AN OBSERVATIONAL STUDY ON INDICATIONS FOR PRIMARY CESAREAN SECTION AT A TERTIARY CARE CENTRE

Sanjana Kurimella, Subhashini Revu, Ratna Manjula Songa, Siddhartha Kancharla, Karuna Guguloth
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Abstract

Background: Caesarean section is the most commonly performed obstetric surgical procedure which with a suitable indication is potentially lifesaving. But it has many disadvantages for both mother and baby. Aims and Objectives: Hence, the present study is taken up to analyze various indications of primary cesarean section in a tertiary hospital, with an aim to reduce the C-section rate. Material and Methods: This is a Retrospective Observational study conducted at GGH Guntur, a tertiary care center, for 1 year from 1st October 2022 to 30 September 2023. All primary cesarean sections done at GGH, Guntur during the study period were included. All Repeat cesarean sections, primary sections done in other hospitals and referred to GGH Guntur, and patients with a previous history of laparotomy done for any obstetric or gynecological cause were excluded. Results: During the study period, out of 7548 deliveries, Normal deliveries were 3591, whereas Total cesarean sections were 3957. Of them, 2148 were primary cesarean sections and 1809 were repeat cesarean sections. So, the rate of primary cesarean section in our hospital was 54.3%. Fetal distress (32%) was found to be the most common indication for primary c-section followed by Cephalo Pelvic Disproportion (CPD) (26%). Conclusion: Our study highlights the need to lower c-section rates. Efforts like counseling women about the benets of Normal Vaginal Delivery(NVD), precise use of partograph, judicious use of oxytocin with other labour-inducing agents, timely admission and wise decision making while considering c-section, and expertization of instrumental vaginal delivery skills should be taken to achieve this.
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关于一家三级医疗中心初次剖腹产适应症的观察研究
背景:剖腹产是最常见的产科外科手术,如果有合适的指征,有可能挽救生命。但它对母亲和婴儿都有许多不利之处。目的和目标:因此,本研究分析了一家三级医院中初次剖宫产的各种指征,旨在降低剖宫产率。材料与方法:本研究是一项回顾性观察研究,于 2022 年 10 月 1 日至 2023 年 9 月 30 日在 GGH Guntur(一家三级医疗中心)进行,为期 1 年。研究期间在贡图尔 GGH 进行的所有初次剖宫产手术均包括在内。不包括所有重复剖宫产手术、在其他医院完成初级剖宫产手术并转诊到贡图尔GGH的患者,以及曾因任何妇产科原因进行过开腹手术的患者。结果:研究期间,在 7548 例分娩中,正常分娩 3591 例,剖腹产 3957 例。其中,2148 例为初次剖宫产,1809 例为再次剖宫产。因此,我院的初次剖宫产率为 54.3%。胎儿窘迫(32%)是最常见的初次剖腹产指征,其次是头盆不称(CPD)(26%)。结论我们的研究强调了降低剖腹产率的必要性。为实现这一目标,应努力向产妇宣传正常阴道分娩(NVD)的好处,准确使用分宫图,合理使用催产素和其他催产药物,在考虑剖腹产时及时入院并做出明智的决策,以及熟练掌握阴道器械分娩技能。
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