Department of Obstetrics and Gynaecology, Kathmandu Medical College, Sinamangal, Kathmandu, Nepal.
Department of General Practice and Emergency Medicine, Maharajgunj Medical Campus, Institute of Medicine, T.U., Maharajgunj, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2020 Sep 27;58(229):650-653. doi: 10.31729/jnma.5375.
Cesarean section is the surgical delivery of a baby through an incision made in the mother's abdomen and uterus. Repeat cesarean section has recently increased, partly because of concern about increased risk of uterine rupture in women attempting vaginal birth after cesarean delivery. Among the women who underwent cesarean section in their first delivery, 80-96% had a second surgical delivery. Therefore, the present study aimed to describe the prevalence of repeat cesarean section among Nepali women presented at Kathmandu Medical College and Teaching Hospital who had a previous cesarean section.
This was a descriptive cross-sectional study conducted in Kathmandu Medical College and Teaching Hospital from 1st of February to 31st of May 2020. Ethical approval was taken from the Institutional Review Committee of the Kathmandu Medical College. Convenient sampling was done. All pregnant patients between gestational ages of 37-40 weeks with previous cesarean section admitted for safe confinement were included in the study.
Among the 104 women, who had prior cesarean section, 99 (95.19%) had second cesarean section and 5 (4.81%) had vaginal birth after cesarean. The most common indication for the first cesarean section was fetal distress 31 (29.81%) while the indication for the second cesarean section among previously cesarean section women was cephalo pelvic disproportion 39 (39.40%).
The proportion of cesarean section in both first and subsequent delivery is quite high. This high rate may compromise the reproductive future of the women who underwent consecutive cesarean section with possible consequent complications.
剖宫产术是通过在母亲的腹部和子宫上切开一个切口来分娩婴儿的手术。由于担心在剖宫产后阴道分娩的女性中子宫破裂的风险增加,最近重复剖宫产的次数有所增加。在第一次分娩中接受剖宫产的女性中,有 80-96%进行了第二次手术分娩。因此,本研究旨在描述在加德满都医学院和教学医院接受过剖宫产的尼泊尔女性中,再次剖宫产的发生率。
这是一项在加德满都医学院和教学医院进行的描述性横断面研究,时间为 2020 年 2 月 1 日至 5 月 31 日。本研究已获得加德满都医学院机构审查委员会的伦理批准。采用方便抽样。所有妊娠年龄在 37-40 周之间且有先前剖宫产史的孕妇,均因安全分娩而入院,均纳入研究。
在 104 名有先前剖宫产史的女性中,有 99 名(95.19%)进行了第二次剖宫产,5 名(4.81%)进行了剖宫产后阴道分娩。第一次剖宫产的最常见指征是胎儿窘迫 31 例(29.81%),而先前剖宫产女性的第二次剖宫产指征是头盆不称 39 例(39.40%)。
首次和随后分娩的剖宫产比例都相当高。这种高比率可能会影响连续接受剖宫产的女性的生殖未来,并可能导致随后出现并发症。