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Abstract

Background: Caesarean section or caesarean delivery is a surgical procedure in which
a baby is delivered through abdominal and uterine incision. A Caesarean delivery
can be planned ahead of time or performed in an emergency. It carries more risk
than a vaginal delivery. Caesarean delivery is mainly done in to save foetus and at
times to save the mother by termination of pregnancy. It is sometimes associated with
great deal of mortality and morbidity due to either intra operative or postoperative
complications. Emergency LSCS has more complications as compared to elective
LSCS. Most of the patients undergoing Emergency LSCS are un booked as compared
to Elective LSCS. Complications are present both in Emergency and Elective LSCS
with emergency relatively more. Most of the un booked and referred patients undergo
emergency LSCS which contributes to major complications
Aims and objectives: The aim was to determine the prevalence of Caesarean delivery
in Silchar Medical College and to study the most common cause leading to mortality
and morbidity in patients undergoing Elective and emergency LSCS.
Materials and Method: A hospital based prospective observational study was
conducted in Silchar Medical College and Hospital from 1st June 2021 to 31st May
2022 after approval from ethical committee. A total of 300 patients attending the
Labour room were examined during the study period.
Results: During our study period total number of births were 9831, out of which
4375 birth were by Caesarean delivery. It was found that un-booked cases contributed
more in emergency LSCS. Since P < 0.001, the un-booked patients are significantly
associated with emergency LSCS. The maximum number of the patients had
their education up to matriculation and maximum number of the patients were
socioeconomically middle class. Highest number of cases belonged to age group 21
to 25years both in emergency LSCS and elective LSCS. Highest number of C-section
is perform for primigravida and incidence of C section is decreasing with increasing
parity. In our study patients undergoing emergency LSCS were mostly given midline vertical incision and transverse incision was common in elective LSCS patients. Out of
the total of 200 patients who had emergency LSCS 30 of the patients were admitted
in central ICU who were maternal near miss and out of 100 patients with elective
LSCS only two patients were maternal near miss. fetal distress is the most common
indication in emergency LSCS and previous Caesarean with associated complication is
most common indication for Elective LSCS. Intra operative complications are higher
with patients undergoing emergency LSCS. Patients undergoing emergency LSCS had
more complications in postoperative period as compared to Elective LSCS. Anaemia
was the most common maternal risk factor in the group of people undergoing
Emergency LSCS and Gestational diabetes mellitus was common among in Elective
LSCS group. There was a death of one patient out of 300 patients. She was a referred
case of obstructed labour with severe anaemia. LSCS done with one blood in hand.
She expired within 24hrs. in ICU
Conclusion: From our study we have found that anaemia and late referral is one of the
leading causes in maternal mortality and morbidity
Key words: LSCS- lower segment caesarean section. ICU-Intensive care unit, BOH-Bad
obstetric history

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