective study conducted in Department of Obstetrics and Gynaecology, Raja Rajeswari Medical College and Hospital, Bangalore from January 2018 to July 2019. Second stage LSCS were analysed in terms of indications, intraoperative and post-operative complications, neonatal morbidity.Results: In our hospital during study period there were 2639 deliveries and total number of LSCS 1146 (43.42%) and caesarean section rate was 35-45% and second stage LSCS 60 (5.23%).Conclusions: Second stage LSCS associated with more number of maternal and neonatal morbidity. Adequate clinical exposure and appropriate training are essential for safe performance in second stage LSCS.
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Chaurasia, Vaishali, and Sushruta Shrivastava. "Record based analysis of indications and complications of 500 cases of lower segment cesarean sections at a tertiary care hospital." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 2 (2019): 393. http://dx.doi.org/10.18203/2320-1770.ijrcog20190003.
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Background: The drastically increasing rate of caesarean section is a topic of constant worry and analysis throughout the world. In order to understand the degree to which caesarean section may be preventable, it is important to know why caesarean section are performed. This study is aimed to find out the rate of caesarean section at our institute, various indications of the procedure and complications related to them.Methods: This study was carried out retrospectively in the department of obstetrics and gynecology at Chirayu Medical College and Hospital, Bhopal. Study period was from January 2017 to December 2017. 500 cases of lower segment cesarean section were studied including both elective and emergency caesarean sections. Statistical analysis of age, parity, period of gestation, indications of LSCS and complications was done.Results: The rate of caesarean section came out to be 47.7%, which is far above recommended. Majority of patients (81.6%) were in 21-30 years age group; while the number of primary and repeat caesarean section were comparable (40.8% and 59.2%respectively). Commonest indication was previous LSCS (31.6%) followed by fetal distress (21.6%). Surgical site infection was present in 4.6% cases whereas, post-partum hemorrhage occurred in 5.8% cases. Three patients underwent obstetric hysterectomy and two cases of maternal mortality were reported among post LSCS patients.Conclusions: Increasing rates of caesarean section has contributed to maternal morbidity along with financial burden. Individualization of the indication and careful evaluation, following standardized guidelines, practice of evidenced-based obstetrics and audits in the institution, can help us limit rate of caesarean section.
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Dodampahala, S. H., Lal Chandrasena, and Vasitha Abeysuriya. "Incisional herniae following lower segment caesarean section: A 20-year chart review." Sri Lanka Journal of Obstetrics and Gynaecology 45, no. 2 (2023): 80–83. http://dx.doi.org/10.4038/sljog.v45i2.8078.
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Introduction: The rates of caesarean delivery is increasing worldwide as well as in Sri Lanka. Incisional hernia is a known complication of abdominal surgery. To our knowledge there has been no study to assess the incidence of incisional hernia following caesarean section in Sri Lanka. This study was to assess the incidence of incisional hernia requiring surgical repair after lower segment caesarean section (LSCS) in a cohort during a 20-year period.Methods: This was a chart review based on tertiary care private sector hospital in Sri Lanka. Hernia repairs performed during 2002 to 2022 were identified. The data was retrieved from computer based data base and previous bed head tickets. The main inclusion criterion was a caesarean delivery from the 01st of January 2002 to 31st of December 2022 in women with no history of previous abdominal surgery. The cohort was assessed from their first caesarean delivery until 20 years in the inclusion period for an event of hernia repair. The following exclusion criteria for the hernia repairs were used: Diastasis rectiwithout hernia, hernia not in the caesarean incision, and no hernia. The study was approved by the Research and Ethical Committee of Nawaloka Hospital Sri Lanka. The patient records and the data-set were anonymized before analysis. No conflict of interest.Results: There were 2675 records retrieved. The mean age of the patients was 28±7.5 years. There were 10/2675 (0.37%) patients were found to incisional herniae following LSCS. The majority (7/10) of patients with incisional hernia had lower midline incisions for their LSCS. The average time duration of the occurrence of incisional hernia following a single LSCS was 19.5±2.3 months and it was 14.3±1.6 and 12.3±1.5 months for following second and third LSCS respectively. Majority of the incisional herniae were done as routine cases. Following the incisional hernia repair one patient had a recurrence after year.Conclusion: The overall incidence of having an incisional hernia requiring repair of a caesarean delivery was 0.37%. Most herniae appeared within the first two years and associated with the lower midline incisions.
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Anita Sharma, Himanshi Gangwal, Madhu Bhat, Nilesh Yadav, and Ekta Meena. "Vaginal delivery after previous one lower segment caesarean section at a tertiary care hospital." International Journal of Science and Research Archive 6, no. 2 (2022): 104–9. http://dx.doi.org/10.30574/ijsra.2022.6.2.0139.
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Aims & Objectives: To find out the predictors of spontaneous term vaginal birth after a previous one lower segment caesarean delivery. Materials & Methods: A prospective study was conducted in the Department of Obstetrics & Gynecology, SMS Medical College, and Jaipur from March 2015 to October 2016. 120 pregnant women with a history of one previous Lower segment caesarean section (LSCS) were enrolled in the study. Results: In our study, 60% cases had a successful Vaginal birth after caesarean section (VBAC) and 40% underwent a repeat emergency LSCS for failed trial of labour after caesarean section. Anterior position of cervix, cervical dilatation ≥ 3cm, effacement ≥ 60-70%, vertex position at or below the ischial spine at the time of admission in labour room were significant factor in favoring a successful VBAC. The incidence of scar dehiscence was 5.83%. There was no maternal or neonatal mortality. Conclusion: Trial of labour after caesarean section (TOLAC) can be given in selected cases with good monitoring of Fetal heart sound (FHS) and progress of labour under supervision of trained staff at a tertiary care hospital.
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Gurunule, Amit A., and Himangi S. Warke. "Maternal and foetal outcome in elective versus emergency caesarean sections." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 4 (2017): 1222. http://dx.doi.org/10.18203/2320-1770.ijrcog20170927.
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Background: Caesarean delivery is defined as the birth of the foetus through an incision in the abdominal wall (i.e. laparotomy) and the uterine wall (hysterotomy). The purpose was to analyze the maternal and foetal outcome in elective versus emergency caesarean sections retrospectively in a tertiary care centre and to analyze the indications of elective versus emergency caesarean sections.Methods: A retrospective observational study of the cases undergoing caesarean sections in KEM hospital, Mumbai, India was carried out during the period of September 2013 to September 2015. Maternal and foetal outcome was studied. The data was collected and analyzed from the maternal medical records. The neonatology records were also examined.Results: Out of the 600 selected patients, 300 patients in each group of elective and emergency caesarean section were studied. The usual indications of emergency caesarean sections were foetal distress, followed by meconium stained amniotic fluid (MSAF) and cephalopelvic disproportion (CPD). The most frequent indicator for elective lower segment caesarean section (LSCS) was patient with previous LSCS not willing for vaginal birth, followed by breech presentation and previous multiple LSCS. There was a significant difference seen in the occurrence of fever, urinary tract infections and wound infections in the two groups. These were more common in the emergency caesarean section group. Significant difference was also seen in the incidence of postpartum haemorrhage in the two groups, which was more in the elective caesarean section group.Conclusions: The maternal morbidity, intra operative and postoperative complications were more in the emergency LSCS group as compared to patients who underwent elective LSCS.
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Sinha, Madhulika, and Taruna Dua. "Assessing caesarean section trends in tertiary care using Robson’s ten group classification." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 11, no. 6 (2022): 1703. http://dx.doi.org/10.18203/2320-1770.ijrcog20221443.
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Background: This study determined which clinical situations contributed to and led to caesarean delivery in tertiary care hospitals, using Robson’s classification approach, and to audit the rising prevalence of caesarean sections.Methods: This retrospective data collection study was conducted for 2 years at a tertiary care hospital. Mothers who gave birth between October 2017 and 2019 were included in the study. Using Robson’s method they were categorized into ten groups. In each of the ten categories, the caesarean delivery rates were calculated and analysed. The contribution of each category to the overall caesarean section rate and percentage was computed.Results: In our hospital, 384 of the 550 women who gave birth during the study period underwent a lower segment caesarean section (LSCS), with an overall C section rate of 69.8%. Group 5 (multiparous with prev 1 or more LSCS) contributed to the highest C-sections followed by group 2 (Primi who were induced or whose caesarean section was done without labour). Although groups 6, 7, 8, and 9 did not contribute significantly to overall C-sections, C section rates in this group of patients are approaching 100%. The primis who came in spontaneous labour had the least LSCS rate (29.47%).Conclusions: Women who have had a previous caesarean delivery and primigravidas who were induced or had LSCS without labour account for a growing percentage of caesarean deliveries. Public policies and awareness should be aimed at minimising LSCS, especially by lowering the number of elective CS in these women and supporting vaginal delivery.
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Bano, Arjumand, and Aithagoni Srikavya. "The Study of Intra-Operative Difficulties in One Repeat Caesarean Section Compared with Two or More Caesarean Sections." Journal of Evolution of Medical and Dental Sciences 10, no. 33 (2021): 2745–48. http://dx.doi.org/10.14260/jemds/2021/560.
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BACKGROUND Most commonly done obstetric procedure globally is caesarean section. The incidence of C-section is continuously increasing because risk associated with vaginal delivery after caesarean, previous caesarean section is an important indication for Csection. The purpose of this study was to assess the difficulties during intra-operative period in women who undergo caesarean section repeatedly and also to study the comparison between difficulties with women with previous one caesarean section and women with previous 2 or more C-sections. METHODS It is a prospective observational study conducted on 150 women in the Department of Obstetrics & Gynaecology in Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar in women with history of previous caesarean sections (one or more). The women were divided into two groups - Group 1 - Those with previous one caesarean section and Group 2 - Those with previous two or more caesarean sections. RESULTS Out of 150 cases randomly selected and studied who had repeated caesarean section,90 had 1 previous lower segment caesarean section (LSCS), 60 had two or more caesarean sections, the highest number of caesarean sections were performed on women between the age group of 20 - 29 years. Out of these, some cases did not show intra-operative complications, some showed variety of intra-operative complications. Most common type of complications that they came across were adhesions (44 %) in 1 previous LSCS, 65 % in 2 or more LSCS. There were no cases of scar rupture, uterine rupture, bowel injury, caesarean hysterectomy in the study population, probable reason could be that cases were taken elective or taken with a short trial of labour with high level of intrapartum monitoring. CONCLUSIONS Higher incidence of intra-operative complication is seen in women with previous caesarean sections. KEY WORDS Repeat C - Section, Adhesions, Intra-operative Complications
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Kuldeep, Rathod, Tailor Shruti, Bhatia Saral, and Prajapati Nilam. "To Study Indications and Feto-Maternal Outcome of Elective LSCS." International Journal of Pharmaceutical and Clinical Research 15, no. 10 (2023): 1224–27. https://doi.org/10.5281/zenodo.11287533.
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<strong>Objective: </strong>To study indications and feto-maternal outcome of Elective LSCS. <strong>Methods:</strong> A prospective observational study was conducted in Department of Obstetrics and Gynaecology enrolling 130 consenting subjects undergoing Elective Caesarean section over the period of 12 months. <strong>Results:</strong> In our study, majority of the subjects(77.69%) belonged to age group of 20-29 years. 46.84% of the study subjects underwent their elective Caesarean section after 38 weeks of gestation. In our study, 53.84% of subjects were primipara. Majority of the subjects(35.38%) underwent their elective Cesarean section for previous CS with negative consent for VBAC followed by 15.38% subjects for prev 2 lscs, 14.61% for cephalo-pelvic disproportion. 3% of subjects had developed maternal complications and 2.3% subjects had neonatal complications. <strong>Conclusion: </strong>As caesarean section being associated with maternal morbidity and neonatal outcome, decision for Elective Cesaerean section should be undertaken after considering all obstetric factors and medical conditions.
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Kaur, Hersimran, Sahil Garg, Madhav Choudhary, Ashita Rukmini, Neha Jha, and Pankaj Kumar. "Ondasetron and its effects on haemodynamics during LSCS under regional anaesthesia- A Randomized double blind controlled trial." Panacea Journal of Medical Sciences 14, no. 2 (2024): 350–55. http://dx.doi.org/10.18231/j.pjms.2024.062.
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Subarachnoid block (SAB) is also known as the method of choice of anaesthesia for lower segment caesarean section. The most common complications associated with it include hypotension and bradycardia. Ondansetron, now days is emerging as an effective alternative for the prevention of spinal induced hypotension in elective LSCS patients. Our aim was to analyse & study the effect of Ondansetron 6mg I.V. on hemodynamics in lower segment caesarean section (LSCS) under regional anaesthesia. Study was conducted on a total of 60 parturients divided into 2 groups (Group I & Group II) scheduled for elective lower segment cesarean sections under Subarachnoid block. Comparison of mean heart rate between the Group I and Group II was found to be statistically not significant (p&#62;0.05) at all the time intervals. The difference was found to be statistically significant (p=0.001), showing significantly higher intraoperative fluid requirement in Group II in comparison to Group I. We observed that ondansetron 6mg I.V. given as a premedication 15 minutes before the administration of SAB resulted in a lesser incidence of hypotension following SAB.
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Ganapathi, Trupthi, and Hemangi K. Chaudhari. "Ultrasonographic measurement of uterine lower segment scar thickness in cases of previous one caesarean section and obstetric outcome." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 11 (2018): 4454. http://dx.doi.org/10.18203/2320-1770.ijrcog20184488.
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Background: Vaginal birth after caesarean section (VBAC) has become an integral part of modern obstetrics with more than 1lakh VBACs achieved each year nationwide. Several studies have reported perinatal risks associated with failed trial of labour and uterine rupture in women attempting VBAC, due to concerns about these complications, the rate of VBAC deliveries has continued to fall in developed countries, with an inverse increase in Caesarean Sections (CS). To better assess the risk of uterine rupture, many authors have proposed sonographic measurement of scar or lower uterine segment (LUS) thickness near term, assuming that there is an inverse correlation between LUS thickness and the risk of uterine scar defect. Therefore, this assessment for the management of women with prior CS has increased safety by selecting women with the lowest risk of uterine rupture.Methods: Present study was a prospective observational study which assessed the obstetric outcome in women with previous lower segment caesarean section willing for trial of labour. Secondly, authors aimed to ascertain the best cut off values for predicting uterine rupture.Results: Present study found that as duration between previous LSCS and next pregnancy increased there was better chance of VBAC. As the baby weight increased VBAC rate reduced. Study also showed that scar thickness of 2.55mm and above measured by transabdominal method in the third trimester can be safely given trial of VBAC.Conclusions: Authors thus conclude that measurement of lower uterine segment/ scar thickness can help obstetrician decide whether VBAC is safe or not in patients with previous one LSCS willing for VBAC. Scar thickness of more than 2.55mm can be given safe trial of labour in women with previous one lower segment caesarean section.
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Dalal, Monika, Smiti Nanda, Jagjit S. Dalal, et al. "Maternal and neonatal outcome in pregnancy with previous lower segment caesarean section undergoing trial of scar." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 9 (2021): 3434. http://dx.doi.org/10.18203/2320-1770.ijrcog20213465.
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Background: Women with previous LSCS often have to make a decision about mode of delivery of their second baby. As the rate of caesarean section is continuously increasing, vaginal birth after caesarean section (VBAC) is a good strategy to decrease caesarean rate. The present study was planned to assess the fetomaternal outcome in pregnancies with previous lower segment caesarean section undergoing trial of scar and to identify the factors, which can influence the outcome of trial of scar.Methods: This was a prospective observational study on 100 patients at a tertiary care institute. Pregnant women with previous LSCS were selected randomly for the study on the basis of the inclusion and exclusion criteria. Each labor monitored closely using a partogram. Decision for repeat emergency caesarean was taken by consultant. All women included in the study were followed through delivery and till discharge.Results: Out of 100 pregnant women 49 % cases had successful VBAC, 50% had emergency caesarean and one patient had laparotomy for rupture uterus. In women, who also had a prior vaginal delivery, 72% delivered vaginally, as compared to 40% of the women who did not undergo prior vaginal delivery (p value=0.003). Women who were in spontaneous labor, 59.21% delivered vaginally, whereas women who were induced, 16.6% delivered vaginally. The rate of perinatal complication was more in the patients who required an emergency CS after a failed trial. Conclusions: Our findings may encourage obstetricians to encourage VBAC in the properly screened ANC patients and decrease the rate of recommending caesarean section.
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Sharma, Reena, and Poojan Dogra. "Indications and rate of caesarean delivery at tertiary care hospital: a retrospective study." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 10 (2017): 4367. http://dx.doi.org/10.18203/2320-1770.ijrcog20174406.
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Background: Worldwide there has been an increase in the rate of caesarean delivery due to multiple factors. Objective of the study was to assess the prevalence and different indications of caesarean section in this institute.Methods: The aim of the study is to analyse the rates and indications of lower segment caesarean section (LSCS) in our institution. We conducted a retrospective study over a period of six months; 1st September 2016 to 1st March 2017 at SLBSGMC Mandi at Nerchowk. Total number of patients who delivered in our hospital during the defined study period was recorded and a statistical analysis of various parameters was done.Results: The total number of women delivered over the study period was 2075, out of which caesarean sections (CS) were 473. The overall CS rate calculated was 22.8%. Previous LSCS was the leading indication to the CS rate.Conclusions: Routine obstetric audits should be done to analyse the various indications of emergency and elective caesarean sections so that protocols and guidelines can be implemented to curtail the increasing trend of caesarean delivery.
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Meena, Pragati, Seema Meena, Bharti Sharma, and Richa Chaudhary. "Comparative study on maternal morbidity in elective and emergency caeserean section at tertiary hospital." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 12, no. 9 (2023): 2700–2704. http://dx.doi.org/10.18203/2320-1770.ijrcog20232724.
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Background: The incidence of caesarean sections has significantly increased over the previous thirty years and nearly doubled in the current decade, because of more liberalisation of indications of caesarean sections. India’s caesarean section rates have surpassed the WHO cutoff point of 15%, raising serious public health issues. The prevalence of the C-section in India was 8.5% in NFHS-3 while data in NFHS-4 show that it has increased to 17.2%. Thus, almost 9% has increased over 10 years. Objective was to compare the maternal morbidity in elective and emergency caesarean section. Methods: Institution based comparative study was conducted among 108 females undergoing lower segment caesarean section at JNUIMSRC, Jaipur. After taking written informed consent patients were enrolled for the study. Once the data was collected it was analysed as per appropriate statistical analysis. Results: Incidence of emergency LSCS was 23.6% and of elective LSCS was 76.4%. the most common maternal indication was previous LSCS (38.1%) and most common fetal indication was fetal distress (13.3%) followed by malpresentation (11.4%). Incidence of intraoperative complications was 29% with most common complications being atonic PPH (12.4%) followed by traumatic PPH (5.9%), bladder and bowel injury (0.7%). Incidence of post operative complications was 51.9% with most common being anaemia (20.8%), PPH (10%), puerperal sepsis (8%). Conclusions: If performed for medical reasons, CS can save the lives of both mothers and babies. Therefore, CSs should preferably only be performed when necessary for medical reasons. Morbidity is more with emergency LSCS than elective LSCS with PPH being the most common intraoperative complication and anemia being most common post operative complication.
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Priyanka, Bajpayee Minakshi, and Rani Sinha Abha. "Tranexamic acid to Reduce Blood Loss in Women at High Risk for Postpartum Hemorrhage undergoing Cesarean Section: A Randomized Controlled Trial." International Journal of Pharmaceutical and Clinical Research 15, no. 3 (2023): 1447–51. https://doi.org/10.5281/zenodo.12791004.
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<strong>Background</strong><strong>:</strong> One of the leading causes of maternal death worldwide is postpartum haemorrhage. Significant blood loss raises the risks associated with blood transfusions and, as a result, raises the possibility of needing urgent surgical operations like artery ligation or hysterectomy. In low- or middle-income nations in particular, it can also result in prolonged anaemia. This study goal was to find out whether tranexamic acid effectively and safely reduces blood loss during and after lower segment caesarean sections. <strong>Method</strong><strong>:</strong> From January 2022 to December 2022, 200 women who were having lower segment caesarean sections (LSCS) at the Obstetrics and Gynecology Department at SKMCH, Muzaffarpur, Bihar, participated in a randomised, controlled trial. One gramme of tranexamic acid was administered intravenously to 100 of them 20 minutes prior to making a skin cut so that they could be compared to 100 additional individuals who did not receive it. During two sessions, blood loss was measured and collected. The first period covered the time from placental delivery to the end of LSCS, while the second covered 2 hours after delivery. <strong>Results</strong><strong>:</strong> Tranexamic acid significantly decreased blood loss from the conclusion of LSCS to two hours after delivery; it went from 128.57±23.72 ml in the control group to 79.0±14.18 ml in the experimental group (p=0.0001). The amount of blood loss from placental delivery to end of LSCS was also considerably less in the study group than in the control group (308.80±43.60 ml versus 349.18±42.17 ml) (P=0.0001). In neither group were there any complications or negative effects noted. <strong>Conclusion</strong><strong>:</strong> The use of tranexamic acid significantly reduces the amount of blood loss during and after the lower segment caesarean section and has no adverse side effects or problems, such as thrombosis. Tranexamic acid can be used effectively and safely in women having LSCS.
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Dr., Chinmay Godbole. "Incidence of Perioperative Arrhythmias among females having Lower Segment Caesarean Section under Spinal Anaesthesia- A descriptive crosses sectional study." International Journal of Medical and Pharmaceutical Research 1, no. 1 (2020): 86–91. https://doi.org/10.5281/zenodo.7655685.
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<strong>Background</strong>: The most frequent emergency or elective cases we encounter are lower segment caesarean sections (LSCS). In the majority of these cases, regional anaesthesia is used. Due to the altered physiology of pregnancy and anaesthesia, perioperative cardiac arrhythmias are frequent in these situations. Most of these arrhythmias are benign, which is significant. When under spinal anaesthesia, some arrhythmias, however, can result in a rapid vascular collapse and raise peri-partum morbidity and fatality rates. Although there are few case reports, the frequency of intraoperative arrhythmias is not fully known. Thus it was decided to conduct this study on the prevalence of arrhythmias in LSCS patients during spinal anaesthesia. <strong>Methodology</strong>: We carried out this prospective study between January 2022 and December 2022, over a one-year span. In this one year, 1260 individuals had LSCS while under spinal anaesthesia. Ninety patients were left out because they had issues unrelated to pregnancy. Also omitted were 260 patients who had gestational diabetes mellitus, gestational hypertension, eclampsia, or pre-eclampsia. 20 instances were turned over to general anaesthesia after being disqualified due to insufficient block. Included in the study group were 890 patients. <strong>Results</strong>: In the present study, out of 890 patients, 115 individuals (12.9%) experienced arrhythmias following surgery. Bradycardia was observed in 45 (5.06% of the patients), and ventricular ectopics were observed in 35 (3.93%). There were 18 [2.02%] patients with supra ventricular tachycardia, 12 [1.35%] with atrio-ventricular blocks, 8 [0.89%] with atrial ectopic, and 3 [0.34%] with atrial fibrillation. <strong>Conclusion</strong>: During anaesthesia, arrhythmias are rather typical. The majority of these perioperative arrhythmias spontaneously return. Most of them have stable hemodynamics, and only a small percentage of them require treatment. The anesthesiologists should exercise caution, and the surgeons should be more gentle. The patient must be closely watched and continuously monitored.
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Shamrao Ramji Wakode and Sakshi Pramod Sharma. "Vaginal birth after multiple caesarean section: a case report from India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 12, no. 5 (2023): 1513–15. http://dx.doi.org/10.18203/2320-1770.ijrcog20231255.
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Lower segment caesarean sections increase the possibility of maternal morbidity. Hence, since last few decades, initiative for trial of labor after caesarean delivery is being encouraged in selected cases. Accordingly, a 23-year-old fifth gravida, who had a history of previous three lower segment caesarean sections and one vaginal birth approached for delivery service and plan for her vaginal delivery was made after thorough examination and evaluation. A live female child of 3100 grams was delivered following episiotomy. In post-partum period, it was observed that uterus was involuted on abdominal examination and uterine contours were regular in ultrasonography. As the evidences for practice of vaginal delivery in women who underwent 2 or more previous LSCS are still fewer, this report intends to highlight the possibility of successful vaginal birth after multiple caesarean sections.
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Omama Sumbul Islam, Hajra Hilal Ahmed, and Muhammad Jamaluddin. "Intra-Abdominal Gossypiboma found during Cholecystectomy, 12 years after Lower Segment Caesarean Section." ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 24, no. 2 (2019): 115–18. http://dx.doi.org/10.58397/ashkmdc.v24i2.40.
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Retained Surgical Foreign Bodies (RSFBs) is an uncommon event in the surgical practice. Most of them occur after intra-abdominal and pelvic surgeries. They usually present within days after surgery but their incidental discovery after decades has also been reported.We present a case of a 44-year- old obese and diabetic female patient who presented with clinical and radiological findings of chronic calculus cholecystitis. She had past surgical history of Lower Segment Caesarean Section (LSCS) 12 years back, followed by a negative laparotomy. During her open cholecystectomy procedure, a hard mass was found between the small bowel loops. When removed and examined, it was found to be a retained surgical sponge which was most likely left in her body during prior LSCS procedure. Asymp- tomatic, uncomplicated and (ultrasonographically) undetected nature of RSFB in our case suggests its consideration and careful search if there is past history of intra-abdominal or pelvic surgery.
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Satani, Drumil Rasikbhai, Dhara Mukeshbhai Virsodiya, Mahipalsinh Jorsangbhai Chauhan, and Parthsinh Manubhai Parmar. "An Audit of Preterm Caesarean Sections at a Tertiary Care Centre in Gujarat." International Journal of Pharmaceutical and Clinical Research 16, no. 10 (2024): 631–36. https://doi.org/10.5281/zenodo.14038167.
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<strong>Introduction: </strong>Preterm Caesarean sections are performed when early delivery becomes necessary due to maternal or fetal complications, posing challenges for both maternal and neonatal outcomes. These procedures require careful clinical decision-making to balance the risks and benefits, aiming to prevent adverse outcomes like fetal distress, antepartum hemorrhage, or pre-existing maternal conditions. Auditing preterm Caesarean sections provides valuable insights into the indications, management strategies, and outcomes, helping optimize care in high-risk pregnancies. <strong>Material and Methods:</strong> This retrospective observational study was conducted at a tertiary care teaching hospital in Gujarat to analyze the incidence, indications, and outcomes of preterm Caesarean sections (CS). It included both elective and emergency preterm CS cases performed before 37 weeks of gestation, focusing on maternal demographics, obstetric details, and maternal and neonatal outcomes. Data were analyzed using descriptive statistics, and the Robson Classification system was applied to categorize cases. Statistical significance was tested to identify meaningful differences between elective and emergency CS groups. <strong>Results</strong>: In our study on preterm Caesarean sections (CS) at a tertiary care center in Gujarat, 66.7% of women were nulliparous, with 83.3% having no previous uterine scar and 88.3% presenting with cephalic fetal positions. The primary indications for lower segment Caesarean sections (LSCS) included antepartum hemorrhage (11.7%), fetal distress (10%), and sickle cell crisis (11.7%). NICU admissions were necessary for 86.7% of newborns, primarily for observation or further care. Most preterm deliveries involved babies weighing between 1.5-2.5 kg (73.3%), with 96.7% of cases being preterm births. Maternal outcomes were positive, with 93.3% discharged without complications, reflecting the effective management of preterm LSCS cases. <strong>Conclusion: </strong>Our audit of preterm Caesarean sections at a tertiary care center in Gujarat found fetal distress, antepartum hemorrhage, and prior Caesareans as the primary indications. Most women had favourable obstetric profiles with stable outcomes, highlighting effective perioperative management and the multifactorial nature of neonatal outcomes.
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Abid, Komail, Rashid Iqbal, Syed Ali Raza Shah, and Sana Tariq. "Intravenous Ondansetron Efficacy in Preventing Post Spinal Shivering during Lower Segment Caesarean Section." Pakistan Armed Forces Medical Journal 73, no. 6 (2023): 1636–39. http://dx.doi.org/10.51253/pafmj.v73i6.6688.
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Objective: To determine IV Ondansetron efficacy in preventing post-spinal shivering during LSCS. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Anaesthesiology, Combined Military Hospital, Rawalpindi Pakistan, from Sep 2018 to Mar 2019. Methodology: A total of 60 women undergoing LSCS under spinal anaesthesia were included. Group-A was given 8 mg/4 ml Ondansetron, while Group-B was given 4 ml Normal Saline 0.9% IV immediately before induction of spinal anaesthesia. Body temperature, level of sensory block, and shivering scores during the peri-operative period were recorded. After surgery, patients were shifted to Post Anaesthesia Care Unit (PACU). Shivering was graded using Crossley and Mahajan 5-item scale. Injection Tramadol 1mg/kg intravenously was used as a rescue anti-shivering drug. Results: The majority of the patients 33(55.0%) were between 18-25 years of age. Efficacy of Intravenous Ondansetron in preventing post-operative shivering during spinal anaesthesia in patients undergoing caesarean section was seen in 26 86(67%) patients (Group-A) as compared to 17(56.67%) patients in the Control Group (Group-B) (p-value=0.010). Conclusion: The study concluded that there was less post-operative shivering with intravenous Ondansetron during spinal anaesthesia in patients undergoing caesarean section as compared to the Control Group.
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Mushtaq, Javeria, Tayyiba Wasim, and Jamshaid Feroze. "A Case Report of Scar Endometrioma, A Rare Entity." Annals of King Edward Medical University 28, no. 2 (2022): 210–12. http://dx.doi.org/10.21649/akemu.v28i2.5101.
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Scar endometriosis is an uncommon entity. Its diagnosis is often delayed because it often resembles to several surgical conditions and dermatological diseases. It is almost always iatrogenic in origin. Here we are discussing a 38 old year old women who presented with scar endometriosis after Lower Segment Caesarean Section (LSCS).
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De, Devjani, Sonal Saxena, Geeta Mehta, Reena Yadav, and Renu Dutta. "Risk Factor Analysis and Microbial Etiology of Surgical Site Infections following Lower Segment Caesarean Section." International Journal of Antibiotics 2013 (September 1, 2013): 1–6. http://dx.doi.org/10.1155/2013/283025.
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Background. Lower segment caesarean section (LSCS) is a common mode of delivery now and surgical site infection is the second most common infectious complication in these patients. This study was planned with this background to have a comprehensive approach to SSI following LSCS. Methods. 500 consecutive patients undergoing LSCS, irrespective of indication, were studied. A questionnaire was developed to assess the risk factors associated with development of SSI. All patients were followed up from day one of surgery till discharge and then up till the postoperative day 30 after discharge. Results. SSI was identified in 121 (24.2%) out of 500 patients. In all age groups, Gram-negative bacilli were the commonest finding. The commonest isolate was Acinetobacter species (32.03%) followed by Staphylococcus aureus and coagulase negative Staphylococcus (21.09%). 23.8% of Staphylococcus aureus strains were MRSA. By multivariate logistic regression premature rupture of membrane (PROM), antibiotics given earlier than 2 hours and increased duration of stay in the hospital were found to be significant. Conclusions. A proper assessment of risk factors that predispose to SSI and their modification may help in reduction of SSI rates. Also, frequent antimicrobial audit and qualitative research could give an insight into the current antibiotic prescription practices and the factors affecting these practices.
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Wani, Reena J., Kruti Doshi, Sumayya Ansari, and Mahin C. Bhatt. "Perioperative concerns and outcomes in obstetric patients undergoing lower segment caesarean section in the wake of the COVID-19 pandemic: a retrospective analysis." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 11, no. 5 (2022): 1477. http://dx.doi.org/10.18203/2320-1770.ijrcog20221280.
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Background: In the current COVID-19 pandemic, pregnant women are considered high risk due to adverse maternal and foetal complications that are known to occur with antepartum viral infections. In addition to immunological changes in pregnancy that alter the response to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, the disruption of routine antenatal services as a result of the pandemic has also adversely affected expectant mothers.Methods: We conducted this retrospective observational study as a comprehensive comparative analysis of the method of delivery in COVID positive women, the choice of anaesthesia and maternal and foetal outcomes in women undergoing lower segment caesarean sections with COVID infection as well as the COVID negative patients during the first wave of the pandemic.Results: The rate of caesarean section was comparable between the two groups. The rates of general and regional anaesthesia did not change with COVID positive status. However, we found that meconium-stained liquor with foetal distress as an indication for lower segment caesarean section (LSCS) was markedly higher in COVID positive patients. There was also a significantly higher requirement for ICU admission and ventilator support in the positive patients as a result of COVID-related complications. No significant difference was observed in the maternal and neonatal mortality rate between the two groups.Conclusions: In our experience, COVID-19 positive status did not impact the rate of LSCS, but significantly increased the need for intensive care.
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T., Heera Shenoy, Remash K., and Sheela Shenoy T. "Determinants and outcomes of caesarean delivery: elective versus emergency in a tertiary care teaching institute in Kerala, India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 10 (2019): 4000. http://dx.doi.org/10.18203/2320-1770.ijrcog20194370.
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Background: Globally, the caesarean delivery rate is rising continuously, making caesarean one of the most common surgical procedures. The purpose was to analyse the determinants and maternofoetal outcomes in elective versus emergency caesarean sections in a tertiary care centre.Methods: All women, who gave birth by Caesarean deliveries done over a period of 1 year (January 2018-December 2018), were studied in Travancore Medical College in Kerala, India. Indications of caesarean, whether emergency or elective, medical morbidities, Gestational age at decision, birthweights and extended hospital stay and new-borns needed to resuscitate were looked into. The data was collected and analysed from the hospital registry.Results: Out of the 378 selected patients, 95 patients in group of elective and 283 emergency caesarean section were studied. The indications of emergency caesarean sections were failed induction, non-progression of labour, CPD, Previous caesarean in labour, foetal distress. The most frequent indicator for elective lower segment caesarean section (LSCS) was patient with previous LSCS not willing for vaginal birth, followed by breech presentation and high risk pregnancy ( BOH and ART). Younger mothers, gestational age remote from term, low-birth weight, and extended hospital stay were statistically significant in mothers undergoing emergency caesarean delivery. Fever, urinary tract infections, need for maternal and neonatal ventilation, blood transfusion, scar dehiscence were more common in the emergency caesarean group.Conclusions: The antenatal morbidity, low birth weights, decision taken preterm for salvaging the baby, postoperative complications and extended stay were more in the emergency caesarean when compared to elective caesarean.
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Kumar, Ajay, Anuj Singh, and V. B. Tripathi. "Previous caesarean scar rupture: mortality averted a case report." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 11 (2020): 4719. http://dx.doi.org/10.18203/2320-1770.ijrcog20204842.
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Uterine rupture at the site of a previous cesarean section scar is an uncommon but catastrophic complication of pregnancy by associated with significant foetal and maternal mortality and morbidity. A 31-year old woman, G6P3A2L1 with previous lower segment cesarian section (LSCS), booked case was admitted at 37 week of gestation with complaint of leaking per vaginal (P/V) in our tertiary care centre. Patient had spontaneous labor pain, which subsided after few contractions and sustained hemorrhagic shock with utero placental insufficiency due to previous LSCS scar rupture. Due diligence and expeditious caesarean management strategy needs to be adopted in parturient with previous caesarean patients owing due to risk of scar rupture. Ultrasonography is a useful tool which can be used to assess women with previous cesarean section to carry out risk stratification for subsequent pregnancies.
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Sebastian, Gisi, Seetesh Ghose, and P. Soundararajan. "Comparison of maternal and neonatal outcome in elective lower segment cesarean section done at 38 and 39 weeks." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 4 (2017): 1604. http://dx.doi.org/10.18203/2320-1770.ijrcog20171436.
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Background: Time to perform elective LSCS is a relevant issue related to mother and foetus. LSCS can be done from 37 weeks onwards because foetal lungs mature by then. But foetuses born at 37 weeks of gestation have more risk of developing respiratory problems, transient tachypnoea of new born, hypothermia, hypoglycaemia and NICU admission.The purpose of this study is to find out appropriate gestational age at which elective LSCS can be performed without adverse maternal and neonatal outcome.Methods: This is an observational comparative study done on 209 antenatal women who underwent elective caesarean section from December 2014 to January 2016.Patients were divided into two groups after taking consent. Maternal parameters like formation of lower uterine segment need for blood transfusion. Neonatal parameters like Apgar score, respiratory distress syndrome and NICU admission with indication and duration were analyzed by chi-square test. Gestational Age and Pre-Op Hb and Post-Op Hb were analyzed by independent ‘t’test.Results: In this study 55% of the pregnant women belong to 38 weeks,45% belongs to 39 weeks. The formation of lower uterine segment was statistically significant and the need for blood transfusion was slightly increased at 39 weeks. But there was no significant difference in Apgar score, Respiratory distress, NICU admission comparing both study groups.Conclusions: Elective caesarean section can be done safely at 38 weeks without affecting maternal and perinatal outcome.
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Kumari, Garima. "Caesarean scar endometriosis." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 11 (2021): 4331. http://dx.doi.org/10.18203/2320-1770.ijrcog20214356.
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Endometriosis is defined by the presence and growth of ectopic functional endometrial tissue outside the uterus. The symptoms are nonspecific, typically involving abdominal wall pain at the time of menstruation. It commonly follows obstetrical and gynecological surgeries. The diagnosis is frequently made only after excision of scar the diseased tissue. A case report of 34 year old female patient presenting with scar endometriosis 7 years after her last LSCS (lower segment caesarean section). The patient came with the complaint of supra pubic swelling since 6 months, which was growing slowly. Her menstrual history was regular, but she had lower abdominal pain during menstruation. On clinical history, examination and USG finding the swelling was diagnosed as scar endometriosis.
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Karasala, Varalakshmi, Upendra Kumar, Archana Tripathi, and Mukesh Somvanshi. "Clinical evaluation of perfusion index (PI) as a predictor of post spinal hypotension in lower segment caesarean section (LSCS)." Indian Journal of Clinical Anaesthesia 9, no. 4 (2022): 445–49. http://dx.doi.org/10.18231/j.ijca.2022.090.
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Hypotension is a common complication, subsequently spinal anaesthesia in lower segment caesarean section, which can cause adverse maternal & foetal outcomes. A new decisive research area in obstetric anaesthesia is prevention & early treatment of spinal hypotension to improve maternal & foetal outcomes. A novel parameter, Perfusion index (PI) is tried during sub arachnoid block for predicting hypotension in lower segment caesarean section (LSCS). In this study, 60 parturient belonging to ASA status 1 or 2 with apparent pregnancies scheduled for elective LSCS received spinal anaesthesia with 2ml of 0.5% heavy bupivacaine by using an orange (25G) Quincke needle at L3-L4 or L4-L5 interspinous space. Haemodynamics & perfusion index were recorded at regular intervals. Baseline perfusion index was correlated with degree of hypotension by using Receiver Operative Characteristic curve. Baseline perfusion index & other parameters were correlate by Karl Pearson correlation method. : In our study 34.5% incidence of hypotension among study theme & momentous correlation between fall in systolic blood pressure from baseline & baseline perfusion index (r = 0.436; P &#60; 0.05). The optimal utmost point for perfusion index was found to be 3.5 with a sensitivity of 37% & specificity of 97%. A higher incidence of hypotension was found in Parturient having baseline perfusion index more than 3.5 following sub arachnoid block in elective LSCS.
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Etiobhio, Osemudiamen S., Ismail Awadalla, Arwa Khadir, et al. "Vaginal Birth after Caesarean Section (VBAC): A Case Report on V-Back in Saudi Arabia." Scholars International Journal of Obstetrics and Gynecology 7, no. 04 (2024): 195–98. http://dx.doi.org/10.36348/sijog.2024.v07i04.008.
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Repeat caesarean sections increase the possibility of maternal morbidity. Worldwide, the need for a trial of labor after caesarean delivery is gaining more ground in selected cases. Here, we report a case of an unbooked 37-year-old multigravida, with a history of five (5) previous lower-segment caesarean sections who presented in spontaneous labor. A live male baby of 2900 grams was delivered following episiotomy. Post-partum, she was observed with normal findings and a serial follow-up ultrasound scan showed normal uterine contours and surrounding structures. As the evidence for the practice of vaginal delivery in women who underwent 2 or more previous LSCS are still fewer, this report intends to highlight the possibility of successful vaginal birth after multiple caesarean sections putting into consideration the optimal care of the parturient. The term ''V-back" was coined from the Roman numeral 'v' meaning five (5), the case here has had five (5) previous lower segment cesarean sections come "back" for spontaneous vaginal delivery.
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Prasad, Sangeeta G., and Preeti Malhotra. "Assessing the pros and cons of vaginal birth after caesarean relative to elective repeat caesarean section." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 4 (2020): 1350. http://dx.doi.org/10.18203/2320-1770.ijrcog20201085.
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Background: Recent years have witnessed a rise in rate of primary caesarean section (CS). No. of women reporting with a previous CS scar is also increasing. Judicious trial of labor in such patients can prevent repeat caesarean section. Aim of this study was to assessing the safety and success rate of vaginal birth after caesarean (VBAC) in selected cases of patients who have undergone previous lower segment CS (LSCS) is the main aim of this study.Methods: In this prospective observational study carried out in a tertiary care teaching hospital over a period of 1 year. 375 pregnant women with a history of one previous LSCS for non-recurrent indications were enrolled. The statistical technique of t-test was administered for relative comparison with respect to maternal and neonatal complications across the two groups, i.e. repeat LSCS and vaginal delivery.Results: Out of 375 patients 187 patients (49.9%) underwent elective LSCS for recurrent indication and for non-recurrent indication associated with some complicating factor. Trial of labor in 188 (50.10%) was given out of which 59.3% had spontaneous vaginal delivery,7.20% had instrumental delivery and 33.50% landed into emergency CS. Commonest cause of Em. LSCS being Fetal distress. As regards maternal complications, no statistically significant difference was found between the Repeat LSCS and Vaginal delivery groups (t = 0.779, p > 0.05). On similar lines, there was no statistically significant difference across both groups as regards neonatal complications (t = 0.632, p > 0.05).Conclusions: Taking into account the increased trend of primary CS, trial of VBAC in selected cases is very important. It can be concluded that VBAC has chances of success in cases with previous one LSCS but it must be carefully investigated and monitored.
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Shrestha, Aashika, Junu Shrestha, and Sangeeta Devi Gurung. "Appraisal of caesarean section incidence and indications at manipal teaching hospital, Pokhara, Nepal." Asian Journal of Medical Sciences 12, no. 1 (2021): 50–54. http://dx.doi.org/10.3126/ajms.v12i1.30846.
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Background: Worldwide lower segment caesarean section (LSCS) is the most commonly performed obstetric operation. Though it’s a lifesaving procedure it is sometime associated with both short and long term risk which can extend many years beyond current delivery and affect health of mother, fetus and future pregnancy.
 Aims and Objective: The study aims to examine the incidence and indication of caesarean section at Manipal teaching hospital.
 Materials and Methods: A retrospective descriptive study of 2140 cases was carried out at a teaching hospital in Pokhara, Nepal. Data regarding total number of vaginal delivery and caesarean section performed in 1 year duration from August 2019 to July 2020 was obtained from the operation record book and medical record section of hospital. Other information regarding age, parity, gestational period and indication of cesarean section were obtained and depicted in tabulated form. The collected secondary data has been analyzed employing frequencies and percentage.
 Results: During the one year study period, 2140 deliveries were made out of which 1170 (54.7%) cases underwent caesarean section. Out of those cases 78.8% of women underwent emergency LSCS. Most of the women were in the age group of 21-30 years (69.2%). In 81.2% cases caesarean was done between 38-42 weeks gestation. 52.3% of cases were multigravida, 43.8% were primigravida and only 3.1% were grand multigravida. Most common indication of caesarean were fetal distress (23.7%), previous LSCS (23%), cephalopelvic disproportion (15.6%), oligohydramnios (11%) followed by breech, preeclampsia, eclampsia and non-progress of labour.
 Conclusion: This study revealed that the incidence of caesarean section was high in the hospital and majority of the patients who underwent caesarean section had an emergency caesarean section. The commonest indications were fetal distress and repeat cesarean section. The issue requires further investigation to identify reasons for high CS rate and raises necessity of policy guidelines and intervention in order to prevent possible unjustified use of surgical delivery.
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Sharma, Neelam, and Anshul Jhanwar. "Study of incidence, trends and determinants of caesarean section in tertiary care hospital of Rajasthan, India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 7 (2018): 2672. http://dx.doi.org/10.18203/2320-1770.ijrcog20182504.
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Background: Lower Segment Caesarean section (LSCS) is recommended when vaginal delivery might pose a risk to the mother or baby. Worldwide rise in LSCS rate during the last three decades, has been the cause of alarm and needs an in-depth study.Methods: It was a retrospective, observational study conducted in Obstetrics and Gynecology department of Jhalawar medical college, Jhalawar. Data were obtained from medical record database of patients admitted for deliveries from October 2017 to March 2018 over period of six months. The total number of patients delivered and the number of LSCS done were counted to find the incidence of LSCS in our hospital. Age, parity and gestational age of the patients who underwent LSCS were tabulated.Results: In present study the incidence of LSCS was 31.1%. Of these cases 91% belonged to age group 20 -29 yrs. Emergency LSCS (72.1%) and primary LSCS (66.5%) were more common. The commonest indication of LSCS was previous LSCS in 35% followed by foetal distress, breech presentation, severe oligohydrominos and pre-eclampsia.Conclusions: In present study LSCS rate was high as compared to the WHO standard. The scheme like Janani Suraksha Yojana (JSY) may have a great impact on accepting institutional deliveries by poor women which may be a reason of the increase of LSCS in India. Utilization of antenatal care, better doctor patient communication, doctor’s commitment to reduce the rate of LSCS, may help to reduce the increasing rate of caesarean delivery.
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Gupta, Nidhi, and Renuka Sinha. "Intra-operative uterine scar condition and fetomaternal outcome in patients of previous lower segment caesarean section (LSCS) with scar tenderness." International Journal of Research in Medical Sciences 5, no. 11 (2017): 4911. http://dx.doi.org/10.18203/2320-6012.ijrms20174943.
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Background: During past few years, there is increasing trend in trial of labor in cases of previous lower segment caesarian section (LSCS). It needs vigilant approach in identifying signs and symptoms of giving way of previous scar. This study is to see the intra-operative uterine scar condition and feto-maternal outcome in patients of previous LSCS with scar tenderness.Methods: This is a prospective study done in Safdarjung hospital, New Delhi. It includes 120 patients of previous lower segment caesarian section with scar tenderness operated as emergency cases over a period of one year. It excludes elective repeat LSCS.Results: During this period repeat emergency LSCS was done in 862 cases and scar tenderness was seen in 120 cases (13.92 %). Out of 120 cases enrolled for the study intra-operative scar was intact in 69 cases (57.5%). Scar was thinned out in 27 cases (22.5%). Scar dehiscence was found in 21 cases (17.5%). Rupture occurred in 3 cases (2.5%) out of which 2 were Fresh still births. NICU admission was done in 11 cases (9.17%). 1 neonatal death occurred. No maternal death was recorded. Average hospital stay was 6 days. Blood transfusion was needed in 23 cases (19.2%).Conclusions: Scar tenderness is a very important tool for predicting scar integrity. All cases of previous LSCS should have institutional delivery.
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Patel, Purvi, Mansi Shah, and Lata Parmar. "Effect of Physiotherapy Treatment in Early Postpartum Period after Lower Segment Caesarean Section (LSCS)." International Journal of Current Research and Review 13, no. 12 (2021): 155–59. http://dx.doi.org/10.31782/ijcrr.2021.131205.
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Gunturu, Nagajyothi, D. Shivani, and P. Sravanthi. "Study of the efficacy of tranexamic acid in reducing blood loss after child birth." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 5 (2021): 1863. http://dx.doi.org/10.18203/2320-1770.ijrcog20211502.
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Background: The aim was to study the efficacy of tranexamic acid in reducing blood loss after childbirth in normal vaginal delivery and LSCS.Methods: 200 pregnant women divided into two groups group 1 and group 2, 100 women undergoing LSCS and 100 women undergoing vaginal delivery. Study group will be given 1 g iv tranexamic acid along with active management of third stage of labor and control subjects will be given only active management of third stage. Clinical observations and laboratory examinations, measurement of blood loss were measured.Results: Distribution with respect to indication of LSCS like fetal distress, cephalopelvic disproportion, abnormal presentation, previous LSCS, arrest of descent, failed induction and onset of labor were comparable between both the groups. Study group showed marked decrease in blood loss when compared to controls from time of placental delivery to 2 hours postpartum in women undergoing vaginal delivery and caesarean section. There was a significant fall in mean Hb level among the control group when compared with the study group. There was no significant difference in the vital signs of the subjects in both the groups. The incidence of adverse effect like nausea, vomiting and diarrhoea were not increased in the study group when compared to the control group. Also the incidence of thrombosis was not increased with tranexamic acid.Conclusions: Tranexamic acid significantly reduced the amount of blood loss after vaginal delivery and lower segment caesarean section. Its use was not associated with any adverse drug reactions like nausea, vomiting, diarrhoea or thrombosis. Tranexamic acid can be safely administered in pregnant women undergoing vaginal delivery and lower segment caesarean section.
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Sharma, Shanta, and Indra Dhakal. "Cesarean Vs Vaginal Delivery : An Institutional Experience." Journal of Nepal Medical Association 56, no. 209 (2018): 535–39. http://dx.doi.org/10.31729/jnma.3467.
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 Introduction: According to the WHO, 15% of deliveries have precise indication for cesarean section where it is mandatory for the preservation of maternal and/or fetal health. Increasing rates of Lower Segment Caesarean Sections puts foreword various question that, whether a LSCS need to be reflected as a normal delivery in this twenty first century. There are conflicting reports regarding the safety of caesarean sections. While a significant number of cesarean delivery are performed for obstetrical indications, some are simply due to maternal request and may incur several risks for the child. Not much study has compared the complications of caesarean section with those of vaginal birth. Objective of this study is to find out and compare the common complications of cesarean section with vaginal deliveries on mothers.
 Methods: A descriptive study was conducted in two selected hospitals of Rupandehi district, Nepal. Data was collected as per pretested structured proforma from 550 respondents randomly and analyzed by using SPSS, MANOVA and Chi-square test to determine associations between categorical variables.
 Results: In total of 550 mothers, 408 (74.2%) had vaginal delivery and 142 (25.8%) had cesarean delivery.The common maternal complications were postpartum hemorrhage 116 (21.1%), prolonged labor 47 (8.5%) and wound infection 42 (7.6%).
 Conclusions: The result of the study shows that the maternal complications were higher among LSCS compared to vaginal delivery.
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., Veeramma, and Puneeta Mahajan. "Maternal outcomes in patients with previous one lower segment caesarean section undergoing trial of labour: prospective observational study." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 5 (2018): 1822. http://dx.doi.org/10.18203/2320-1770.ijrcog20181910.
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Background: The incidence of caesarean section is on the rise and has increased 2-3 folds from the initial rate of 10% during the last decade. The objective of the present study was to compare maternal outcomes in successful and failed trial of labour in women with previous one LSCS.Methods: This prospective observational study was carried out in Department of obstetrics & Gynaecology, Sanjay Gandhi memorial Hospital, New Delhi during 2015-2016 and included 150 gravid women with previous LSCS. The study was undertaken during March 2015 to May 2016. The ethical committee approval for the study has been taken.Results: out of 150 patients who had given a trial of labour, 64.7% (97) underwent successful VBAC and 35.3 %( 53) underwent emergency repeat LSCS. Majority of cases 59.3% were in age group <25 years followed by 36.7% in age group of 25-30 years. Most of the cases are para one 72.7% and remaining are multipara (27.3%). LSCS group: 83% para1 and 17% are multipara. VBAC group: 67.01 % para 1 and 32.9% multipara. There is no significant statistical difference between parity and mode of delivery. (p=0.591). Majority of cases 52.7% were in between 37-39 weeks and 47.3% cases were in between 39-42 weeks. Majority cases 89.3% had Bishop’s score 4-6 and 10.7% had Bishops score >6.Conclusions: This study reveals that successful VBAC rate was 64.7% and 35.3% emergency repeat caesarean section.
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Santwana, Kumari, Kumar Anuj, and Sinha Anupama. "A Hospital-Based Study to Assess the Clinical Evaluation of Perfusion Index (PI) as a Predictor of Post Spinal Hypotension in Lower Segment Caesarean Section (LSCS)." International Journal of Current Pharmaceutical Review and Research 16, no. 04 (2024): 758–61. https://doi.org/10.5281/zenodo.12804647.
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AbstractAim: The aim of the present study was to assess the clinical evaluation of perfusion index (PI) as a predictor ofpost spinal hypotension in lower segment caesarean section (LSCS).Methods: The present study was conducted in the Department of Obstetrics and Gynecology, JLNMCH,Bhagalpur, Bihar, India for one year. Informed & written consent was obtained from every parturient who camefor caesarean section. A total of 50 subjects were analyzed.Results: Out of 7 parturient had high standard PI (PI>3.5), 6 parturient foster hypotension, though out of 43parturient had low pattern PI (PI≤3.5), 10 parturient foster hypotension. The parturient with high & low standardPI, systolic pulse diminished altogether after spinal infusion. However, more prominent reduction in systolic pulseat 5-10 min & 25 min in parturient having high benchmark PI had after spinal infusion than parturient having lowstandard PI.Conclusion: Perfusion Index (PI) can be used to predict post spinal hypotension in healthy parturient undergoinglower segment caesarean section. Parturient higher risk of developing post spinal hypotension with baseline PImore than 3.5 compared to those with baseline PI less than 3.5
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Malik, Adiba, Kamrun Nessa, Yasmin Ara Begum, et al. "Incidence and indications of LSCS among Doctors Community of Chattogram." Chattagram Maa-O-Shishu Hospital Medical College Journal 20, no. 2 (2021): 37–40. http://dx.doi.org/10.3329/cmoshmcj.v20i2.56471.
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Background: Lower segment caesarean section (LSCS) is a surgical intervention, which is carried out to ensure the safety of mother and baby when vaginal delivery is not possible or when danger to mother and baby would be greater with vaginal delivery. This study is designed to identify indication of LSCS and detect complications if any among the respondents.
 Materials and methods: Cross sectional descriptive study where 95 female doctors of Chattogram were selected by convenient sampling without knowing their mode of delivery and if it is LSCS then indication of LSCS , maternal and neonatal complications were noted.
 Results: Age of the respondents at the time of interview were noted and most of them were between 31- 40 years 52 (55%), regarding income most of them between 100000 -200000 42(44%) most of the delivery occurred in the private clinics 92 (70%) regarding mode of delivery, LSCS was 92 (70%) vaginal delivery 40 (30%) regarding indications of LSCS most common was repeat caesarean section 27 (29%) and second common was LSCS due to maternal interest 18 (20%) and others were severe preeclampsia 10 (11%) fetal distress 08(09%) placenta previa, Diabetes with big baby, cephalopelvic disproportion, PROM with non progression of labour. PPH was the most common complication 05 (63%), next was paralytic ileus 02 (25%) and left ventricular failure 01 (12%). Common neonatal comoplications were low birth weight baby 904 (40%), prematurity 03 (30%) and birth asphyxia 03 (03%).
 Conclusion: LSCS is a major surgical procedure for delivery. Inspite of its low maternal morbidity and mortality due to improved surgical technique, modern aneasthetic skill and availability of blood and blood products, still it carries a slightly greater risk in subsequent pregnancy, so we should be rational in doing primary caesarean section.
 Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 37-40
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Khaniya, Bishal. "Fetomaternal Outcome in Second Stage Caesarean Section." Nepalese Medical Journal 3, no. 1 (2020): 279–81. http://dx.doi.org/10.3126/nmj.v3i1.28923.
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Introduction: Second stage caesarean section is usually associated with the deeply engaged head, less liquor, and thinned out the lower uterine segment. This can lead to a high risk of maternal morbidities like an extension of the lower uterine segment incision, uterine atony, and injury to urinary bladder as well as neonatal morbidities such as birth asphyxia, NICU admission, and meconium aspiration syndrome. This study aims to observe the maternal and neonatal outcomes of caesarean delivery performed in the second stage of labor.
 Materials and Methods: This was a retrospective study of the fetomaternal outcome of all women with singleton, a cephalic fetus at term delivered by caesarean section in the second stage of labor over one year at Tribhuwan University Teaching Hospital.
 Results: During this study period, there were 4653 deliveries. A total of 2274(48.88%) were born by caesarean section, out of which 1739 (76.5%) were elective and 535(23.5%) were emergency. Among emergency LSCS 36(6.72%) were performed in the second stage of labor. Most of the indications were nondescent of head 34(93.5%) followed by intraoperative maternal complications (hematuria; n=14; 38.88%). Postoperative maternal who had complications were prolong catheterization: 14(38.88%), postoperative fever : 10 (27.77%), prolong hospitalization: 5(13.88%). In perinatal complications meconium stain liquor : 10(27.77%), NNU admissions : 5(13.88%), Apgar score <5 at 5 min : 5 (13.55%), NICU admission : 2(5.54%), fresh stillbirth : 1(2.77%) were observed.
 Conclusions: Caesarean sections done in the second stage of labor are associated with severe maternal and neonatal complications.
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Borse, Dhananajay, Binay Mitra, and Aparna Sharma. "Previous two lower segment caesarean section with placenta previa and placenta accreta woman with COVID-19 suspect: case report." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 10 (2020): 4311. http://dx.doi.org/10.18203/2320-1770.ijrcog20204332.
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A pregnant woman with gravida 3, para 2, living 2 and gestational age of 37 weeks and 3 days was referred to a zonal hospital as previous two lower segment caesarean section (LSCS) term pregnancy with placenta previa for safe confinement with complaints of dry cough. She was admitted with a diagnosis of COVID-19 suspect. During her hospitalization, oxygen (O2) saturation was normal. On investigations her counts were normal. Patient was planned for elective LSCS. COVID-19 test i.e. real time-polymerase chain reaction (RTPCR) report was suspect and asked for repeat sampling. During elective LSCS, delivered single live female baby with intra operative findings of placenta previa with adherent placenta and permpartum hysterectomy was done for same. Uterus with placenta was sent for histopathological examination (HPE). During the surgery her oxygen concentration was normal. Her postoperative recovery was uneventful.
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Dr., Varsha. S. Powade. "Study of Trial of Labour after Caesarean Section (TOLAC)." International Journal of Medical and Pharmaceutical Research 4, no. 2 (2023): 547–54. https://doi.org/10.5281/zenodo.7874455.
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<strong>Introduction</strong>: Caesarean section is one of the most commonly performed major surgical procedures. Worldwide increase in caesarean section (CS) rate during the last three decades has been the cause for concern. As ours is a tertiary health care centre catering around 20,000 deliveries per year and patients with previous caesarean scar get referred from surrounding primary health centers in huge number. In order to reduce c-section rates, TOLAC are conducted as per departmental standard operative procedures and WHO standards. Objective: To study incidence of trial of labour after c-section, progress of labour in active phase, maternal and fetal outcome in cases of trial of labour after c-section at tertiary care center. <strong>Methods</strong>: Prospective Observational study in tertiary institute from october 2020- september 2022 in the department of obgy. Ethical approval was taken. 200 cases were studied after applying inclusion and exclusion criteria with CTG monitoring. <strong>Results</strong>: A total of 200 subjects with previous one cesarean section were studied. 71.50% underwent successful trial of vaginal birth (57.50 % vbac, 08.50 % vaccum and 05.50 % forceps) and 28.50% required cesarean section. Maximum number of women who had VBAC has LSCS (Lower Segment Caesarean Section) in the past for fetal distress(33%). LSCS (failed VBAC) was done maximally for fetal distress 37 (64.90%), then for failure to progress 15 (26.30%) and impending scar dehiscence 5 (08.80%). Maternal complications were lower in the VBAC group: fever (0.69%), blood transfusion (06.30 %). <strong>Conclusion</strong>: Success rate of TOLAC at our institute is 75 %.The study shows encouraging result for VBAC in a well facilitated set up to be followed to reduce Caesarean rate.
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Subedi, Nilam, Asmita Ghimire, Asmita Shrestha, and Padam Raj Pant. "Caesarean myomectomy: How safe it is? A retrospective analysis." Grande Medical Journal 4, no. 1 (2024): 24–27. https://doi.org/10.3126/gmj.v4i1.79361.
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BackgroundLeiomyoma uterus not only causes menorrhagia, pain abdomen but also complicates pregnancy in various ways. The objectives of present analysis were to investigate the outcome in cases of pregnancy complicated by fibroids undergoing lower segment cesarean section (LSCS) in Grande International Hospital, Kathmandu Nepal. MethodFourteen cases of leiomyoma with pregnancy underwent LSCS with myomectomy following the delivery of the baby. The suturing of the uterus was done using vicryl no 1 and vicryl no 1 ‘0’ for closing the dead space after myomectomy. Continuous oxytocin infusion was given for next 12 hrs. The cases were analyzed for age of patient, parity, gestational age, an indication of LSCS, type of fibroid, size of fibroid, blood loss, duration of operation, and blood transfusions. ResultThirty-eight fibroids of various sizes (3-15cm) were removed from 18 women. The fibroid was on both anterior uterine walls with most being subserous and intramural. Mean blood loss (excluding cesarean section) was 76.1 ml and mean operative time (only myomectomy) was 26.1 mins. Three patients had a whole blood transfusion in post-operative period. No hysterectomy was required in any case. ConclusionMyomectomy during cesarean section is possible and safe in selected cases with proper indications and also with expert hands. It avoids a second surgery and its associated morbidity.
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Saba, Ghaffari, and Rahman Khatibur. "A Hospital Based Observational Assessment of the Role of Perfusion Index (PI) as a Predictor of Post Spinal Hypotension in Lower Segment Caesarean Section (LSCS)." International Journal of Current Pharmaceutical Review and Research 16, no. 05 (2024): 263–66. https://doi.org/10.5281/zenodo.12785824.
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AbstractAim: The aim of the present study was to assess the clinical evaluation of perfusion index (PI) as a predictor ofpost spinal hypotension in lower segment caesarean section (LSCS).Methods: The present study was conducted in the Department of Obstetrics and Gynecology, Gauri Devi Instituteof Medical Science & Hospital, Durgapur, West Bengal, India. Informed & written consent was obtained fromevery parturient who came for caesarean section. A total of 50 subjects were analyzed.Results: Out of 7 parturient had high standard PI (PI>3.5), 6 parturient foster hypotension, though out of 43parturient had low pattern PI (PI≤3.5), 10 parturient foster hypotension. The parturient with high & low standardPI, systolic pulse diminished altogether after spinal infusion. However, more prominent reduction in systolic pulseat 5-10 min & 25 min in parturient having high benchmark PI had after spinal infusion than parturient having lowstandard PI.Conclusion: Perfusion Index (PI) can be used to predict post spinal hypotension in healthy parturient undergoinglower segment caesarean section. Parturient higher risk of developing post spinal hypotension with baseline PImore than 3.5 compared to those with baseline PI less than 3.5.
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Devalla, Aditya Rameshbabu, Sanjot S. Ninave, and Amol P. Singam. "To Compare the Incidence of Post-Dural Puncture Headache Using 25G Quincke and 25G Whitacre Spinal Needles in Patients Undergoing Lower Segment Caesarean Section." Journal of Evolution of Medical and Dental Sciences 10, no. 14 (2021): 1014–19. http://dx.doi.org/10.14260/jemds/2021/217.
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BACKGROUND Spinal anaesthesia is the first preference of anaesthesia in obstetric surgery. Post dural puncture headache (PDPH) is more common after C-section in young parturients. In the present world which is developing and fast-paced, brisk recovery along with minimal side effects & importantly early ambulation are now the need of the hour. This headache is more worrying to the mother who is required to tend to the newborn baby. This study compared the incidence of PDPH subsequent to subarachnoid blockade for lower segment Caesarean section (LSCS) 25G Whitacre & 25G Quincke needles. We wanted to compare the incidence of PDPH using 25G Quincke and 25G Whitacre spinal needles in patients undergoing LSCS. METHODS Two hundred (ASA II) American Society of Anaesthesiologists 11 females who were pregnant and in the age group of 20 - 50 years, planned to get sub-arachnoid blockade for C-section, were assigned randomly into two equal groups (N = 100 each). Both groups received spinal anaesthesia with 25-gauge Quincke and 25 gauge Whitacre needle. Postoperatively, incidence, site, onset, severity and duration of headache was studied. RESULTS The incidence of post spinal headache was 6 % in the Quincke group. No patients in Whitacre group had PDPH. The number of lumbar punctures required for successful sub arachnoid block was recorded in both the groups. 92 % patients from group Q and 88 % patients from group W required only one puncture. 8 % patients from group Q and 12 % patients from group W required two punctures. CONCLUSIONS It is prudent to conclude that 25G Whitacre spinal needle is a better alternative to 25G Quincke needle for reducing the incidence of post dural puncture headache in patients undergoing lower segment Caesarean section. KEY WORDS Spinal Anaesthesia, Post Dural Puncture Headache, Caesarean Section
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Mac Sweeney, Claire, Paula Connolly, Adrian B. Brady, and Áine Cafferkey. "Anaesthetic management of a parturient with hereditary haemorrhagic telangiectasia (HHT) and pulmonary haemorrhage requiring urgent caesarean section." BMJ Case Reports 13, no. 1 (2020): e231120. http://dx.doi.org/10.1136/bcr-2019-231120.
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A 25-year-old gravida 3 para 3 with a history of hereditary haemorrhagic telangiectasia (HHT) and embolised pulmonary arteriovenous malformations (PAVMs) was admitted at 36 weeks gestation with haemoptysis, epistaxis and CT evidence of recent alveolar haemorrhage. An urgent caesarean section was planned. Both previous pregnancies had been delivered by elective lower segment caesarean section (LSCS) under subarachnoid block (SAB) at term. Preanaesthetic planning involved consultation with our tertiary maternity referral centre, the national HHT centre and our tertiary adult referral centre, which has interventional radiology and cardiothoracic capabilities. A whole spine MRI was carried out to rule out vascular malformation. Following multidisciplinary discussion, the decision was made to proceed with caesarean section in our hospital under SAB. Wide bore intravenous access was sited and blood product availability was ensured in case of acute pulmonary haemorrhage. The LSCS was uneventful. Postoperatively following discharge from the hospital, the patient experienced recurrent episodes of small volume haemoptysis, and had further PAVM embolisation in the national HHT centre. This report highlights the difficulties in managing complex parturients in a non-tertiary referral centre and underlines the importance of communication and multidisciplinary team discussion to determine the most appropriate management.
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Palaria, Urmila, Kamal Nayan Joshi, and Yeeti Upreti. "Achondroplasia and emergency caesarean section: A case report." Indian Journal of Clinical Anaesthesia 8, no. 1 (2021): 129–32. http://dx.doi.org/10.18231/j.ijca.2021.025.
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Achondroplasia is the commonest variety of rhizomelic dwarfism, which results from abnormal cartilage formation at epiphyseal growth plates. The peculiar facial features, bony deformities and systemic abnormalities often pose a difficulty in administration of anesthesia, particularly in the parturients. There are very few reported cases of spinal anesthesia in achondroplastic parturients, because of its feared high risks. We reported, two cases of achondroplastic parturients with short stature, planned for emergency lower segment caesarean section (LSCS), in view of cephalo-pelvic disproportion under spinal anesthesia. We discussed the anesthetic issues to achondroplastic parturients and finally did under spinal anesthesia. Besides, a myriad of problems encountered in these patients warrant a careful pre-anesthetic evaluation to warrant patients' safety and affirmative procedure outcomes.
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Paudel, Bandana, Sanjay Gautam, Sumitra Paudel, and Shailesh Poudyal. "Incidence of hypotension in lower segment Caesarean section - a comparison of intrathecal Fentanyl- Bupivacaine combination with Bupivacaine alone." Birat Journal of Health Sciences 9, no. 1 (2024): 98–103. http://dx.doi.org/10.62065/bjhs548.
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Introduction: After subarachnoid block with conventional heavy Bupivacaine, hypotension is the most common complication and is caused by decrease in systemic vascular resistance and/or cardiac output. Even with standard doses of the drug for parturient, there are evidences of severe hypotension and other complications despite adequate analgesia and anaesthesia. Adjuvants are used to enhance the quality of blocks with less complications. Objectives: It was to evaluate the effectiveness of combining bupivacaine and fentanyl for spinal anesthesia during lower segment Caesarean section (LSCS) as opposed to using bupivacaine alone for the incidence of hypotension. Methodology: This is a prospective study of 210 patients aged 18-35 years of American society of Anesthesiologists Physical Status II undergoing elective lower segment Caesarean section, randomly assigned to two groups: Group A, received a mixture of intrathecal 2ml of 0.5% Bupivacaine and 10 mcg Fentanyl(2.2ml) and Group B, received only 2.2 ml of Bupivacaine. Noninvasive blood pressure was checked at 1,2,4,6,10,20,40 and 60 min after subarachnoid block and then post-surgery. Results: The occurrence of hypotension was higher in Group B (26.6%) compared to Group A (8.6%). Conclusion: Our study suggests that the intrathecal Fentanyl-Bupivacaine combination is effective in reducing the incidence of hypotension after SAB for elective LSCS. Additional research is needed to determine this combination’s optimal dosage and timing.