Abstract
Background and Aim: The aim of this study was to study the prevalence, indications and the different complications of cesarean section in King Khalid Hospital (KKH). Methods: This was a cross-sectional study done in one-year duration (January 2016- December 2016) at KKH Hospital (Majmaah Saudi Arabia) in the Gynecology & Obstetrics Department. The study population consisted of 394 women who delivered at the hospital during the period of the study. Results: Most of patients who underwent cesarean section were in the age group of 26-30 years (33.8%) and the lowest number was in the age group 15-20 (1%), the majority of patients were housewife (80.7%), regarding the parity most of them fall in the range para 2-4 (62.7%). C.S prevalence was 30.1% (394) and vaginal delivery was 69.9.1% (918), performed as an emergency (59.1%) and the rest were done electively (40.9%). almost one third of C-sections had complications 31.9% ,the other two third were free of complications (68.1%), the highest rate of complications was abdomen and pelvic adhesion 88 (69%) followed by intra- and post-partum hemorrhage10 (7.9%), bladder injury 4 ( 3.1% ) and poor wound healing was 4 ( 3.1%). Conclusions: This study concluded that KKH Majmaah hospital has high prevalence of C.S in comparison to the international figures which need effective strategies to bring this number to normal figures, pelvic adhesion is the most frequent complication which can led to further future complications.
Keywords: Cesarean section · prevalence · indications · complications · Majmaah · Saudi Arabia
References
- 1.Abenhaim HA, Benjamin A. Higher caesarean section rates in women with higher body mass index: are we managing labour differently. Journal of Obstetistics Gynaecology Canadian. 2011;33(5):443–448. [2]BillardM.Cesareansectionondemand: is it a fad or an advance in medical practice? Can Fam Physician. 2011;57(11): 406, 1243.
- 2.Ashtiani N, Hagmolen of ten Have W, Vreede WT, Vogt WP, van Elburg RM. Respiratoire complicaties bij vroege electieve sectio caesarea [Respiratory complications in early elective caesarean section] Ned Tijdschr Geneeskd. 2009;153:157.
- 3.McDonnell NJ, Paech MJ, Clavisi OM, Scott KL, Group AT. Difficult and failed intubation in obstetric anaesthesia: an observational study of airway management and complications associated with general anaesthesia for caesarean section. Int J Obstet Anesth. 2008;17(4):292–297.
- 4.Maric T, Tomic V, Darko K. Puerperalne komplikacije u prvorotki porodenih carskim rezom: studija parova [Puerperal complications in nulliparous women deliv- Majmaah Journal of Health Sciences ,Vol. 8, Issue 3, September - 2020 , Muharam - 1442 43 Cesarean Delivery in Majmaah, SaudiArabia: prevalence, indications and complications ered by section caesarean: pair study] Med Arh. 2006;60(4):246–250.
- 5.Bulow-Lehnsby AL, Gronbeck L, Krebs L, Langhoff-Roos J. Komplikationer i forbindelse med kejsersnit i elektivt sectio-team [Complications of elective caesarean section performed by a special section team] Ugeskr Laeger. 2006;168(47):4088–4090
- 6.Jonsdottir G, Bjarnadottir RI, Geirsson RT, Smarason A. Eru tengsl a milli ti[eth]ni keisaraskur[eth]a og bur[eth]armalsdau[eth]a a Islandi undanfarin 15 ar? [No correlation between rates of caesarean section and perinatal mortality in Iceland] Laeknabladid. 2006;92(3):191–195
- 7.Hounton SH, Newlands D, Meda N, De Brouwere V.Acost-effectiveness study of caesarean-section deliveries by clinical officers, general practitioners and obstetricians in Burkina Faso. Hum Resour Health. 2009;7:34
- 8.Murray SF. Relation between private health insurance and high rates of caesarean section in Chile: qualitative and quantitative study. BMJ. 2000;321(7275): 1501–1505
- 9.Giani U, Bruzzese D, Pugliese A, Saporito M, Triassi M. Risk factors analysis for elective caesarean section in Campania region (Italy) Epidemiol Prev. 2011;35(2):101–110
- 10.Kmietowicz Z. NICE advises against caesarean section on demand. BMJ. 2004;328(7447):1031
- 11.Sultan AH, Stanton SL. Preserving the pelvic floor and perineum during childbirth – elective caesarean section? Br J Obstet Gynaecol. 1996;103(8):731–734
- 12.Scioscia M, VimercatiA, Cito L, Chironna E, Scattarella D, Selvaggi LE. Social determinants of the increasing caesarean section rate in Italy. Minerva Ginecol. 2008;60(2):115–120
- 13.Barton A. Caesarean section and litigation. Lancet. 2001;357(9255):556
- 14.Belizan JM, Quaranta P, Paquez E, Villar J. Caesarean section and fear of litigation. Lancet. 1991;338(8780):1462
- 15.McCallum C. Explaining caesarean section in Salvador da Bahia, Brazil. Sociol Health Illn. 2005;27(2):215–242 44 Majmaah Journal of Health Sciences ,Vol. 8, Issue 3, September - 2020 , Muharam - 1442 Cesarean Delivery in Majmaah, SaudiArabia: prevalence, indications and complications
- 16.Nuttall C. Caesarean section controversy. The caesarean culture of Brazil. BMJ. 2000;320(7241):1074
- 17.Ba’aqeel HS. Cesarean delivery rates in Saudi Arabia: a ten-year review. Ann Saudi Med. 2009;29(3):179–183
- 18.Feng XL, Xu L, Guo Y, Ronsmans C. Factors influencing rising caesarean section rates in China between 1988 and 2008. Bull World Health Organ. 2012;90(1):30–39.
- 19.Barber EL, Lundsberg LS, Belanger K, Pettker CM, Funai EF, Illuzzi JL. Indications contributing to the increasing cesarean delivery rate. Obstet Gynecol. 2011;118(1):29–38
- 20.Stavrou EP, Ford JB, ShandAW, Morris JM, Roberts CL. Epidemiology and trends for caesarean section births in New SouthWales,Australia:apopulation-based study. BMC Pregnancy Childbirth. 2011; 11:8
- 21.American College of Obstetricians andGynecologistsACOGcommitteeopinion no. 559: cesarean delivery on maternal request. Obstet Gynecol. 2013;121(4): 904–907
- 22.Al-Mubarak KA, Adamchak DJ. Fertility attitudes and behavior of Saudi Arabian students enrolled in U.S. universities. Soc Biol. 1994 Fall-Winter;41(4):267–273
- 23.Wilson D, Dornan J, Milsom I, Freeman R. UR-CHOICE: can we provide mothers-to-be with information about the risk of future pelvic floor dysfunction? Int Urogynecol J. 2014;25(11):1449–1452
- 24.Rogers RG, Leeman LM, Borders N, et al. Contribution of the second stage of labour to pelvic floor dysfunction: a prospective cohort comparison of nulliparous women. BJOG. 2014;121(9):1145–1153.
- 25.Handa VL, Pierce CB, Munoz A, Blomquist JL. Longitudinal changes in overactive bladder and stress incontinence among parous women. Neurourol Urodyn. 2015;34(4):356–361
- 26.Gyhagen M, Bullarbo M, Nielsen TF, Milsom I. A comparison of the long-term consequences of vaginal delivery versus caesarean section on the prevalence, severity and bothersomeness of urinary incontinence subtypes: a national cohort study in primiparous women. BJOG. 2013;120(12):1548–1555 Majmaah Journal of Health Sciences ,Vol. 8, Issue 3, September - 2020 , Muharam - 1442 45 Cesarean Delivery in Majmaah, SaudiArabia: prevalence, indications and complications
- 27.Gyhagen M, Bullarbo M, Nielsen TF, Milsom I. The prevalence of urinary incontinence 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery. BJOG. 2013;120(2):144–151
- 28.Faisal I, Matinnia N, Hejar AR, Khodakarami Z. Why do primigravidae request caesarean section in a normal pregnancy? A qualitative study in Iran. Midwifery. 2014;30(2):227–233
- 29.Adekanle DA, Adeyemi AS, Fadero FF. Booking status and caesarean section outcome in LAUTECH teaching Hospital, Osogbo. Niger J Med. 2008;17(1):25–28
- 30.Kottmel A, Hoesli I, Traub R, et al. Maternal request: a reason for rising rates of cesarean section?Arch Gynecol Obstet. 2012;286(1):93–98.
- 31.Shaaban MM, Ahmed WS, Khadr Z, El-Sayed HF. Obstetricians’ perspective towardscesareansectiondeliverybasedon professional level: experience from Egypt. Arch Gynecol Obstet. 2012;286(2): 317–323
- 32.Pradhan A, Tincello DG, Kearney R. Childbirth after pelvic floor surgery: analysis of Hospital Episode Statistics in England, 2002–2008. BJOG. 2013;120(2):200–204
- 33.Demoulin G,ThubertT, Faivre E,Trichot C, Deffieux X. Grossesse et post-partum des patientes porteuses de bandelette sous-uretrale: revue de la litterature [Pregnancy and postpartum of women with mid-urethral sling procedure: a review of the literature] J Gynecol Obstet Biol Reprod (Paris) 2013;42(6):518–524
- 34.Tommaselli GA, Di Carlo C, Formisano C, Fabozzi A, Nappi C. Vaginal delivery following single incision sling (TVT-Secur) for female stress urinary incontinence. J Obstet Gynaecol Res. 2013;39(2):608–610
- 35.Kohorst F, Flock F, Kreienberg R, ReichA. Pregnancy and delivery after tension-freevaginaltape(TVT)procedure:literaturereviewandcasereport.EurJObstet Gynecol Reprod Biol. 2010;151(1):10–13
- 36.Tan HJ, Siu W, Faerber GJ, McGuire EJ, Latini JM. Long-term durability of pubovaginal fascial slings in women who then become pregnant and deliver. Int Urogynecol J. 2010;21(6):631–635
- 37.Ebulue V, Vadalkar J, Cely S, Dopwell F, Yoong W. Fear of failure: are we 46 Majmaah Journal of Health Sciences ,Vol. 8, Issue 3, September - 2020 , Muharam - 1442 Cesarean Delivery in Majmaah, SaudiArabia: prevalence, indications and complications doing too many trials of instrumental delivery in theatre? Acta Obstet Gynecol Scand. 2008;87(11):1234–1238
- 38.Gharoro EP, Enabudoso EJ. Labour management: an appraisal of the role of false labour and latent phase on the delivery mode. J Obstet Gynaecol. 2006;26(6):534–537
- 39.Vimercati A, Greco P, Loizzi V, Loverro G, Selvaggi L. Medicina Difensiva nella scelta del taglio cesareo [“Defensive medicine” in the choice of cesarean section] Acta Biomed Ateneo Parmense. 2000;71(Suppl 1):717–721
- 40.Kornacka MK, Kufel K. Ciecie cesarskie a stan noworodka [Neonatal outcome after cesarean section] Ginekol Pol. 2011;82(8):612–617.
- 41.Laws P, Sullivan EA. Australia’s mothers and babies 2007. Sydney,Australia: National Perinatal Statistics Unit; 2009
- 42.Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Mathews TJ, Kirmeyer S, Osterman MJK. Births: final data for 2006. Natl Vital Stat. 2009;58(24):1–85
- 43.Information Centre. Method of delivery, 1980 to 2007–8. NHS maternity Statistics, England: 2008-09. Department of Health; 2009
- 44.Zeitlin J, Szamotulska K, Drewniak N, Mohangoo A, Chalmers J, Sakkeus L, Irgens L, Gatt M, Gissler M, Blondel B. Preterm birth time trends in Europe: a study of 19 countries. BJOG. 2013.
- 45.Tetsuya K & Helain L. Surgical site infections after cesarean delivery: epidemiology, prevention and treatment. Maternal Health, Neonatology and Perinatology. 2017:3. 10.1186/s40748-017-0051-3. doi:10.1186/s40748-017-0051-3
- 46.AlSheeha M, Epidemiology of Cesarean Delivery in Qassim, Saudi Arabia, journal of medical science 2018 May 20; 6(5): 891–895.
- 47.Eri Maeda. .Cesarean section rates and local resources for perinatal care in Japan, The Journal of Obstetrics and Gynecology Research , 44 (2): 208-16
Peer review
Peer reviewed by 2 reviewers, who chose to remain anonymous.