Assessment of Indications and Complications of Caesarean Section in A Private Medical College Hospital of Bangladesh.

Caesarean section (CS) is the most frequently performed major operation in obstetrics. Its frequency is gradually increasing because of extended indications. Now-a-days, caesarean section is also being performed at patient's request in absence of a medical indication. It is necessary to assess the risk and benefits to take a judicious decision to select cases for caesarean section. The cross sectional descriptive type of observational study was carried out among purposively selected 100 pregnant women admitted to the department of Obstetrics and Gynaecology of Community Based Medical College Hospital, Mymensingh, Bangladesh during the period of August 2011 to January 2012 to identify elective and emergency indications of caesarean section, to identify the common complications to identify the risk factors associated with complications and to establish a comparison between complications of elective and emergency caesarean section. The median age group of patients being operated was 20 to 25 years and operation were carried out on patients due to various indications. Principal indications were faetal distress (26%), PROM (15%), failed progress of labour and breech presentation were 8% each, other indications were eclampsia (4%), obstructed labour (5%), scar tenderness (4%), history of previous 2 caesarian section 5%. The rate of elective caesarean section was 21% while emergency operations were done in 79% of cases. Among the 100 patients 19% patients developed complications. Among the complications wound infection was most common (37%), then post partum haemorrhage and urinary tract infection 26% and 11% respectively. Other complications were abdominal distension, Puerperal sepsis, anaemic heart failure, wound dehiscence and Wound haematoma 5% each. We should try to keep the rate of caesarean section within optimum ranges (10%) as recommended by World Health Organization.

Two levels of intervention in low-income women with depressive symptoms: compliance and programme assessment.

AIMS: This study reports on the evaluation of a brief group intervention for women of limited means with depressive symptoms. METHOD: A comparison design was used with pre-, post- and four-month follow-up assessments for 93 women in the group intervention condition who were given six two-hour sessions of psycho-educational intervention, and 42 women in a minimum individual condition who received a 20-minute explanation in addition to the educational material, which yielded the following results. RESULTS: Both conditions were effective in motivating participants to engage in self-help activities (making time for themselves every week, using writing as a means of sorting out problems, talking to someone about their problems and carrying out the reflection and cognitive behavioural exercises) and to seek further professional help when necessary. The intervention condition was more positively evaluated since participants regarded it as having a greater influence on their life and problems. Influence was related to better understanding and coping with problems, mood improvement, changes in the way they thought about things, knowing themselves better and being more accepting of themselves. CONCLUSIONS: The results suggest that both interventions tackle important issues related to depression in women but further data are needed for a better understanding of this relationship.

Outcome results of two levels of intervention in low-income women with depressive symptoms.

The effectiveness of 2 levels of intervention in reducing depressive symptoms in women was evaluated using a comparison design for a group condition (6 2-hr weekly sessions) and a minimum individual condition (20-min individual orientation plus psychoeducational material) with pretreatment, posttreatment, and follow-up assessments (93 in the group and 42 in the individual condition). A multivariate analysis of variance showed significant differences, in the expected direction, within the groups but not between conditions. Further comparisons showed a significant reduction from pretreatment to posttreatment and from pretreatment to follow-up assessment. Similar results were found for criteria-related variables (somatic and anxiety symptoms); an increase in self-esteem was observed as well.