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A Six-Year Review of caesarean sections at the Federal Teaching Hospital Abakaliki, Ebonyi State, South East Nigeria

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Open Journal of Obstetrics and Gynecology 2020年第12期10卷 1669-1676页

作者： Johnbosco E. Mamah Obiora G. Asiegbu Uzoma V. Asiegbu Kenneth C. Ekwedigwe Ugochukwu U. Nnadozie Love Okafor Obstetrics and Gynaecology Department Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria Paediatrics Department Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria Division of Plastic Surgery Department of Surgery Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria

Background: Globally, the rise in the rate of caesarean section is becoming a public health problem. This study examined the rate, indications and complications of caesarean section at the Federal Teaching Hospital Abakaliki (FETHA). Subjects and Methods: This was a six-year retrospective study covering January 1st 2012 to December 31st 2017. Patients who met the inclusion criteria were identified from the theatre records and their case notes retrieved from the health information unit of the hospital. Information extracted includes sociodemographic data, indications and types of caesarean section performed and the complications. Data was collected using a structured proforma and entered into a secured personal computer. Data analysis was performed by means of Epi Info version 7. Results are presented in tables, means and simple percentages. Results: During this period, a total of 11,215 deliveries were recorded at FETHA, of these, 3908 were delivered by CS giving a caesarean section rate of 34.8%. The mean age of the study subjects was 29.3 ± 5.03 years. Almost half (49.7%) of the patients were in the 20 - 29 age group. Multiparous women made up 36.0% while nulliparous women were 12.6%. The most common indication for an emergency caesarean section was failure

关键词： Abakaliki caesarean section rate Maternal Mortality Perinatal Mortality

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Evaluation and Relevance of Indications for Primary caesarean section: A Five-Year Experience Report from Nevers Hospital Center

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Open Journal of Obstetrics and Gynecology 2023年第2期13卷 183-191页

作者： Aliou Diouf Remy Kosi Thérèse Mikoka Emilie Serre Philippe Kadhel Centre Hospitalier de Nevers Nevers France CHU de Dijon Dijon France

Context: The caesarean section rate continues to increase in our different health structures specially for women who have not had a scar in the uterus. Objectives: The aim of this study was to analyze the key factors and main indications for primary caesarean sections and to find ways to reduce the increasing rates. Patients and Method: This is a longitudinal and retrospective study carried out from June 1, 2018 to July 31, 2022. The study included all patients who had a cesarean-section for the first time (primary caesarean). An anterior uterine scar was a non-inclusion criterion. Data were collected prospectively using Synfonievre and Agopra software via patients’ files and information collection sheet. Data were analyzed with SPSS 21 software, Mac version. Averages were calculated for quantitative data and percentages for qualitative data. The statistical tests used were the Pearson Chi2 test. The observed differences were considered significant when the p-value was less than 0.05. Results: During the study period, we recorded 8832 deliveries and 3148 caesarean sections (35.6%). Primary CS concerned 70% of overall C-section rate. The main indications were FHR Fetal Heart rate abnormalities (FHRA) (27%), followed by the other indications (including preterm delivery, umbilical cord dystocia, malpresentation of fetus, foetal abnormalities, elective CS, triple gestation, mother abnormalities);dystocia or prolonged labor (18.7%), breech presentation in a twin pregnancy with 11.3% and 9.6% respectively. We recorded more vaginal deliveries with labor induction: 81.4% against 75.2%. An obstetrical audit led to better labor management and a reduction in the cesarean section rate. Conclusion: We need to focus on diagnosis of fetal distress, management of breech presentation during of a twin birth and a singleton. Induction of labor can be an effective alternative in certain indications. An obstetrical audit is needed to reverse the caesarean section rate.

关键词： caesarean section rate Indications Apgar Score Obstetrical Audit

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