Abstract
Introduction- Caesarean section is the most commonly performed major emergency surgical procedure in Obstetrics. With the improved caesarean skill of the obstetrician and techniques of anesthesia, the caesarean section has become a safe surgical procedure .The rate of caesarean section has shown progressive rise in last three decades in most part of the world .The immediate operative morbidity and the likelihood of complications in subsequent pregnancies, raise question marks regarding rising caesarean section rates.Material and methods- Retrospective analysis of 3980 caesarean sections performed at tertiary care teaching hospital over six years period, was undertaken to find out the rate of caesarean sections, indications and associated maternal morbidity and mortality .Results-The rate of caesarean section was in between 20 and 22 percent ,during the study period .The rate has been fairly constant throughout the study period. The common indications were previous caesarean section, fetal distress, cephalopelvic disproportion, pre-eclampsia or antepartum haemorrhage. Anemia and urinary infections resulted in postoperative febrile morbidity. Incidence of wound related complications were not significant .There were twelve maternal deaths ,of which six were due to severe uncontrolled hemorrhage from placental bed during caesarean section.Conclusion-Caesarean section rate can be maintained at acceptable limits by judicious selection of cases, allowing vaginal births after caesarean sections, external cephalic versions , assisted vaginal breech deliveries in selected cases and proper interpretation of results of electronic fetal monitors. Pain relief by epidural analgesia can reduce the fear of labour and rate of elective caesarean sections.
Highlights
Caesarean section is the most commonly performed major emergency surgical procedure in Obstetrics
It has added to the maternal morbidity and mortality .With this background, present study was carried out to analyze the data related to caesarean deliveries performed at a tertiary care teaching hospital located in rural area of Maharashtra
Caesarean section rate was highest in primigravidas and it came down subsequently with every subsequent pregnancy. (Table.2) Seventy four percent women were booked and had adequate number of antenatal visits. (Table.3) Most of the caesarean sections (92%) were done as an emergency procedure. (Table.4) Sixty six percent caesarean sections were performed under spinal anaesthesia and remaining under general anaesthesia It was observed that the rate of caesarean section was fairly constant during six years study period
Summary
Caesarean section is the most commonly performed major emergency surgical procedure in Obstetrics. It has added to the maternal morbidity and mortality .With this background, present study was carried out to analyze the data related to caesarean deliveries performed at a tertiary care teaching hospital located in rural area of Maharashtra. (Table.1) Seventy five percent of women were having either first or second pregnancy at the time of caesarean section.
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