Clinical study of various intraoperative complications observed during lower segment caesarean section surgeries at a tertiary care hospital
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 2277-2282
AbstractBackground: 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
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