Post-partum complications within one week after cesarean section: A study of 100 cases in a tertiary Hospital

Author(s): Dr. Sarmin Sultana Swarna, Dr. Dipannita Dhar, Dr. Farjana Sarmin, Dr. Fatema Akter Doly, Dr. Minara Sikder, Dr. Rubina Bari, Dr. Anjumanara Begum.

Background:

Delays in seeking, accessing, and receiving quality care in facilities increase Caesarean delivery rates and risks of adverse outcomes. Other co-morbidities worsen low socioeconomic conditions and nutritional status. Good maternal and perinatal outcomes can be ensured through essential obstetric and newborn care provided by skilled attendants during pregnancy and childbirth.

Aim of the study:

To identify the early post-partum complications after the cesarean section.

Methods:

Admitted patients were selected with convenience sampling, a non-probability sampling technique for elective and emergency cesarean sections. The primary endpoint was risk factors and elective and emergency cesarean section indications in primi and multigravida. The secondary endpoint includes determining the maternal and fetal outcome of elective and emergency cesarean section in primi and multigravida. Main outcome measure (s): Age, socioeconomic status, antenatal care, gestational age, weight, blood pressure, complication, an indication of cesarean section, sex, APGAR score, and birth weight.

Result:

Most patients in the third decade in both groups and women of low-income socioeconomic status were 71.9% in primi and 65.1% in multi-group. The mean gestational age was 37.6±3.4 weeks in the primi group and 38.1±2.8 weeks in the multi-group. Most women were on irregular antenatal care, 52.6% in the prime group and 53.5% in the multi-group. Meanwhile, 17.5% and 14.0% in prime and multi-group did not receive antenatal check-ups during their pregnancy periods. The mean weight was 52.8±5.4 kg (mean ±SD) in the primi group and 53.3±7.0 kg (mean ±SD) in the multi-group. In the primi group, the majority, 46(80.74%) mothers had an emergency cesarean section, and in the multi-group, 30(69.8%) had an elective cesarean section. A systolic and diastolic blood pressure comparison did not show any statistically significant difference between the two groups. Indications of elective CS gestational diabetes mellitus were found to be 4(36.4%) in primi gravida and 2(6.7%) in multigravida, which was statistically significant (p<0.05) between the two groups. However, other indications of elective CS were not statistically significant (p>0.05) between the two groups. Indications of emergency CS: The majority, 15(32.6%) patients, had failed induction in primi gravida and 6(46.2%) in multigravida. This was followed by 14(30.4%) had post-dated pregnancy in primi gravida and 6(46.2%) in multigravida. Indications of emergency CS were not statistically significant (p>0.05) between the two groups. In primi groups, 8.8% of patients had haemorrhage per operative complication; in multi groups, 7.0% had haemorrhage. In post-operative complication, in primi groups, 10.5% of patients had wound infection, and in multi groups, 11.6% had wound complications.

Conclusion:

Risk factors associated with emergency cesarean section were irregular/no antenatal care, poor educational level, most of the patients were homemakers, and most of them came from low socioeconomic families. Major decision-makers in their families were husbands and mother-in-laws. Common indications were failed induction, cephalo pelvic disproportion, low-lying placenta, pre-eclampsia, malposition, and breech presentation.