A 6-year review of maternal outcomes for second stage cesarean section in Hospital Universiti Sains Malaysia

Objectives: To determine the prevalence of cesarean section performed in the second stage of labour and to identify the maternal outcomes and its associated risk factors in these women. Study design: This retrospective study was carried out in the Hospital University Sains Malaysia (HUSM). Medic...

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Main Author: Rashid, Nurul Nafizah Mohd
Format: Thesis
Language:English
Published: 2018
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Online Access:http://eprints.usm.my/47583/1/Dr.%20Nurul%20Nafizahohd%20Rashid-24%20pages.pdf
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spelling my-usm-ep.475832020-10-18T07:09:50Z A 6-year review of maternal outcomes for second stage cesarean section in Hospital Universiti Sains Malaysia 2018 Rashid, Nurul Nafizah Mohd RG Gynecology and obstetrics Objectives: To determine the prevalence of cesarean section performed in the second stage of labour and to identify the maternal outcomes and its associated risk factors in these women. Study design: This retrospective study was carried out in the Hospital University Sains Malaysia (HUSM). Medical records of 207 women with singleton cephalic pregnancies at term, identified from the hospital database, who underwent a second stage cesarean section (SSCS) between 1st January 2010 and 31st December 2015, were reviewed and demographic and outcome data were collected. Results: During the study period 8197/42,546 (19.3%) babies were delivered by CS. Two hundred and fifty seven CS (4.1%) were performed in the second stage of labour. Almost half of the women were nulliparous (49.3%) and 87.9% had spontaneous labour and 59.4% (n=123) had oxytocin augmentation. There were 48 (23.2%) whom had previous cesarean sections and 147 (71.1%) had the station below zero (62.3%, 7.7% and 1.0% for station 0, +1 & +2 respectively). 85.5% of women had a second stage CS without a trial of instrumental delivery. The mean duration of second stage in this study was 144 (±56.2) minutes and mean estimated blood loss was 545 (±357) mls. 12.6% of women (n=26) had postpartum hemorrhage (greater than or equal to 1000mls). 10.6% (n=22) of these women required blood transfusion. Only 1 woman (0.5%) need to be admitted to intensive care unit post-operatively. 78.7% (n=163) had the overall length of hospital stay for 3 days. 18.4% (38) and 15.9% (33) of women had extended uterine tear and uterine atony respectively. Otherwise none of the women sustained neither cervical tear nor bladder injury. The parity (p<0.001), attempted instrumentation (p<0.001), and baby weight (p<0.004) were statistically significant association with the total blood loss. The risk factors for extended uterine tear was statistically significant associated with parity (p<0.012) and attempted instrumentation (p<0.001) respectively. Conclusions: The overall outcomes of second stage CS performed in HUSM is comparable to studies done in other centres. Current practices need to be maintained or improved especially with regards to meticulous documentation and training of junior obstetric staff to provide the best care for the patients. 2018 Thesis http://eprints.usm.my/47583/ http://eprints.usm.my/47583/1/Dr.%20Nurul%20Nafizahohd%20Rashid-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution Universiti Sains Malaysia
collection USM Institutional Repository
language English
topic RG Gynecology and obstetrics
spellingShingle RG Gynecology and obstetrics
Rashid, Nurul Nafizah Mohd
A 6-year review of maternal outcomes for second stage cesarean section in Hospital Universiti Sains Malaysia
description Objectives: To determine the prevalence of cesarean section performed in the second stage of labour and to identify the maternal outcomes and its associated risk factors in these women. Study design: This retrospective study was carried out in the Hospital University Sains Malaysia (HUSM). Medical records of 207 women with singleton cephalic pregnancies at term, identified from the hospital database, who underwent a second stage cesarean section (SSCS) between 1st January 2010 and 31st December 2015, were reviewed and demographic and outcome data were collected. Results: During the study period 8197/42,546 (19.3%) babies were delivered by CS. Two hundred and fifty seven CS (4.1%) were performed in the second stage of labour. Almost half of the women were nulliparous (49.3%) and 87.9% had spontaneous labour and 59.4% (n=123) had oxytocin augmentation. There were 48 (23.2%) whom had previous cesarean sections and 147 (71.1%) had the station below zero (62.3%, 7.7% and 1.0% for station 0, +1 & +2 respectively). 85.5% of women had a second stage CS without a trial of instrumental delivery. The mean duration of second stage in this study was 144 (±56.2) minutes and mean estimated blood loss was 545 (±357) mls. 12.6% of women (n=26) had postpartum hemorrhage (greater than or equal to 1000mls). 10.6% (n=22) of these women required blood transfusion. Only 1 woman (0.5%) need to be admitted to intensive care unit post-operatively. 78.7% (n=163) had the overall length of hospital stay for 3 days. 18.4% (38) and 15.9% (33) of women had extended uterine tear and uterine atony respectively. Otherwise none of the women sustained neither cervical tear nor bladder injury. The parity (p<0.001), attempted instrumentation (p<0.001), and baby weight (p<0.004) were statistically significant association with the total blood loss. The risk factors for extended uterine tear was statistically significant associated with parity (p<0.012) and attempted instrumentation (p<0.001) respectively. Conclusions: The overall outcomes of second stage CS performed in HUSM is comparable to studies done in other centres. Current practices need to be maintained or improved especially with regards to meticulous documentation and training of junior obstetric staff to provide the best care for the patients.
format Thesis
qualification_level Master's degree
author Rashid, Nurul Nafizah Mohd
author_facet Rashid, Nurul Nafizah Mohd
author_sort Rashid, Nurul Nafizah Mohd
title A 6-year review of maternal outcomes for second stage cesarean section in Hospital Universiti Sains Malaysia
title_short A 6-year review of maternal outcomes for second stage cesarean section in Hospital Universiti Sains Malaysia
title_full A 6-year review of maternal outcomes for second stage cesarean section in Hospital Universiti Sains Malaysia
title_fullStr A 6-year review of maternal outcomes for second stage cesarean section in Hospital Universiti Sains Malaysia
title_full_unstemmed A 6-year review of maternal outcomes for second stage cesarean section in Hospital Universiti Sains Malaysia
title_sort 6-year review of maternal outcomes for second stage cesarean section in hospital universiti sains malaysia
granting_institution Universiti Sains Malaysia
granting_department Pusat Pengajian Sains Perubatan
publishDate 2018
url http://eprints.usm.my/47583/1/Dr.%20Nurul%20Nafizahohd%20Rashid-24%20pages.pdf
_version_ 1747821805340459008