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Pavlidou E, Antasouras G, Papadopoulou SK, Alexatou O, Papandreou D, Mentzelou M, Tsourouflis G, Louka A, Rodopaios NE, Chrysafi M, Sampani A, Giaginis C. Association of Maternal Risk Factors with the Prevalence of Caesarean Section Deliveries: A Cross-Sectional Study. Med Sci (Basel) 2023; 11:66. [PMID: 37873751 PMCID: PMC10594507 DOI: 10.3390/medsci11040066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 09/25/2023] [Accepted: 10/08/2023] [Indexed: 10/25/2023] Open
Abstract
In the last few years, there has been a gradually increasing rate of caesarean section deliveries worldwide that negatively affects both mothers' and children's health. The present survey intended to explore the relations of common maternal risk factors with the prevalence of caesarean sections. This is a cross-sectional study including 5182 healthy mothers from geographically diverse regions of Greece, which has applied relevant inclusion and exclusion criteria. An elevated 56.4% incidence of caesarean sections was noted. The prevalence of caesarean section deliveries was estimated to be 51.5% in private hospitals and 48.5% in public hospitals. Maternal age, pre-pregnancy overweight/obesity, excess gestational weight gain, preterm birth, financial status, smoking habits, and private type of birth hospital were considerably associated with a high probability of caesarean section, regardless of several confounders. In conclusion, caesarean section rates are constantly increasing, and various maternal risk factors additively elevate its incidence, which additionally enhances the likelihood of postpartum complications for both the mothers and their infants. Public health procedures and approaches are strongly recommended to notify future mothers of the potential risk factors that may result in adverse pregnancy outcomes of caesarean section delivery, highlighting its use only for emergency medical reasons and also promoting healthier nutritional and lifestyle habits that may reduce the increasing prevalence of caesarean section deliveries.
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Affiliation(s)
- Eleni Pavlidou
- Department of Food Science and Nutrition, University of the Aegean, 81400 Lemnos, Greece; (E.P.); (G.A.); (O.A.); (M.M.); (A.L.); (M.C.)
| | - Georgios Antasouras
- Department of Food Science and Nutrition, University of the Aegean, 81400 Lemnos, Greece; (E.P.); (G.A.); (O.A.); (M.M.); (A.L.); (M.C.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, 57001 Thessaloniki, Greece;
| | - Olga Alexatou
- Department of Food Science and Nutrition, University of the Aegean, 81400 Lemnos, Greece; (E.P.); (G.A.); (O.A.); (M.M.); (A.L.); (M.C.)
| | - Dimitrios Papandreou
- Department of Clinical Nutrition & Dietetics, College of Health Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates;
| | - Maria Mentzelou
- Department of Food Science and Nutrition, University of the Aegean, 81400 Lemnos, Greece; (E.P.); (G.A.); (O.A.); (M.M.); (A.L.); (M.C.)
| | - Gerasimos Tsourouflis
- Second Department of Propedeutic Surgery, Medical School, University of Athens, 11527 Athens, Greece;
| | - Aikaterini Louka
- Department of Food Science and Nutrition, University of the Aegean, 81400 Lemnos, Greece; (E.P.); (G.A.); (O.A.); (M.M.); (A.L.); (M.C.)
| | - Nikolaos E. Rodopaios
- Department of Social Medicine, Preventive Medicine and Nutrition, Medical School, University of Crete, 70013 Heraklion, Greece;
| | - Maria Chrysafi
- Department of Food Science and Nutrition, University of the Aegean, 81400 Lemnos, Greece; (E.P.); (G.A.); (O.A.); (M.M.); (A.L.); (M.C.)
| | - Anastasia Sampani
- First Department of Pathology, Medical School, University of Athens, 11527 Athens, Greece;
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, University of the Aegean, 81400 Lemnos, Greece; (E.P.); (G.A.); (O.A.); (M.M.); (A.L.); (M.C.)
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Rosli AA, Nawi AM, Atan IK, Kalok AM, Ahmad S, Ismail NAM, Mahdy ZA, Rahman RA. Cervical dilatation at diagnosis of active phase of labour determines the mode of delivery and peripartum outcomes: a retrospective study in a single tertiary centre in Malaysia. BMC Pregnancy Childbirth 2023; 23:221. [PMID: 37005571 PMCID: PMC10067294 DOI: 10.1186/s12884-023-05523-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 03/15/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND There is an increasing trend of Caesarean section rate in Malaysia. Limited evidence demonstrated the benefits of changing the demarcation of the active phase of labour. METHODS This was a retrospective study of 3980 singletons, term pregnancy, spontaneous labouring women between 2015 and 2019 comparing outcomes between those with cervical dilation of 4 versus 6 cm at diagnosis of the active phase of labour. RESULTS A total of 3403 (85.5%) women had cervical dilatation of 4 cm, and 577 (14.5%) at 6 cm upon diagnosis of the active phase of labour. Women in 4 cm group were significantly heavier at delivery (p = 0.015) but significantly more multiparous women were in 6 cm group (p < 0.001). There were significantly fewer women in the 6 cm group who needed oxytocin infusion (p < 0.001) and epidural analgesia (p < 0.001) with significantly lower caesarean section rate (p < 0.001) done for fetal distress and poor progress (p < 0.001 both). The mean duration from diagnosis of the active phase of labour until delivery was significantly shorter in the 6 cm group (p < 0.001) with lighter mean birth weight (p = 0.019) and fewer neonates with arterial cord pH < 7.20 (p = 0.047) requiring neonatal intensive care unit admissions (p = 0.01). Multiparity (AOR = 0.488, p < 0.001), oxytocin augmentation (AOR = 0.487, p < 0.001) and active phase of labour diagnosed at 6 cm (AOR = 0.337, p < 0.001) reduced the risk of caesarean delivery. Caesarean delivery increased the risk of neonatal intensive care admission by 27% (AOR = 1.73, p < 0.001). CONCLUSIONS Active phase of labour at 6 cm cervical dilatation is associated with reduced primary caesarean delivery rate, labour intervention, shorter labour duration and fewer neonatal complications.
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Affiliation(s)
- Anizah Aishah Rosli
- Department of Obstetrics & Gynaecology, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Malaysia
- Department of Obstetrics & Gynaecology, Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia
| | - Azmawati Mohd Nawi
- Department of Statistics, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Malaysia
| | - Ixora Kamisan Atan
- Department of Obstetrics & Gynaecology, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Malaysia
- Department of Obstetrics & Gynaecology, Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia
| | - Aida Mohd Kalok
- Department of Obstetrics & Gynaecology, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Malaysia
- Department of Obstetrics & Gynaecology, Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia
| | - Shuhaila Ahmad
- Department of Obstetrics & Gynaecology, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Malaysia.
- Department of Obstetrics & Gynaecology, Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia.
| | - Nor Azlin Mohamed Ismail
- Department of Obstetrics & Gynaecology, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Malaysia
- Department of Obstetrics & Gynaecology, Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia
| | - Zaleha Abdullah Mahdy
- Department of Obstetrics & Gynaecology, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Malaysia
- Department of Obstetrics & Gynaecology, Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia
| | - Rahana Abd Rahman
- Department of Obstetrics & Gynaecology, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Malaysia
- Department of Obstetrics & Gynaecology, Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia
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Mezemir R, Olayemi O, Dessie Y. Trend and associated factors of cesarean section rate in Ethiopia: Evidence from 2000-2019 Ethiopia demographic and health survey data. PLoS One 2023; 18:e0282951. [PMID: 36928080 PMCID: PMC10019649 DOI: 10.1371/journal.pone.0282951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 02/28/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND The world health organization considers cesarean section (CS) prevalence of less than 5% suggests an unmet need. On the other hand, a prevalence of more than 15% may pose to risk to mother and child, however, access to CS in a resource-limited country like Ethiopia was much lower than the aforementioned level, Therefore, this was the first study to determine the trend of CS, and factors that influence it. METHODS This was done based on the five Ethiopia Demographic and Health Surveys. Trend analysis was done separately for rural and urban. The significance of the trend was assessed using the Extended Mantel-Haenszel chi-square test. The factors on CS delivery were identified based on DHS 2016 data. A multi-level logistic regression analysis technique was used to identify the factors associated with cesarean section delivery. The analysis was adjusted for the different individual- and community-level factors affecting cesarean section delivery. Data analysis was conducted using STATA 14.1 software. RESULT The rate of cesarean section increased from 5.1% in 1995 to 16% in 2019 in an urban area and 0.001 in 1995 to 3% in a rural area, the overall increment of CS rate was 0.7% in 1995 to 2019 at 6%. The odds of cesarean section were higher among 25-34 years (AOR = 2.79; 95% CI: 1.92, 4.07) and 34-49 years (AOR = 5.23;95% CI: 2.85,9.59), among those educated at primary school level (AOR = 1.94; 95% CI: 1.23,3.11), secondary education (AOR = 2.01; 95% CI: 1.17, 3.56) and higher education (AOR = 4.12; 95% CI: 2.33-7.29)with multiple pregnancies (AOR = 11.12; 95% CI: 5.37, 23.), with obesity (AOR = 1.73; 95% CI: 1.22, 2.45), living in an urban area (AOR = 2.28; /95% CI: 1.35-3.88), and increased with the number of ANC visit of 1-3 and 4th(AOR = 2.26; 95% CI: 1.12, 4.58), (AOR = 3.34; 95% CI: 1.12, 4.58), respectively. The odds of cesarean section are lower among parity of 2-4 children (AOR = 0.54; 95% CI: 0 .37, 0.80) and greater than four birth order (AOR = 0.42;95% CI: 0.21,0.84). CONCLUSION In Ethiopia, the CS rate is below the WHO recommended level in both urban and rural areas, thus, intervention efforts need to be prioritized for women living in a rural area, empowering women's education, encouraging co-services such as ANC usage could all help to address the current problem.
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Affiliation(s)
- Rahel Mezemir
- Pan African University, Life and Earth Sciences Institute (Including Health and Agriculture), Ibadan, Nigeria
- St. Paul’s Hospital Millennium Medical College, School of Nursing, Addis Ababa, Ethiopia
- * E-mail: ,
| | - Oladapo Olayemi
- Department of Obstetrics and Gynaecology, College of Medicine, Pan African University Life and Earth Sciences Institutes, University of Ibadan, Ibadan, Nigeria
| | - Yadeta Dessie
- College of Health and Medical Sciences Haramaya University, Harar, Ethiopia
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Handayani AFSD, Sitepu M, Effendi IH, Asroel EM, Halim B, Rivany R, Ardiansyah E. Correlation between Blood Glucose Levels on Niche Incidence after Cesarean Section. Open Access Maced J Med Sci 2023. [DOI: 10.3889/oamjms.2023.11029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND: Long-term sequelae of cesarean section (CS) is formation of niche in CS surgical scar. Blood glucose involved in wound healing process after CS.
AIM: This study was to find correlation of blood glucose level with niche in CS patients.
METHODS: This research was an observational and analytic study with case series design conducted at Department of Obstetrics and Gynecology, Universitas Sumatera Utara, RSUP H Adam Malik Medan, and Sundari Hospital Medan Starting from July to August 2022. To assess correlation between variables, eta test was used to assess the correlation of blood glucose with incidence of niche. The analysis results were said to be significant if p < 0.05, with 95% CI.
RESULTS: Mean of patients were in 21–29 years (70%), multiparity with 12 patients (40%), aterm gestational age with 30 patients (100%), 16 patients (53.3%) with anteflexion uterus, previous CS 2 times were the majority with 9 patients (30%), and 17 patients (56.7%) were elective CS. Incidence of niche was 63.3%. Triangular were the most found niche with 11 patients (36.7%). Mean of total myometrial thickness, depth of niche, and residual myometrial thickness were 5.23 ± 11.2 mm, 2.44 ± 2.75 mm, and 5.23 ± 11.22 mm, respectively. Mean blood sugar level was 103.3 ± 17.4 mg/dl. From eta analysis, there was no correlation between blood glucose levels post-CS patients using eta test with p = 0.872.
CONCLUSION: There was no significant correlation between blood glucose levels on niche incidence in post-CS patients.
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Bhattarai B, Panthi S, Yadav GK, Gautam S, Acharya R, Neupane D, Khanal N, Khatri B, Neupane K, Adhikari S, Lageju N, Basnet LB, Pyakurel P, Yadav SP. Association of geographic distribution and birth weight with sociodemographic factors of the maternal and newborn child of hilly and mountain regions of eastern Nepal: a cross-sectional study. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001579. [PMID: 36645745 PMCID: PMC9716932 DOI: 10.1136/bmjpo-2022-001579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 11/18/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES To determine the association of geographic distribution, and birth weight with sociodemographic factors of the maternal and newborn child of hilly region (lower altitude) and mountain region (high altitude) of eastern Nepal as well as the prevalence of low birth weight (LBW) and large for gestational age (LGA) among term singleton deliveries in eastern Nepal. METHODOLOGY A cross-sectional study was conducted in the district-level hospitals of Dhankuta, Tehrathum, Solukhumbu and Taplejung districts of eastern Nepal of Province 1. Mothers with preterm or post-term delivery, multiple pregnancies, stillbirth/intrauterine fetal death and incomplete records were excluded from the study with only 1386 term pregnancies (37-42 weeks) delivered at the respective facilities between 17 July 2019 and 16 July 2020 were included. The appropriate data were entered in Microsoft Excel 2019 V.16.0 and statistical analysis was performed by using the statistical package for social sciences, IBM SPSS V.29. RESULTS The low maternal age, Dalit ethnic group, low gravidity, low parity, higher antenatal care (ANC) visits (≥4), incomplete deworming and dT vaccination status, breech deliveries and LBW newborns were significantly attributed to hilly region (lower altitude) (p value <0.05). Similarly, the hilly region, lower and/or no ANC visits and early term gestation had significant negative association with birth weight at the lower quantiles only. Meanwhile, the female newborn had significant and negative association with birth weight distribution at all seven quantiles. The prevalence of the LBW, average for gestational age and LGA newborn child among term singleton deliveries in Eastern Nepal is 6.6%, 85.8% and 7.6%, respectively. CONCLUSIONS The local organisations should focus on adequate antenatal care visits in mountain region and coverage of dT vaccine and deworming medications in hilly region. Appropriate measures and programmes should be initiated to bring down LBW in hilly region.
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Affiliation(s)
- Bharosha Bhattarai
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sagar Panthi
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Gopal Kumar Yadav
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Swotantra Gautam
- Department of Internal Medicine, Advent Health, Orlando, Florida, USA
| | - Rochana Acharya
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Durga Neupane
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Nimesh Khanal
- Department of Internal Medicine, Tower Health Reading Hospital, Reading, Pennsylvania, USA
| | - Bharat Khatri
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Krishna Neupane
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sugat Adhikari
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Nimesh Lageju
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Lila Bahadur Basnet
- Curative Service Division, Ministry of Health and Population, Department of Health Services, Kathmandu, Nepal
| | - Prajjwal Pyakurel
- School of Public Health and Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Shankar Prasad Yadav
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
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Islam MS, Awal MA, Laboni JN, Pinki FT, Karmokar S, Mumenin KM, Al-Ahmadi S, Rahman MA, Hossain MS, Mirjalili S. HGSORF: Henry Gas Solubility Optimization-based Random Forest for C-Section prediction and XAI-based cause analysis. Comput Biol Med 2022; 147:105671. [DOI: 10.1016/j.compbiomed.2022.105671] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 05/24/2022] [Accepted: 05/24/2022] [Indexed: 01/02/2023]
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Khatri RB, Durham J, Assefa Y. Investigation of technical quality of antenatal and perinatal services in a nationally representative sample of health facilities in Nepal. Arch Public Health 2022; 80:162. [PMID: 35787734 PMCID: PMC9252055 DOI: 10.1186/s13690-022-00917-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Access to routine antenatal and perinatal services is improved in the last two decades in Nepal. However, gaps remain in coverage and quality of care delivered from the health facilities. This study investigated the delivery of technical quality antenatal and perinatal services from health facilities and their associated determinants in Nepal. METHODS Data for this study were derived from the Nepal Health Facility Survey 2015. The World Health Organization's Service Availability and Readiness Assessment framework was adopted to assess the technical quality of antenatal and perinatal services of health facilities. Outcome variables included technical quality scores of i) 269 facilities providing antenatal services and ii) 109 facilities providing childbirth and postnatal care services (perinatal care). Technical quality scores of health facilities were estimated adapting recommended antenatal and perinatal interventions. Independent variables included locations and types of health facilities and their management functions (e.g., supervision). We conducted a linear regression analysis to identify the determinants of better technical quality of health services in health facilities. Beta coefficients were exponentiated into odds ratios (ORs) and reported with 95% confidence intervals (CIs). The significance level was set at p-value < 0.05. RESULTS The mean score of the technical quality of health facilities for each outcome variable (antenatal and perinatal services) was 0.55 (out of 1.00). Compared to province one, facilities of Madhesh province had 4% lower odds (adjusted OR = 0.96; 95%CI: 0.92, 0.99) of providing better quality antenatal services, while health facilities of Gandaki province had higher odds of providing better quality antenatal services (aOR = 1.05; 95% CI: 1.01, 1.10). Private facilities had higher odds (aOR = 1.13; 95% CI: 1.03, 1.23) of providing better quality perinatal services compared to public facilities. CONCLUSIONS Private facilities provide better quality antenatal and perinatal health services than public facilities, while health facilities of Madhesh province provide poor quality perinatal services. Health system needs to implement tailored strategies, including recruiting health workers, supervision and onsite coaching and access to necessary equipment and medicine in the facilities of Madhesh province. Health system inputs (trained human resources, equipment and supplies) are needed in the public facilities. Extending the safe delivery incentive programme to the privately managed facilities could also improve access to better quality health services in Nepal.
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Affiliation(s)
- Resham B Khatri
- School of Public Health, Faculty of Medicine, the University of Queensland, Brisbane, Australia.
- Health Social Science and Development Research Institute, Kathmandu, Nepal.
| | - Jo Durham
- School of Public Health, Faculty of Medicine, the University of Queensland, Brisbane, Australia
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Yibeltal Assefa
- School of Public Health, Faculty of Medicine, the University of Queensland, Brisbane, Australia
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Haque M, Umar B. Growing concern over rising caesarean section rates: Is it a problem for low- and middle-income countries only? ADVANCES IN HUMAN BIOLOGY 2022. [DOI: 10.4103/aihb.aihb_148_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Das P, Samad N, Sapkota A, Al-Banna H, A Rahman NA, Ahmad R, Haque M, Godman B. Prevalence and Factors Associated With Caesarean Delivery in Nepal: Evidence From a Nationally Representative Sample. Cureus 2021; 13:e20326. [PMID: 35028222 PMCID: PMC8743029 DOI: 10.7759/cureus.20326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2021] [Indexed: 12/16/2022] Open
Abstract
Background Caesarian sections (CS) are life-saving management for a pregnant mother and fetus subject to obstetric complications. The World Health Organization (WHO) expected CS rates not to exceed 10 to 15 per 100 live births in any country. This study aimed to assess the prevalence of CS and its associated factors from the 2016 Nepal Demographic and Health Survey (NDHS), building on previous studies mentioned in detail in the latter part of the paper. Methods This study analyzed the secondary data from the 2016 Nepal Demographic and Health Survey (NDHS), conducted from June 19, 2016, to January 31, 2017. The survey is undertaken every five years; consequently, the data capture the information in the previous five years from the data collection period. We used the 2016 NDHS, which is implemented by the new Enumeration Area (EA) under the support of the Ministry of Health (MOH) and funded by the U.S. Agency for International Development (USAID). In the rural areas, the sample is stratified and selected in two stages. In the first stage, wards are selected as the primary sampling units (PSU), with households subsequently chosen from the PSUs. In the urban areas, the sample is nominated in three stages. In the first stage, wards are selected as PSUs; in the second stage, one EA is chosen from each PSU, and finally, households are selected from the EAs. Then data were collected from the women in the reproductive age group within the selected households. Results The prevalence of CS in Nepal conforms to the WHO standard with 7.8, 7.5, and 8.1 per 100 deliveries, or 9.8, 8.9, and 9.1 per women's last births in the previous one, three, and five years, respectively. Older mothers of 30 years old or more, having high incomes, being overweight and obese, using the internet, ante-natal care (ANC) visits of more than four times, ANC by doctors, twin delivery, and having babies of 4 kg or more, had higher odds for a CS while having two or more children seemed to be protective towards CS. Conclusion These findings can be used to update health policies surrounding CS delivery to limit unnecessary CS and ensure better health as CS is not without complications.
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Affiliation(s)
- Pranta Das
- Statistics, University of Dhaka, Dhaka, BGD
| | | | - Ashmita Sapkota
- Public Health, School of Health and Allied Science, Pokhara University, Pokhara, NPL
| | - Hasan Al-Banna
- Social Welfare, Institute of Social Welfare and Research, University of Dhaka, Dhaka, BGD
| | | | - Rahnuma Ahmad
- Physiology, Medical College for Women and Hospital, Dhaka, BGD
| | - Mainul Haque
- Pharmacology and Therapeutics, National Defence University of Malaysia, Kuala Lumpur, MYS
| | - Brian Godman
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, ARE
- Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, Glasgow, GBR
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Shrestha DB, Khatri R, Oli PR, Malla R, Shrestha C, Khatiwada R, Silwal P, Shah PB. Cesarean Section in a Maternity Unit of a Tertiary Care Center of Nepal: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2021; 59:322-326. [PMID: 34508541 PMCID: PMC8369590 DOI: 10.31729/jnma.5150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 05/07/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction: Cesarean section is a common obstetric procedure which is done to reduce complications in high risk pregnancies. The aim of study was to find out the prevalence of cesarean section in a maternity unit of a tertiary care center. Methods: A descriptive cross-sectional study was conducted among 497 pregnant women presenting in a maternity unit of a tertiary center of Kathmandu, Nepal over a period of six months from March to August 2017 after taking ethical approval from Institutional Review Committee (Ref. 24). In this study, the prevalence of cesarean section, perinatal outcome, maternal and neonatal complications if any were observed. Data and descriptive analysis were done using Statistical Package for the Social Sciences version 22. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: The prevalence of cesarean section was 171 (34.4%) at 95% Confidence interval (30.2-38.7). Most common indication for cesarean section was fetal distress 53 (31%). The maternal complications developed in 11 (6.4%) among those who delivered via cesarean delivery; Surgical Site Infection being the most common maternal complication. The neonatal intensive care unit admission rate among the newborns via cesarean section delivery was 48 (27.43%) and neonatal sepsis 14 (8%) was most common adverse neonatal outcome. Conclusions: The cesarean rate at the study center is higher than standard target rate of World Health Organization. Neonatal and maternal adverse outcome in current study were comparable with existing literatures.
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Affiliation(s)
- Dhan Bahadur Shrestha
- Department of Gynaecology and Obstetrics, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal
| | - Ratna Khatri
- Department of Gynaecology and Obstetrics, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal
| | | | - Rosy Malla
- Department of Gynaecology and Obstetrics, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal
| | - Cimona Shrestha
- Department of Gynaecology and Obstetrics, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal
| | - Roshan Khatiwada
- Department of Gynaecology and Obstetrics, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal
| | - Pratik Silwal
- Department of Gynaecology and Obstetrics, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal
| | - Prajwol Bikram Shah
- Department of Internal Medicine, Nepal Medical College Teaching Hospital, Jorpati, Kathmandu, Nepal
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