Complication Of Cesarean Section Research Articles

Органосохраняющие технологии при гнойных воспалительных осложнениях кесарева сечения

Органосохраняющие технологии при гнойных воспалительных осложнениях кесарева сечения

Prevalence of Early Maternal Complications of Cesarean Section and its Relationship with Body Mass Index in Fatemieh Hospital of Hamadan

Prevalence of Early Maternal Complications of Cesarean Section and its Relationship with Body Mass Index in Fatemieh Hospital of Hamadan

Obstetrics Outcome after a Nutritional Health Education Program for Pregnant Females at Zagazig University Hospitals; An Interventional Study

Background: Nutrition during pregnancy is an important element for the pregnant women and their developing fetus, they must take enough calories and nutrients to provide the essential requirements for both themselves and their fetus and to prevent complications of abnormal weight gain in pregnancy. Objectives: To determine the effect of the nutritional health education program on changing knowledge, attitude, and practice towards a healthy lifestyle during pregnancy, obtaining optimal weight gain and consequently its effect on maternal and fetal outcomes. Subjects and Methods: An interventional study (pre-post test), in Zagazig university antenatal care outpatient clinic was conducted. Subjects' Criteria: 135 pregnant females in the first trimester aged 18-35 years who did not have any chronic medical disorder with Body Mass Index between 18.5 and 24.9 kg/m2 were enrolled. Methods: Data collection was done using a semi-structured questionnaire about females’ socio-demographic characteristics, obstetric, family and clinical history. Health education sessions were applied to the pregnant females and their knowledge, attitude, and practice about healthy nutrition were assessed before and after the intervention. Ultrasound was performed, maternal and fetal outcomes were detected. Results: This study was conducted on 135 pregnant females from whom 9 cases had excluded at the time of delivery due to the detection of ultrasound abnormalities and 16 women were dropped out during the follow-up period. After the nutritional education program, the proportions of adequate knowledge, attitude, and practice were increased from (28.2% to 77.3%), (8.2% to 75.5%) and (32.7% to 77.3%) respectively (p-value <0.001). There was a statistically significant higher cesarean section, Intra and post-partum complications (85.7%vs 42.9%p<0.001), (71.4% vs17.2% p<0.001) and (25.7%vs7.1% p=0.008) [Odds (95% C.I); 8 (6.7-11.3), 12.1(11.7-13.9) and 4.5(1.2-8.7)], higher neonatal weight and neonatal blood glucose (p<0.001& 0.009) in over-weight versus optimal weight gain groups respectively. Conclusion: The intervention was effective in increasing pregnant females’ knowledge, attitude, and practice towards healthy nutrition during pregnancy, obtaining optimal weight gain and improving maternal and fetal outcomes.

Investigating the Relationship Between Personality Dimensions and Choice of Type of Delivery in Patients Referred to Hazrat Abolfazl Hospital in Minab County

Background: Human choices and decisions are highly affected by some psychological and personality traits. These psychological characteristics may also be related to the choice of delivery type. Therefore, the present study aimed to investigate the relationship between personality dimensions and choice of delivery type (cesarean section or normal) in pregnant women referred to Abolfazl hospital in Minab county, Iran, in 2018. Materials and Methods: This is a cross-sectional descriptive study. The statistical population consisted of all pregnant women referred to Abolfazl medical center in 2008 in Minab, 118 of whom were selected by convenience sampling. The NEO Five-Factor Inventory (NEO-FFI) was used to collect the data. Results: There was a significant difference in the choice of delivery type (normal and cesarean section) in pregnant women with extraversion and conscientiousness personality traits (P value <0.05). The mean extraversion and conscientiousness scores were higher in patients who tended to have a vaginal delivery than in those who had chosen cesarean section. Conclusion: The results of the present study show that personality traits can determine the type of delivery by creating specific moods; therefore, considering the high level of complications of cesarean section (CS) and high CS rate in Iran, we can change people’s attitudes and play a role in reducing the number of CSs through long-term training.

Comparison Of Three Different Treatment Methods For Cesarean Scar Pregnancy.

Background/AimCesarean scar pregnancy is a long term complication of cesarean section. There is a lot of controversy about the best treatment methods. We retrospectively summarized the clinical characteristics of patients with cesarean scar pregnancy and explored the advantages and disadvantages of fertility-preservation treatment method.MethodsFrom January 2008 to September 2017, a total of 204 cases of cesarean scar pregnancy were retrospectively reviewed. 145 patients underwent transvaginal clearance, 33 patients underwent endoscopic surgery, and 26 patients underwent uterine artery embolism. The clinical characteristics, diagnosis, various treatment methods, and clinical outcomes were analyzed.ResultsThere were no significant differences among the three groups in terms of patient age, number of previous cesarean sections, serum human chorionic gonadotropin, and clinical symptoms. The difference in mean gestational sac diameter (23.5±2.1mm vs 31.3±2.4mm vs 30.8± 1.9mm), surgical time (31.4±2.5min vs. 45.8±2.2min vs. 51.4±1.9min), blood loss (53.3± 5.5mL vs. 105.2±3.2mL vs. 75.6 ±3.5mL), blood transfusion (1/145 case vs.3/33 case vs. 0/26 case), discomfort (1/145 case vs.9/33 case vs. 16/26 case), hospital stay (6.1±1.1 day vs. 7.4±0.9 day vs.18.6±1.5 day), fever duration (1.0±0.5 day vs. 2.1±2.8 day vs. 5.7±3.5 day), and hospital expense (¥ 7825.9±234.9 vs. ¥ 10248.3± 312.9 vs. ¥ 18774.9±243.6) in transvaginal pregnancy tissue clearance, endoscopic surgery, and uterine artery embolism groups were significantly different.ConclusionTransvaginal clearance is an effective and relatively safe treatment option for patients with cesarean scar pregnancy.

Prophylactic negative pressure wound therapy for surgical site infection in obese women undergoing cesarean section: an evidence synthesis with trial sequential analysis

Objective Current evidence for negative pressure wound therapy (NPWT) on surgical site infection (SSI) and wound complications in cesarean section is conflicting. The objective of this study was to evaluate the efficacy of prophylactic NPWT for preventing SSI and other wound complications in obese women undergoing cesarean section (CS). Methods We systematically searched PubMed, Embase, the Cochrane Library and clinicaltTrial.gov to identify randomized controlled trials (RCTs) that compared NPWT with standard dressing for cesarean section. The primary outcome was SSI. Secondary outcomes were overall wound complications and hospital readmission. Risk ratio (RR) with 95% confidence intervals (CIs) was calculated using random-effects models. Review Manager 5.3 was applied to analyze the collected data. Results Eight RCTs involving 1972 patients were included in this meta-analysis. The pooled results showed that the risk of SSI was significantly lower with the use of NPWT when compared with standard dressing (RR = 0.68, 95%CI = 0.51–0.90, p = .008). However, there was no difference in overall wound complications (RR = 0.93, 95%CI = 0.74–1.17, p = 0.52) and hospital readmission (RR = 1.03, 95%CI = 0.67–1.60, p = .89) between two groups. Current evidence was not confirmed by trial sequential analysis. Conclusion On the basis of our findings, NPWT decreases the risk of SSI after cesarean section in obese women after CS, despite this approach does not reduce the overall wound complications and hospital readmission. However, further RCTs are needed to make conclusive evidence.

Comparative analysis of neonatal sequelae after classic M. Stark and modified cesarean section

Over the last twenty years, a sharp perinatal birth rate has registered high perinatal morbidity and mortality in the country. Despite the fact that the number of cesarean sections is constantly increasing, the perinatal mortality rate in the country remains positive and in 2017 was 7.9%%. The purpose of the study was a comparative analysis of the features of the course of the early neonatal period and the frequency of neonatal complications in classical cesarean section according to M. Stark and according to a modified method for improving perinatal outcomes. The selection of patients for the comparative study was performed by type of surgery (classic M. Stark technique or modified technique), which was conducted at the clinical basis of the Department of Obstetrics and Gynecology №1 ONMedU for the period from 2015 to 2018 according to a randomized principle in the obstetric department of the Kherson Regional Clinical Hospital (clinical base of the Department of Obstetrics and Gynecology No. 1 ONMedU). The formation of clinical groups was carried out according to retrospective data from 205 birth histories, the delivery of which was carried out by caesarean section. Statistical processing of the results was carried out using application R of the Microsoft Exel 2003 program. Analysis of quantitative indicators was analyzed using the arithmetic mean value (M) and the error in determining the average value (± m). Qualitative indicators were measured in absolute and relative (percentage) values. The significance of differences in the parametric characteristics in the appropriate groups was evaluated using Student's t test (t - test) and analysis of variance (ANOVA). In the calculations, the differences were considered statistically significant at p <0.05 (95% confidence level (CI) and at p <0.01 (99% confidence level). By using modified access to the abdominal cavity, which involved grasping the peritoneum with the index finger and stretching all layers of the anterior wall in a blunt fashion by two surgeons at the same time, it was almost twice possible to reduce the time to fetal extraction in the main study group (p˂0.001). The condition of newborns on the Apgar scale at 1 and 5 minutes of life in the first clinical group of the study was better (p=0.005). Due to the modified features of fetal extraction, it was possible to reduce the incidence of HID CNS in newborns (p=0.022), to 6 times reduce the need for treatment at the III level (p=0.004). The indicator of early neonatal mortality in the newborns of the first clinical group was zero, whereas in the comparison group 2 cases were recorded. However, the difference is not significant (p=0.223). Thus, the modified Caesarean section improves the overall condition of the newborns according to the Apgar scale at 1 and 5 minutes of life, is accompanied by a decrease in the frequency of some complications in the early neonatal period, creates a certain additional reserve for the improvement of perinatal complications and requires further comprehensive studies.

Isthmocele: A Review of Management Options for This Novel Entity

The incidence of cesarean section is on rise all over the world and so are the complications associated with the procedure. Isthmocele as a complication of cesarean section is becoming a well documented entity all over the world in medical literature. It presents with symptoms like prolonged post menstrual bleeding, chronic pelvic infection and infertility. A pregnancy can get lodged in this area and can have disastrous consequences for the patient. The present article is an attempt to review to various presenting complaints, diagnosis and management of Isthmocele.International Journal of Human and Health Sciences Vol. 03 No. 03 July’19. Page: 127-133

Repeat Caesarean Sections: Complications and Outcomes

Background: The rising incidence of caesarean section all over the world has been of great concern both to the patients and obstetrician.1 Repeat caesarean section is one of the major reasons which have contributed greatly to high caesarean section (CS) rate.1,2 Although maternal death as a result of CS is now rare, reports of the short-and long-term consequences of the rising CS rate on the childbearing population are conflicting.3 Available data show that repeat caesarean section is associated with many maternal complications, specially intra-abdominal adhesions, central placenta praevia, uterine rupture, caesarean scar pregnancy, caesarean hysterectomy etc.4
 Objective: To evaluate outcome and complications of multiple repeat caesarean section.
 Methodology: This was a cross sectional prospective study conducted in Shaheed Suhrawardy Medical College Hospital (ShSMCH) from 1st June’2016 to 30th November’2016 for a period of six months. The study population were 102 patients, selected randomly who were admitted in ShSMCH for repeat caesarean section.
 Results: Out of 102 patients admitted with history of previous caesarean section, maternal morbidity was 26 (25.49%), which includes intra-abdominal adhesions 19 (18.62%), excessive blood loss 6(5.88%), placenta praevia 4 (3.94%), placenta accreta 1 (.98%), postpartum haemorrhage 11 (10.78%), wound infection 12 (11.76%) etc.
 Conclusion: As the rate of repeat caesarean section continue to rise, surgeons should be more judgemental in doing caesarean section.
 J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 74-79

Cost analysis for deliveries according to maternal age classes for moving to a personalized approach in the health care

Objective: In the last decades, childbearing has moved to higher ages, displaying adverse outcomes related to advanced maternal age at birth. Accordingly, the aim was to perform a cost analysis in women admitted for birth assistance and segregated by age classes (<20, 20–24, 25–29, 30–34, 35–39, 40–45, and ≥45 years). Methods: A total of 18,093 admitted for assistance at delivery in a 5-year period (2012–2016) were included in the analysis. Costs for obstetric complications in vaginal delivery (VD) and cesarean section (CS), based on hospital discharge report from the local health care system, were calculated by using the “diagnosis-related group” (DRG) approach. Results: An overall economic cost due to clinical assistance at delivery of €42.663.481 was computed. A global rate of 59.6% of vaginal deliveries (VD) and 40.4% of cesarean section (CS) was assessed. Among of all maternal age classes, women attributable to classes 30–34 and 35–39 years reached a rate of 62.8%, while values of 24.2 and 13% were observed for those under 30 and over 40 years of age, respectively. A significant increasing trend in terms of maternal stay duration was found across all age groups (from 4.7 to 5.4 days, p < .05), as well as nonspecific delivery costs (from €2.222.49 to €2.401.29, p < .05). Uncomplicated VD decreased across the groups, until to halve between two extreme maternal age groups (38.8 versus 18.6%, p < .05), while a three-fold risk of CS complications was calculated in women over 45 years-old in comparison with those under 20 years of age (4.2 versus 13.9, p < .05), although not significantly different in the cost analysis between two extreme age groups. Conclusions: Increases in maternal age at delivery are associated with higher healthcare costs, driven largely by additional complication rates, irrespective of the delivery mode.

Clinical and anamnestic, pre- and intraoperative predictors of maternal and neonatal complications of cesarean section

Clinical and anamnestic, pre- and intraoperative predictors of maternal and neonatal complications of cesarean section

Surgical complications of cesarean section

Introduction/Objective. Cesarean section birth rate has been constantly increasing worldwide over the last decades. The complications of cesarean section that require relaparotomy are rather serious and relatively rare. The aim of this paper is to present the incidence of surgical complications after Cesarean section at the Clinic of Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, Serbia, during a three-year period (2013?2015). Methods. This is a retrospective study. Data obtained from the medical records/histories were used and processed according to descriptive statistical methods. Results. During the observed period, relaparotomy was necessary in 29 (0.44%) women who had a CS. Relaparotomy was performed due to clinically and ultrasonographically evidenced hematoma of the anterior abdominal wall, retroperitoneal hematoma, hemoperitoneum, and development of hemorrhagic shock, complete wound dehiscence or diffuse peritonitis. There were no lethal outcomes after CS followed by these complications at the Clinic of Gynecology and Obstetrics, Clinical Center of Serbia in Belgrade. Conclusion. The incidence of relaparotomy in our study is similar to other tertiary institutions, as well as the indications for relaparotomy. While generally observed mortality rate after post-cesarean relaparotomy in developed countries is 2.7%, in our study there were no lethal outcomes.

Maternal Complications of Caesarean Section in a Resource-Limited Country: The Case of the Maternity Unit of Kankan Regional Hospital, Guinea

Introduction: Innovations in surgical and anaesthetic techniques to provide a good maternal and child safety have made the cesarean section a routine intervention in obstetrics. However, its complications, especially the short or long term per and postoperative maternal ones, are not exceptional and can affect mothers’ vital prognosis. The objectives of this study were to describe the maternal per and postoperative complications encountered during the cesarean section. Patients and method: This is a prospective, descriptive and analytical study carried out at the maternity ward of Kankan Regional Hospital over a 6 month period from January 1, 2018 to June 30, 2018. Results: During this period, out of a total of 2229 deliveries, 319 caesarean sections were performed i.e. a rate of 12.51%. Complications concerned 111 patients (34.79%). The average age was 28 with extremes of 15 and 45. Non-medical transportation concerned 71.17% of our patients. The cesarean section was performed in emergency situations in 82.8% of cases. Indications were dominated by the fetopelvic disproportion. There was a statistically significant relationship between labour duration and the occurrence of complications. Intraoperative complications were dominated by bleeding (25.22% of all complications and 8.77% of total cesarean sections). Post-operative complications were dominated by parietal suppurations (94.49% of all complications and 34.79% of the total number of cesarean sections). In most cases, patients simultaneously developed several complications. Conclusion: The maternal complications of cesarean sections remain considerable. If the increase in the rate of caesarean sections has contributed to the improvement of the mother-fetal prognosis, the surgical procedure itself is not without complications, which encourages us to review its indications for a better management. Hemorrhagic and infectious complications were the most frequent. These results call for increased asepsis measures in our operation theaters to reduce infectious complications. The increase in Caesarean section rates over the years is faced with increased maternal morbidity in the short and long term. Its indications should be well thought out and should include the responsibility of an experienced obstetrician.

Factors associated with a low prevalence of exclusive breastfeeding during hospital stay in urban and semi-rural areas of southern Vietnam

BackgroundThere is a paucity of data regarding risk factors associated with suboptimal breastfeeding practices in urbanized areas of low-middle income countries (LMICs).MethodsThrough a large prospective birth cohort, which enrolled 6706 infants in Vietnam between 2009 and 2013, we investigated the practice of exclusive breastfeeding during hospital stay in urban and semi-rural populations and aimed to identify factors associated with suboptimal breastfeeding practices. Univariate and multivariable logistic regression were performed to determine factors associated with not exclusive breastfeeding during hospital stay.ResultsOf 6076 mothers, 33% (2187) breastfed their infant exclusively before hospital discharge; 9% (364/4248) in urban and 74% (1823/2458) in semi-rural areas. Exclusive breastfeeding up to 4 months was recorded in 15% (959/6210) of participants; this declined to < 1% (56/6093) at 6 months. Delivery by Caesarean section (Odds Ratio [OR] 0.07; 95% Confidence Interval [CI] 0.04, 0.11 and OR 0.05; 95% CI 0.03, 0.08) and neonatal complications (OR 0.2; 95% CI 0.07, 0.47 and OR 0.25; 95% CI 0.14, 0.46) were common and highly significant risk factors associated with a lack of exclusive breastfeeding during hospital stay in urban and semi-rural settings, respectively.ConclusionsTo our knowledge, this is the first large-scale investigation aimed at identifying factors associated with exclusive breastfeeding during hospital stay in Vietnam. Breastfeeding promotion strategies should prioritize common risk factors in hospital, such as Caesarean section and neonatal complications, and other location specific factors associated with socioeconomics.

Maternal mortality after cesarean section in the Netherlands.

Maternal mortality is rare in high-resource settings. This hampers studies of the association between maternal mortality and mode of birth, although this topic remains of importance, given the changing patterns in mode of birth with increasing cesarean section rates in most countries. Purpose of this study was to examine incidence of cesarean section-related maternal mortality in the Netherlands and association of surgery with the chain of morbid events leading to death. We performed a retrospective cohort study using the Confidential Enquiry into Maternal Deaths, including all 2,684,946 maternities in the Netherlands between January 1st, 1999, and December 31st, 2013, registered in the Dutch Perinatal Registry. All available medical records of cases reported to the Dutch Maternal Mortality and Severe Morbidity Audit Committee were assessed by two researchers, and one or two additional experts in case of contradicting opinions, based on a set of pre-identified clinical criteria. Main outcome measures were (1) incidence and relative risk of maternal death following cesarean section and vaginal birth and (2) incidence of death directly related to cesarean section and death in which cesarean section was one of the contributing factors. Risk of death after cesarean section was 21.9 per 100.000 cesarean sections (86/393,443) versus 3.8 deaths per 100.000 vaginal births (88/2,291,503): Relative Risk (RR) 5.7 (95% Confidence Interval [CI] 4.2-7.7). Death directly related to complications of cesarean section occurred in 8/86 women: 2 per 100,000 cesarean sections. With addition of 43 women in which cesarean section did not initiate, but contributed to the chain of events leading to mortality, risk of death increased to 13 per 100,000 cesarean sections (51/393,443; RR 3.4; 95%CI 2.4-4.8). At the start of cesarean section, pre-existing morbidity was present in 70/86 women (81.4%). Compared to vaginal birth, maternal mortality after cesarean section was three times higher following exclusion of deaths that had no association with surgery. In approximately one in ten deaths after cesarean section, surgery did in fact initiate the chain of morbid events.

ITS FREQUENCY AND INDICATIONS IN DHQ TEACHING HOSPITAL, SAHIWAL.

Introduction: Caesarean Section (CS) is a surgical procedure carried out for thedelivery of the baby when circumstances render the possibility of a safe vaginal birth. Thoughcaesarean section can be life-saving in many situations, its unnecessary use has become a globalhealth concern. For almost 3 decades, the ideal rate for caesarean sections was consideredto be between 10% and 15% but its consistently increasing frequency over the past years hasbrought it to limelight. Objective: To determine the frequency and indications of Caesareansection at DHQ Teaching Hospital, Sahiwal. Study Design: A Cross-sectional descriptive study.Setting: Department of Gynaecology and Obstetrics, DHQ Teaching Hospital, Sahiwal affiliatedwith Sahiwal Medical College, Sahiwal. Period: It was carried out over a period of 6 monthsfrom December, 2016 to May, 2017. Methods: All the caesarean sections carried out during thestudy duration were included. Both maternal and fetal indications were recorded. The patientsnot willing to participate were not included. Results: Out of the total, Caesarean Sectionaccounted for 44.7% of the total deliveries. 72.05 % were elective and 27.49% were emergencyprocedures. Most Common Indications were found out to be previous &gt;2 C-Sections (36.4%),previous 1 C-Section (28.3%). Rest of them were breech presentation (2.69%), obstructed labor(1.68%), fetal distress (2.6%), placenta previa (8.08%), APH (2.02%), post-dated pregnancy(4.04%), uterine rupture (7.56%) and others (6.58%). Conclusion: It was concluded that &gt;2previous C-Sections is the most common indication. The high frequency should be controlledby proper counselling and education of the mothers and families, regarding the complicationsof caesarean section.

CAESAREAN SECTION

Introduction: Caesarean Section (CS) is a surgical procedure carried out for thedelivery of the baby when circumstances render the possibility of a safe vaginal birth. Thoughcaesarean section can be life-saving in many situations, its unnecessary use has become a globalhealth concern. For almost 3 decades, the ideal rate for caesarean sections was consideredto be between 10% and 15% but its consistently increasing frequency over the past years hasbrought it to limelight. Objective: To determine the frequency and indications of Caesareansection at DHQ Teaching Hospital, Sahiwal. Study Design: A Cross-sectional descriptive study.Setting: Department of Gynaecology and Obstetrics, DHQ Teaching Hospital, Sahiwal affiliatedwith Sahiwal Medical College, Sahiwal. Period: It was carried out over a period of 6 monthsfrom December, 2016 to May, 2017. Methods: All the caesarean sections carried out during thestudy duration were included. Both maternal and fetal indications were recorded. The patientsnot willing to participate were not included. Results: Out of the total, Caesarean Sectionaccounted for 44.7% of the total deliveries. 72.05 % were elective and 27.49% were emergencyprocedures. Most Common Indications were found out to be previous &gt;2 C-Sections (36.4%),previous 1 C-Section (28.3%). Rest of them were breech presentation (2.69%), obstructed labor(1.68%), fetal distress (2.6%), placenta previa (8.08%), APH (2.02%), post-dated pregnancy(4.04%), uterine rupture (7.56%) and others (6.58%). Conclusion: It was concluded that &gt;2previous C-Sections is the most common indication. The high frequency should be controlledby proper counselling and education of the mothers and families, regarding the complicationsof caesarean section.

Complications among Mothers and New Born Due to Delivery Process in Selected Hospitals of Rupandehi District Nepal

Child birth is a universally celebrated occasion, yet everyday for thousands of women child birth is experienced not as a joyful event as it should be, but as a private hell that may even end in death. The objective of this study is to determine the complications of normal delivery and cesarean section on the mothers and new born. A descriptive study was conducted in two selected hospitals of Rupandehi district, Nepal. Data was collected as per pretested structured proforma from 550 respondents who were the mothers and new born delivered normally and through cesarean section randomly till the completion of sample size and analyzed by using SPSS, MANOVA and Chi-square test to determine associations between categorical variables. In a total of 550 deliveries,25.8% were cesarean delivery, 42.7% motherssuffered from delivery related complications, common were PPH (21.1%), prolonged labour (8.5%) and wound infection (7.6%). 35.5% of newborn had complications, common were respiratory distress (6.3%) and neonatal jaundice (4.2%). Delivery related complications were higher among Lower segment cesarean section compared to vaginal delivery in mothers and newborn.

Complications among Mothers and New Born Due to Delivery Process in Rupandehi District Nepal

Background: Child birth is a universally celebrated occasion, yet everyday for thousands of women child birth is experienced not as a joyful event as it should be, but as a private hell that may even end in death. The objective of this study is to determine the complications of normal delivery and cesarean section on the mothers and new born.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 who were the mothers and new born delivered normally and through cesarean section randomly till the completion of sample size and analyzed by using SPSS, MANOVA and Chi-square test to determine associations between categorical variables.Results: In a total of 550 deliveries,25.8% were cesarean delivery, 42.7% motherssuffered from delivery related complications, common were PPH (21.1%), prolonged labour (8.5%) and wound infection (7.6%). 35.5% of newborn had complications, common were respiratory distress (6.3%) and neonatal jaundice (4.2%).Conclusions: Delivery related complications were higher among Lower segment cesarean section compared to vaginal delivery in mothers and newborn.Keywords: Cesarean section; child birth; maternal complication; new born; vaginal delivery.

Diagnosis and Management of Bilateral Uterine Arteries Aneurysm during Puerperium

Background- Uterine artery pseudo aneurysm is a rare but it can be one of complication of cesarean section. If treated inadequately, it may cause profuse life-threatening postpartum hemorrhage. We report a rare case of bilateral uterine arteries pseudoaneurysm that lead to life threatening secondary postpartum hemorrhage. Case- 25 years old, PI, she underwent category 1 caesarean delivery, 55 days later she experienced recurrent massive attack of secondary postpartum hemorrhage. The diagnosis of bilateral uterine arteries aneurysm was made by CT angiograph. It was successfully treated by selective embolization of the bilateral uterine arteries.