Online ISSN: 2515-8260

Keywords : LSCS


To Study Upright Position And Dorsal Position During Labor And Their Effect On Maternal And Perinatal Outcome

Shrinivas N. Gadappa Shrutika O. Makde Ankita R.Shah

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 620-633

Women have described birth as an intense powerful life experience that affects their whole life and being, making childbirth the most significant events in their life1. Earliest records of maternal birth positions show the parturient in an upright posture, but over centuries delivering women in upright position has become a lost art2. Current evidence-based practices for management of the second stage of labor supports the practices of delayed pushing, spontaneous pushing, and maternal choice of positions3, 4. About 19,340 deliveries are conducted in our tertiary care center of mothers with traditional values and receptive to adopting various birthing positions. Thus, this study is conducted at our tertiary care institute to compare the various alternative birthing positions and their effects on maternal and perinatal outcome. Objectives-1.To study duration of labor in upright and dorsal position.2.To study maternal outcome in upright and dorsal position.3.To study fetal outcome with respect to APGAR score and need for neonatal resuscitation.4.To study mothers experience and acceptability by visual analogue scale. Material and Methods-A prospective observational study was conducted after ethical clearance in a tertiary care center among 800 mothers admitted to labor room, who were fitting into inclusion criteria and who gave their consent for participation. The data was maintained, compiled and analyzed. Result- Upright position is associated with significant reduction in the duration of second stage of labor in primipara as well as multipara. The rate of episiotomy, LSCS and instrumental delivery is significantly reduced in mothers opting for upright birthing position. When given a choice, mothers readily adopted the upright position as it had an advantage of “being in control” of the birthing process and is associated with decreased pain perception

Clinical study of various intraoperative complications observed during lower segment caesarean section surgeries at a tertiary care hospital

Pankaj Narayan Baravkar, Tanavi Pankaj Baravkar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2277-2282

Background: The cesarean section increases the likelihood of requiring a blood transfusion, the risk of anesthesia complications, organ injury, infection, and thromboembolic disease. Present study was aimed to study, various intraoperative complications observed during lower segment caesarean section surgeries at a tertiary care hospital.
Material and Methods: Present study was retrospective, descriptive study, medical records of women had intraoperative surgical complication/s duringLSCS surgeries at our hospital were analysed.
Results: Incidence of intraoperative complications was 4.87 % (104 out of 2134 LSCS surgeries). Majority were from 26-30 years age group (38.46 %), had parity 1 (46.15 %), had history previous 1 LSCS (38.46 %) & previous 2 LSCS (33.65 %). Common risk factors noted were Obesity (BMI > 25 kg/m2) (37.5 %), hypertensive disorders of pregnancy (20.19 %), Anaemia (19.23 %), previous laparotomy (17.31 %) & h/o intraoperative complication in previous LSCS surgery (16.35 %). In cases with previous LSCS, common indication was impending scar dehiscence (34.62 %) followed by elective LSCS for previous ≥ 2 LSCS (25 %), Antepartum Hemorrhage - Placenta previa (10.58 %), Fetal Distress (9.62 %), Obstructed Labour / Second stage LSCS (8.65 %). Intra-operative complications noted were extension of uterine incision (37.5 %), Dense uterine adhesions (35.58 %), intra operative atonic post-partum haemorrhage (28.04 %), scar dehiscence (18.27 %), bleeding from placental bed (14.42 %), bladder injury (3.85 %), Injury to inferior epigastric vessels (2.88 %), placenta accreta spectrum (1.92 %) & bowel injury (0.96 %). Maternal mortality was observed in 2 cases (1- placenta accreta, 1 – post-partum hemorrhage)
Conclusion: Pregnant women posted for LSCS with pre-operative high-risk factors such as obesity, hypertensive disorders of pregnancy (20.19 %), history of previous laparotomy/intraoperative complication in previous LSCS surgery are prone for intraoperative complications. 
LSCS, obesity, intraoperative complication, previous LSCS surgery 

COMPARATIVE STUDY OF FETOMATERNAL OUTCOME IN PATIENTS UNDERGOING SELECTIVE VS EMERGENCY C SECTION AT A TERTIARY CARE HOSPITAL

Togarikar Sopanrao malharrao

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 1974-1982

Background: Caesarean section or caesarean delivery is defined as the birth of a fetus through incisions in the abdominal wall (Laparotomy) and the uterine wall (Hysterotomy). This definition does not include removal of the fetus from the abdominal cavity in the case of rupture of uterus or in case of an abdominal pregnancy. Caesarean section can be considered one the earliest forms of modern birth technology Aim & Objective: 1.To study the maternal morbidity, mortality, perinatal outcome in patients, undergoing elective and emergency C-section. 2.To compare the maternal morbidity, mortality, perinatal outcome in patients, undergoing elective and emergency Csection. Method: Study design: Prospective study. Study setting: Department of Obstetrics and Gynecology at tertiary care centre. Study duration:……..Study population: The study population included all the women undergoing elective c-section and emergency c-section. Sample size: Results: In Group A: 44% of patients are in the age group of 18-24years and in Group B: 74% of patients are in the age group of 18-24years. A statistically significant value of P=0.01, is obtained suggesting most of the patients undergoing C-section (elective/emergency) are in age group of 18-24years. Strongly significant (P value: P<0.01). The most common risk factor is Previous LSCS. 14(28%) patients had previous LSCS in Group A (Elective C-Section) and 7(14%) patients had previous LSCS in Group B (Emergency C-Section). From the above graph, it can be observed that the patients with risk factor of Previous LSCS are more common with Elective C-Section group compared to Emergency C-Section group. Post-operative complications in Caesarean section were more in Emergency Caesarean Section when compared to Elective caesarean section. PPH is the most common in Emergency group when compared to Elective group. Wound infection is the 2nd most common complication in Emergency group. Conclusions: The factors associated with caesarean section are age, parity, multiple pregnancy, maternal weight gain, and birth weight. Including these factors, the caesarean section is justified under certain circumstances such as cephalo pelvic disproportion and contracted pelvis, dystocia due to soft parts, inadequate uterine forces, antepartum hemorrhage, pre- eclamptic toxemia, eclampsia, fetal distress and prolapse of the cord, malpresentation, maternal distresses such as heart problems, bad obstetric history, habitual intrauterine death of the fetus and elderly primigravida.

STUDY OF INTRAOPERATIVE COMPLICATIONS OBSERVED IN LOWER SEGMENT CAESAREAN SECTION (LSCS) SURGERIES AT A DISTRICT HOSPITAL.

Dr. Pooja Gupta

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 4073-4078

Background: Caesarean section is probably the most common surgical procedure carried out in the field of obstetrics in both industrialized and low-income countries.The risk of complications increases with increasing number of cesarean sections with subsequent adverse fetal and maternal. Present study was aimed to study various intraoperative complications observed in lower segment caesarean section (LSCS) surgeries at a District hospital.
Material and Methods: Present study was hospital based, prospective, observational study, conducted in LSCS surgeries conducted at our hospital, had intraoperative surgical complication/s.
Results: Incidence of intraoperative complications was 2.78 %. Incidence of Intraoperative complications were more previous 2 LSCS cases (34.02 %), followed by previous 1 LSCS cases (39.18 %), previous 3 LSCS cases (5.15 %), as compared to primary CS (9.28 %). Intra-operative complications noted were extension of uterine incision (32.99 %), difficult delivery (27.84 %), intra operative atonic post-partum haemorrhage (21.65 %), scar dehiscence (14.43 %), bleeding from placental bed (11.34 %), bladder injury (4.12 %) & placenta previa (3.09 %). Cases were managed with combination of various surgical interventions such as obstetric hysterectomy, step wise devascularization, uterine compression sutures, bladder repair, & transfusion of blood. Among those cases mortality was observed in 1 case(post-partum hemorrhage).
Conclusion: Preoperative assessment by history, previous records, ultrasonography (placental location & invasion) with intraoperative readiness for additional procedures is need of hour to reduce morbidity & mortality in patients undergoing LSCS.

Prospective observational study of outcome of meconium stained amniotic fluid in newborn

Dr. Hardik R Parmar, Dr. Pankti D Desai, Dr. Sunil C Chand, Dr. Harsha M Makwana, Dr. Naresh C Rathva

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1179-1186

Background: The presence of meconium stained amniotic fluid (MSAF) is a serious sign of fetal compromise, which is associated with an increase in perinatal morbidity, clear amniotic fluid on the other hand is considered reassuring. A study by Mathews and Warshaw found that in 98.4% of cases with meconium stained liquor, the neonates were admitted to the neonatal intensive care units, these were delivered at 37 weeks of gestational age or later as it shows maturation of autonomic nervous system. MSAF occurs in 10% of pregnancies with most occurring at term or particularly post term. The purpose of this study was to evaluate the effect of clear liquor and meconium stained liquor on time and mode of delivery and to find out neonatal morbidity and mortality associated with meconium stained amniotic fluid.
Aim: To correlate the maternal and neonatal factors contributing to morbidly related to Meconium stained amniotic fluid.

Clinical study of fetomaternal outcome of postdated pregnancy in a tertiary care center

Dr. Chaitali R Pandav, Dr. Varsha L Deshmukh, Dr.Shrinivas Gadappa, Dr.PratikshaKandalkar .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1741-1748

Background: Postdated pregnancy is one of the commonest obstetric condition. The pregnancy beyond 40 weeks of gestation is called as post dated pregnancy. Post dated pregnancy increases risk to mother and fetus. In mother there is increased risk of induced labour, instrumental delivery and LSCS and associated morbidities. The risks to the fetus also increases inpostdated pregnancy mainly due to increasing fetal weight, decline in placental function, oligohydramnios which increase chances of cord compression, and meconium aspiration.
Methods: This cross sectional observational study of feto-maternal outcome in post dated pregnancy (Women beyond 40 weeks of gestation) was carried out in the department of obstetrics and gynaecology in tertiary care centre from October 2019 to September 2021, willing to participate and fulfilling the inclusion and exclusion criteria in the study period. Results:  Out of total 300 patients,118 patients (60.82%) went into spontaneous labour and delivered vaginally, whereas 102(34%) patients required caesarean section. Induction of labour was done  in 76(39.17%) patients.Conclusions: The present study, we conclude that, the post dated pregnancy can be considered as a high risk factor as there is more fetal morbidity.

To Study Upright Position And Dorsal Position During Labor And Their Effect On Maternal And Perinatal Outcome

Shrinivas N. Gadappa, Shrutika O. Makde, Ankita R.Shah .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2637-2645

Women have described birth as an intense powerful life experience that affects their whole life and being, making childbirth the most significant events in their life1. Earliest records of maternal birth positions show the parturient in an upright posture, but over centuries delivering women in upright position has become a lost art2. Current evidence-based practices for management of the second stage of labor supports the practices of delayed pushing, spontaneous pushing, and maternal choice of positions3,4.About 19,340 deliveries are conducted in our tertiary care center of mothers with traditional values and receptive to adopting various birthing positions. Thus, this study is conducted at our tertiary care institute to compare the various alternative birthing positions and their effects on maternal and perinatal outcome. Objectives-1.To study duration of labor in upright and dorsal position.2.To study maternal outcome in upright and dorsal position.3.To study fetal outcome with respect to APGAR score and need for neonatal resuscitation.4.To study mothers experience and acceptability by visual analogue scale. Material and Methods-A prospective observational study was conducted after ethical clearance in a tertiary care center among 800 mothers admitted to labor room, who were fitting into inclusion criteria and who gave their consent for participation. The data was maintained, compiled and analyzed. Result- Upright position is associated with significant reduction in the duration of second stage of labor in primipara as well as multipara. The rate of episiotomy, LSCS and instrumental delivery is significantly reduced in mothers opting for upright birthing position. When given a choice, mothers readily adopted the upright position as it had an advantage of “being in control” of the birthing process and is associated with decreased pain perception.