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Abstract
Summary – Conclusion& Recommendation
This study has been done in Zagazig University Hospitals, Obstetrics Department,
in one year from June 2005 - June 2006.
The aim of this study is to reduce maternal & fetal morbidity and mortality and this done
as regard to the incidence of Vaginal deliveries either N.V.D.( spontenous) or assisted
V.D. ( Vaccum & forceps), incidence of CS., as well as maternal and fetal morbidity &
mortality. In the last period it is found that rate of CS increased all over the world.
In United States total cesarean rate increased every year, and in 2002 it was 26.1%, the
highest rate ever recorded. In 2004, 29.1% of all live births were delivered by cesarean
section, according to the National Center for Health Statistics (NCHS).47
In England, cesarean section rates have increased from 9% of deliveries in 1980 to
21% in 2001 therefore about 120,000 caesarean sections are performed annually in
England and Wales. A similar increase in CS rates has been seen in many developed
countries
It this study all cases assessed according to : age of the mother, parity, mode of
delivery, medical disorders, post partum complications (e.g. PPH, infection, DVT ),
and neonatal outcome (live birth or stillbirth ) and this fetus need admission to NICU or
no. The main goal of this study is how to reduce feto-maternal morbidity and mortality.
The following Results was found :
Total numbers of patients who were admitted to obstetric Department in labour during
the period from June 2005 – June 2006 was (6350), Total number of N.V.D. was
( 3821 =60.2% ), Total number of operative V.D. was ( 112 =1.8%), Total number of CS
was ( 2417 = 38.1%). And it was found that ( 43.8% ) due to previous CS,
(13.8% ) due to CPD, ( 9.9% ) due to Malpresentations & Malpositions,
( 9.1% ) due to APH, ( 8.3% ) due to Hypertension & preeclampsia,
(13% ) due to fetal distress, ( 1.2% ) due to previous myomectomy ,
( 0.95% ) due to rupture uterus, total number of live birth was ( 6243 = 98.3% ),
Total number of maternal deaths was ( =0.09%),
total number of still birth was ( 107 = 1.7% ) and total number of babies admitted to
NICU was ( 222 = 3.5% ).
By analysis of results of the study it is found that :
Rate of CS increased allover the World and this is due to previous CS, delay in
childbirth and reduced parity, decrease in rate of vaginal breech delivery, short period
between Pregnancies especially if previous delivery by CS and fear of complications
that may occur to the scar of the uterus during trial of vaginal delivery after CS,
In addition to medical complications that may occur with increased age for the mother.
Conclusion
Rate of cesarean section in Zagazig University Hospitals in one year from June 2005
to June 2006 was ( 2417 = 38.1% ), the cesarean section patient were classified
according to causes of cesarean section, it has been found that (43.8%) were due
to previous cesarean section, (13.8 %) due to CPD, ( 9.9% ) due to Malpresentations
& Malpositions, ( 9.1% ) due to APH, ( 8.3% ) due to Hypertension & preeclampsia,
(13% ) due to fetal distress.
CS due to previous surgery of the uterus :- Myomectomy 1.2%
- Repaired rupture uterus 0.95%
Total number of maternal deaths was ( =0.09%),
Total number of still birth was ( 107 = 1.7% )