Vineshree Govender1, Mala Panday, Jagidesa Moodley. 1. Department of Obstetrics and Gynaecology, Women's Health and HIV Research Group, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Abstract
OBJECTIVE: An audit of second stage caesarean section (C/S) at a tertiary hospital was undertaken to compare the frequency of perinatal and maternal complications between first and second stage C/S and to evaluate the training level of physicians. METHODS: A prospective chart audit of all women who underwent emergency C/S over a 7-month period at a tertiary hospital was conducted. The patients' hospital records were assessed on a daily basis and all relevant information recorded on a structured data sheet categorising demographics, indications for C/S, level of training of decision-maker and surgeon, a consultant's presence, operative complications and neonatal outcome at 5 min post-delivery. The frequency of maternal and neonatal complications was the main outcome measures. RESULTS: There were 975 first stage and 116 second stage C/S. The commonest causes of second stage C/S were cephalo-pelvic disproportion, prolonged second stage and fetal distress. First stage C/S took a mean time of 35.5 min, while second stage C/S took an average time of 41.6 min to perform (p=0.001). There were 37 and 84 records of complications occurring in first and second stage C/S, respectively. CONCLUSION: Maternal complications were significantly higher in second stage C/S while neonatal complications were not significantly different between first and second stage C/S. There was little guidance from consultants at decision-making for second stage C/S.
OBJECTIVE: An audit of second stage caesarean section (C/S) at a tertiary hospital was undertaken to compare the frequency of perinatal and maternal complications between first and second stage C/S and to evaluate the training level of physicians. METHODS: A prospective chart audit of all women who underwent emergency C/S over a 7-month period at a tertiary hospital was conducted. The patients' hospital records were assessed on a daily basis and all relevant information recorded on a structured data sheet categorising demographics, indications for C/S, level of training of decision-maker and surgeon, a consultant's presence, operative complications and neonatal outcome at 5 min post-delivery. The frequency of maternal and neonatal complications was the main outcome measures. RESULTS: There were 975 first stage and 116 second stage C/S. The commonest causes of second stage C/S were cephalo-pelvic disproportion, prolonged second stage and fetal distress. First stage C/S took a mean time of 35.5 min, while second stage C/S took an average time of 41.6 min to perform (p=0.001). There were 37 and 84 records of complications occurring in first and second stage C/S, respectively. CONCLUSION: Maternal complications were significantly higher in second stage C/S while neonatal complications were not significantly different between first and second stage C/S. There was little guidance from consultants at decision-making for second stage C/S.
Authors: Seung Mi Lee; Joong Shin Park; Young Mi Jung; Su Ah Kim; Ji Hyun Ahn; Jina Youm; Chan Wook Park; Jong Kwan Jun Journal: J Korean Med Sci Date: 2018-02-12 Impact factor: 2.153
Authors: Fatimat M Akinlusi; Kabiru A Rabiu; Idayat A Durojaiye; Adeniyi A Adewunmi; Tawaqualit A Ottun; Yusuf A Oshodi Journal: BMC Pregnancy Childbirth Date: 2018-01-10 Impact factor: 3.007