Kattel Pramod
Department of Obstetrics and Gynaecology, Kathmandu National Medical College, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2018 Mar-Apr;56(210):587-592.
Caesarean section is a commonly performed major obstetric surgery to deliver baby under certain indications which may be maternal or fetal. If performed timely, it is helpful to save the life of mother and fetus and if not, it increases both maternal and fetal risks.
A hospital based descriptive cross-sectional study was conducted at Dhading district hospital from 17th October 2016 to 17th October 2017. Total of 41 patients undergoing emergency caesarean section meeting the selection criteria were included.
The incidence of emergency caesarean section was 41 (5.5%). Most common indication for caesarean delivery was fetal distress in 12 (29.3%) followed by failed induction and cephalopelvic disproportion each accounting 6 (14.6%) cases. The least common causes being chorioamnionitis and cord prolapse in 1 (2.4%). Regarding perinatal outcomes, 33 (80.5%) babies delivered were of normal weight. Low Apgar score (<7) at one minute was noted in 8 (19.5%) cases. Neonatal resuscitation in the form of oxygen supplementation was required in 2 (4.9%) cases whereas bag and mask ventilation was required in 5 (12.2%) cases. Referral for neonatal intensive care unit admission was done in 6 (14.6%) cases. There were three neonatal deaths.
Residential posting was fruitful to decrease feto-maternal morbidities and mortalities. Even to minimize the delay of treatment, government should provide adequate equipments and skilled man-power to run neonatal intensive care unit.
剖宫产是一种常见的大型产科手术,用于在某些母体或胎儿指征下分娩。如果及时进行,有助于挽救母婴生命,否则会增加母婴风险。
2016年10月17日至2017年10月17日在达丁地区医院进行了一项基于医院的描述性横断面研究。纳入了41例符合选择标准的急诊剖宫产患者。
急诊剖宫产发生率为41例(5.5%)。剖宫产最常见的指征是胎儿窘迫,共12例(29.3%),其次是引产失败和头盆不称,各占6例(14.6%)。最不常见的原因是绒毛膜羊膜炎和脐带脱垂,各1例(2.4%)。关于围产期结局,33例(80.5%)分娩的婴儿体重正常。8例(19.5%)在1分钟时阿氏评分低(<7分)。2例(4.9%)需要以吸氧形式进行新生儿复苏,5例(12.2%)需要面罩气囊通气。6例(14.6%)转诊至新生儿重症监护病房。有3例新生儿死亡。
驻院工作有助于降低母婴发病率和死亡率。为尽量减少治疗延误,政府应提供足够的设备和技术人员来运营新生儿重症监护病房。