RESUMO
To compare maternal morbidity in elective versus emergency caesarean section in a tertiary care teaching hospital. This comparative study was conducted at Department of Gynecology and Obstetrics, Lady Reading Hospital Peshawar, Pakistan, from July 2006 to June 2007. A total of 100 patients, 50 in emergency and 50 in elective caesarean section group through convenient sampling were included in the study. The sample size was calculated as 100 by keeping 8% prevalence of caesarean section in Pakistan and using WHO software for sample size estimation. The complications were compared in both groups using a semi structured proforma. The comparison was done by using Chi-square test and p-value= 0.05 was considered statistically significant. The mean age was 31.54 +/- 4.64 and 30.83 +/- 5.08 in emergency and elective caesarean section group respectively. Anesthesia related complications were only observed in 11 cases of emergency caesarean section group [Delayed recovery with 8 Cases occurred most] and none in the elective group. Tears in cervix and uterus were noted in 8 cases of emergency caesarean section group only. Hemorrhage was noted in 58% and 4% patients in emergency and elective caesarean section groups respectively. Postoperative complications were found higher in emergency caesarean section as compare to elective caesarean section groups like anemia [70%vs.40%], post partum hemorrhage [40%vs.6%], fever [30%vs.8%]and abdominal distention[30%vs.8%] with p-values of 0.004, 0.007, 0.01, 0.01 respectively. The maternal morbidity including anesthesia related complications, Intra-operative, and postoperative complications were more in the emergency caesarean section as compared to elective caesarean section group
Assuntos
Humanos , Feminino , Morbidade , Emergências , Procedimentos Cirúrgicos Eletivos , Placenta Prévia , Gravidez , Complicações na Gravidez , Complicações do Trabalho de PartoRESUMO
To find out the effect of decreased amniotic fluid index [AFI] on adverse pregnancy outcome at term. This experimental study was conducted at Gynae [B] unit Lady Reading Hospital Peshawar from September 2004 to August 2005. A total of 100 pregnant women admitted in labour ward were included in the study. Fifty cases with an amniotic fluid index of <5cm comprised the patient group. Fifty controls having AFI>5cm were matched with the cases regarding age [ +/- 3years], parity and antenatal complication [hypertension, diabetes]. Apart from demographic details, maternal outcome measures such as induction of labour; mode of delivery; meconium stained liquor; and fetal outcome measures such as Apgar score and admission to neonatal intensive care unit were recorded on a semi structured proforma for both the groups and analyzed by Chi square test using SPSS v.ll. Labour induction was significantly higher in patients having AFI<5cm as compared to the control group [p-value=0.009]. Meconium stained liquor [p-value=0.023] and cesarean section rate for fetal distress [p-value=0.000] were higher in patients having AFI<5cm. Neonatal complications were found to be more frequent in the patients having AFI<5cm and these include, low Apgar score <7 [p<0.00l] and neonatal intensive care unit admission [p=0.078]. There was no perinatal mortality in both the groups. Amniotic fluid index of <5cm was associated with adverse pregnancy outcomes in the form of meconium stained liquor, induction of labour, cesarean section for fetal distress, low Apgar score and neonatal intensive care unit admission