Postoperative maternal consequences of Caesarean section

The objective of this study was to analyze Post-operative complication following Caesarean section and to find out the factors which can reduce maternal morbidity associated with Caesarean section. Study Design: Descriptive observational study conducted from September 2004 - February 2005. [6 month] in department of Obstetrics and Gynaecology, Lahore General Hospital, Lahore. Result: Total number of Births during this period were 2025 total number of Caesarean section were 597 [29.48%] out of which emergency Caesarean section were 518[86.7%] and elective were 79[13.2%]. The Post-operative complication rate was [67.7%]. The different complications encountered in post-operative period were anemia 58.86%, febrile morbidity 22.2%, endometritis 13.8%, urinary tract infection 10.6%, respiratory tract infection account for 7.4%, paralytic illeus 1.2%, wound infection 7.9%, postpartum haemorrhage [Primary or Secondary] 4,9%, one patient had strong suspicion of pulmonary embolism, sever headache due to postdural puncture was found in 3 patients. Other Anaesthesia complication and bladder injury incidence was about 0.74%. 2 maternal deaths occurred one due to sever postpartum haemorrhage and 2nd due to pulmonary embolism. Anemia and infectious morbidity was most common cause of morbidity following Caesarean section: regular antenatal care, good surgical techniques, antibiotic prophylaxis, proper aseptic measures, patient's education and counseling can all work to reduce postoperative complications

Does sweeping of membranes in nulliparous women reduce the need for formal induction of labor?

To evaluate the effectiveness of sweeping of the membranes in nulliparous women to reduce the need for a formal induction of labor. A randomized controlled clinical trial. The study was conducted in the Gynae unit 1 of Jinnah Hospital Complex. Lahore, from April 2001to March 2003. 100 nulliparous women attending the antenatal clinic at 39 weeks of gestation were randomly allocated for the study. 50 women were randomized to sweeping of membranes and 50 to control group. Their outcome measures in terms of proportion of women achieving spontaneous labor, duration of labor and bishop score at the time of admission to the hospital were assessed. Spontaneous labor occurred more often in the sweeping of the membranes group than in the control group [38/50[76%] vs. 19/50[38%] P = 0.002]. In addition a greater proportion of women in the sweeping group had a cervical dilatation of 4 cm or more at the first vaginal examination in the labo r ward [25/50 [49%] vs. 8/50 [16%] P = 0.005. Women allocated to sweeping showed a trend towards having a shorter randomization-delivery interval: 9.4 days vs. 10.6 days in the controls P = 0.087. The need for induction of labor was significantly reduced in those women who underwent sweeping [11% vs26% P = 0.004]. Sweeping of membranes in nulliparous women at 39weeks of gestation significantly decreases the number that will reach 41 weeks of gestation