Shrestha Nischal, Regmi Priyanka, Shrestha Sneha, Nyaupane Kalpana
Nobel Medical College Teaching Hospital, Biratnagar.
Tribhuwan University Teaching Hospital, Kathmandu.
Ann Med Surg (Lond). 2023 Apr 11;85(5):1699-1704. doi: 10.1097/MS9.0000000000000622. eCollection 2023 May.
Caesarean section is performed when there are pregnancy related complications and vaginal delivery cannot be tried or fails. The effect of pandemic lockdown on the availability as well as accessibility of health services is a global concern. The aim of this study was to find out the caesarean section rate and its indication at a tertiary care hospital during COVID-19 pandemic.
A hospital-based cross-sectional study was conducted among women admitted for delivery in the Department of Obstetrics and Gynecology of a tertiary teaching hospital during the second wave of COVID-19 (1 May 2021-30 July 2021). Convenience sampling technique was applied and 1350 women were categorized into groups using Robson ten group classification system. Group size, group caesarean rate, absolute and relative contribution of each group to overall caesarean rate were calculated.
Out of 1350 total deliveries during COVID-19, lower segment caesarean section was done in 446 (33.04%) (30.53-35.55 at 95% Confidence Interval). Major indication for caesarean section was previous caesarean in 185 (41.48%). Most women 202 (45.29%) were from the age group 24-30 years and gestational age between 37 and 42 weeks. Major contributor to the overall caesarean section rate was Robson group 5 (37%).
This study showed higher prevalence of caesarean section delivery rate during COVID-19 pandemic than that compared with 2016 national statistics of Nepal. Despite of several challenges brought by the pandemic, pregnant women were still able to access the emergency obstetric care services in the Eastern part of Nepal. However, future studies should focus on exploring the situation in rural areas too.
当出现与妊娠相关的并发症且无法尝试或无法进行阴道分娩时,会进行剖宫产。大流行封锁对卫生服务的可及性和可获得性的影响是一个全球关注的问题。本研究的目的是了解 COVID-19 大流行期间一家三级护理医院的剖宫产率及其指征。
在 COVID-19 第二波期间(2021 年 5 月 1 日至 2021 年 7 月 30 日),在一家三级教学医院的妇产科对入院分娩的妇女进行了一项基于医院的横断面研究。采用便利抽样技术,使用罗布森十组分类系统将 1350 名妇女分为不同组。计算了每组的组规模、组剖宫产率、每组对总体剖宫产率的绝对和相对贡献。
在 COVID-19 期间的 1350 例分娩中,有 446 例(33.04%)进行了下段剖宫产(95%置信区间为 30.53 - 35.55)。剖宫产的主要指征是既往剖宫产,共 185 例(41.48%)。大多数妇女(202 例,45.29%)年龄在 24 - 30 岁之间,孕周在 37 至 42 周之间。总体剖宫产率的主要贡献者是罗布森第 5 组(37%)。
本研究表明,COVID-19 大流行期间剖宫产分娩率的患病率高于尼泊尔 2016 年的全国统计数据。尽管大流行带来了诸多挑战,但尼泊尔东部的孕妇仍能够获得紧急产科护理服务。然而,未来的研究也应关注农村地区的情况。