DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20171760

A study of maternal morbidity associated with caesarean delivery in tertiary care hospital

Dasari Gayathry, Visweswara Rao Guthi, Sameer Bele, Achanta Vivekannada

Abstract


Background: Cesarean section is one of the most commonly performed surgical procedures in the world. Several studies have demonstrated that c/s poses a greater risk of maternal morbidity and mortality compared to vaginal delivery. Therefore, it is important to assess the morbidities associated with a c/s.

Methods: A hospital based, cross sectional study was conducted among 240 women during the period of March-May 2014. A semi-structured questionnaire was used to evaluate the socio-demographic characteristics, obstetrical characteristics, indications and complications following c/s.

Results: A total of 150 (62.5%) respondents underwent emergency c/s whereas 90 (37.5%) were having elective c/s. The most common indication for cesarean delivery was a previous c/s observed in 70 (29.2%). No postpartum morbidity was observed in 152 (63.3%) of the respondents, whereas 88 (36.7%) had reported some or other kinds of morbidities. Among the various maternal morbidities, postpartum anemia was the most commonly observed morbidity in 22 (9.2%) of the respondents, followed by postpartum hemorrhage by 10 (4.2%) and wound infection was observed in 15 (6.25%).

Conclusions: High maternal morbidity following c/s was observed in studied sample as more than one third of the women had shown some or other kinds of morbidities. Efforts should be made to evaluate the reasons for increasing c/s rate and to reduce the incidence of c/s by careful antenatal and intranatal management. 


Keywords


Cesarean delivery, Indications, Maternal morbidity

Full Text:

PDF

References


De Padua KS, OSIS MJD, Faunder A, Barbosa AH, Filho OBM. Factors Associated with Caesarean Section in Brazilian Hospitals. Rev Saude Publica. 2010;44(1)12-7.

Lee SI, Khang YH, Lee MS. Women’s attitudes towards mode of delivery in a society with high caesarean section rates. Birth. 2004;31:108-16.

UNICEF, WHO, UNFPA, New York: United Nations Children’s Fund; 1997: 1.

AB Caughey. Reducing primary caesarian delivery: Can we prevent current and future morbidity and mortality. J Perinatol. 2009;29:717-8.

Kambo I, Bedi N, Dhillon BS, Saxena NC. A critical appraisal of caesarean section rates at teaching hospitals in India. Int J Gynaecol Obstet. 2002;79:151-8.

Bailey P, Lobis S, Maine D, Fortney J. Monitoring emergency obstetric care: a handbook: World Health Organization; 2009.

Begum I, Khan A, Nasreen, Khan S. Outcome of previous caesarean section. Pakistan J Med Res. 2004;43:130-3.

Sikandar R, Memon A. Maternal & perinatal outcome following emergency caesarean Brazil. Med Channel. 2005;11:68-70.

Ashraf R, Gul A, Bashir A, Tajammal A. Comparison of maternal complication in elective vs. emergency caesarean section. Ann King Edward Med Uni. 2006;12:288-90.

Mc Carthy FP, Rigg L, Cady L, Cullinane F. A new way of looking cesarean section births. Aust NZ J Obstet Gynecol. 2007;47:316-20.

Onankpa B, Ekele B. Fetal outcome following cesarean section in a university teaching hospital. J Natl Med Assoc. 2009;101:578-81.

Barber EL, Lundsberg LS, Belanger K, Pettker CM, Funai EF, Illuzzi JL. Indications contributing to the increasing caesarean delivery rate. Obstet Gynecol. 2011;118(1):29-38.

Santhanalakshmi C, Gnanasekaran V, Chakravarthyet AR. A Retrospective Analysis of Cesarean Section in a Tertiary Care Hospital. Int J Sci Res. 2013;4(9):2097-9.

Thakur V, Chiheriya H, Thakur A, Mourya S. Study of maternal and fetal outcome in elective and emergency caesarean section. Int J Med Res Rev. 2015;3(11):15.

Mukherjee J, Bhattacharya PK, Lahiri TK, Samaddar JC, Mehta R. Perinatal mortality in caesarean section: A disturbing picture of unfulfilled expectations. J Indian Med Assoc. 1993;91:202-3.

YifruBirhan, Ahmed Al. Emergency obstetrics performance with emphasis on a operative delivery outcome. Ethiopian J Health Development. 2004;18:96-106.

Jain M, Patel A. A cross sectional study of rate, indications and complications of primary caesarean section, Int J Reprod Contracept Obstet Gynecol. 2016;5(6):1814-9.

Ghazi A, Karim F, Hussain A, Ali T, Jabbar S. Maternal morbidity in emergency versus elective caesarean section at a tertiary care hospital. J Ayub Med Coll Abbottabad. 2012;24(1):10-3.

Saadia Z, Khan AZ, Naheed F. Comparison of maternal morbidity and mortality between emergency and elective lower segment caesarean section. Ann King Edward Med Uni. 2003;9:90–1.

Raees M, Yasmeen S, Jabeen S, Utman N, Karim R. Maternal morbidity associated with emergency versus elective Cesearn section. J Postgrad Med Inst. 2012;27(1):55-62.

Ko SY, Park SW, Sohn IS, Lee JY, Kwon HS, Hwang HS, et al. Interventional management for complications following C/S published on line before print. Br J Radiol. 2010.84:204–9.

Pomela J, Bains H, Vidhushi B, Annika J. A Comparison of Maternal and Fetal Outcome in Elective and Emergency Caesarean Sections - Indian Obstetrics and Gynecology. Indian Obstet Gynecol. 2012;2(3). Available at http://iog.org.in/

index.php/originalarticles-issue-july-september-2012/73-a-comparison-ofmaternal-and-fetal-outcome-in-elective-and-emergencycaesarean-sections?showall=1&limitstart=. Accessed on 20 December 2016.

Daniel S, Viswanathan M, Simi BN, Nazeema A. Study of Maternal Outcome of Emergency and Elective Caesarean Section in a Semi-Rural Tertiary Hospital. Natl J Med Res. 2014;4(1):14-8.

Soltan MH, Chowdhury N, Adelusi B. Postoperative febrile morbidity in elective and emergency caesarean sections. J Obstet Gynecol. 1996;16(6):508-12.

Souza JP, Gülmezoglu A, Lumbiganon P, Laopaiboon M, Carroli G, Fawole B, et al. WHO Global Survey on Maternal and Perinatal Health Research Group. Caesarean section without medical indications is associated with an increased risk of adverse short-term maternal outcomes: the 2004-2008 WHO Global Survey on Maternal and Perinatal Health. BMC Med. 2010;8:71.