Perioperative Management and Outcomes After Cesarean Section—A Cross-Sectional Study From Rural Rwanda

Mazimpaka, Christian; Uwitonze, Eline; Cherian, Teena; Hedt‐Gauthier, Bethany; Kateera, Fredrick; Riviello, Robert; El‐Khatib, Ziad; Sonderman, Kristin; Gruendl, Magdalena; Habiyakare, Caste; Hakizimana, Sadoscar; Kayitesi, Daniella; Nkurunziza, Theoneste

doi:10.1016/j.jss.2019.07.070

Cited by 15 publications

(14 citation statements)

References 21 publications

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“…This finding is consistent with the study conducted by Rojas et al which demonstrated a significant association of CS with neonatal infection [24]. The intra-operative procedure during CS with a lack of fully sterile conditions might have led to the increased risk of infection [25]. Furthermore, the indications for CS such as fetal distress, cord prolapse, prolonged or obstructed labor contributes to the increased risk for infection [26,27].…”

Section: Discussionsupporting

confidence: 90%

Epidemiology of neonatal infections in hospitals of Nepal: evidence from a large- scale study

et al. 2020

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Background: Every year, neonatal infections account for approximately 750,000 neonatal deaths globally. It is the third major cause of neonatal death, globally and in Nepal. There is a paucity of data on clinical aetiology and outcomes of neonatal infection in Nepal. This paper aims to assess the incidence and risk factors of neonatal infection in babies born in public hospitals of Nepal. Methods: This is a prospective cohort study conducted for a period of 14 months, nested within a large-scale cluster randomized control trial which evaluated the Helping Babies Breathe Quality Improvement package in 12 public hospitals in Nepal. All the mothers who consented to participate within the study and delivered in these hospitals were included in the analysis. All neonates admitted into the sick newborn care unit weighing > 1500 g or/and 32 weeks or more gestation with clinical signs of infection or positive septic screening were taken as cases and those that did not have an infection were the comparison group. Bivariate and multi-variate analysis of sociodemographic, maternal, obstetric and neonatal characteristics of case and comparison group were conducted to assess risk factors associated with neonatal infection. Results: The overall incidence of neonatal infection was 7.3 per 1000 live births. Babies who were born to first time mothers were at 64% higher risk of having infection (aOR-1.64, 95% CI, 1.30-2.06, p-value< 0.001). Babies born to mothers who had no antenatal checkup had more than threefold risk of infection (aOR-3.45, 95% CI, 1.82-6.56, p-value< 0.001). Babies born through caesarean section had more than twofold risk (aOR-2.06, 95% CI, 1.48-2.87, p-value< 0.001) and babies with birth asphyxia had more than threefold risk for infection (aOR-3.51, 95% CI, 1.71-7.20, p-value = 0.001). Conclusion: Antepartum factors, such as antenatal care attendance, and intrapartum factors such as mode of delivery and birth asphyxia, were risk factors for neonatal infections. These findings highlight the importance of ANC visits and the need for proper care during resuscitation in babies with birth asphyxia.

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Section: Discussionsupporting

confidence: 90%

Epidemiology of neonatal infections in hospitals of Nepal: evidence from a large- scale study

et al. 2020

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“…This finding is consistent with the study conducted by Rojas et al which demonstrated a significant association of CS with neonatal infection [22]. The intra-operative procedure during CS with a lack of fully sterile conditions might have led to the increased risk of infection [23]. Furthermore, the indications for CS such as fetal distress, cord prolapse, prolonged or obstructed labor contributes to the increased risk for infection [24,25].…”

Section: Discussionsupporting

confidence: 90%

Epidemiology of neonatal infections in hospitals of Nepal: Evidence from a large- scale study

Budhathoki

Sunny²,

Paudel³

et al. 2019

Preprint

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Introduction Every year, neonatal infections account for approximately 750,000 neonatal deaths globally. It is the third major cause of neonatal death, globally and in Nepal. There is a paucity of data on clinical aetiology and outcomes of neonatal infection in Nepal. This paper aims to assess the incidence and risk factors of neonatal infection in babies born in public hospitals of Nepal.Methods This is a prospective cohort study conducted for a period of 14 months, nested within a large-scale cluster randomized control trial which evaluated the Helping Babies Breathe Quality Improvement package in 12 public hospitals in Nepal. All the mothers who consented to participate within the study and delivered in these hospitals were included in the analysis. All neonates admitted into the sick newborn care unit weighing >1500 gram or/and 32 weeks or more gestation with clinical signs of infection or positive septic screening were taken as cases and those that did not have an infection were the comparison group. Bivariate and multi-variate analysis of socio-demographic, maternal, obstetric and neonatal characteristics of case and comparison group were conducted to assess risk factors associated with neonatal infection.Results The overall incidence of neonatal infection was 7.3 per 1000 live births. Babies who were born to first time mothers were at 59% higher risk of having infection (aOR-1.64, 95% CI, 1.30-2.06, p-value<0.001). Babies born to mothers who had no antenatal check-up had more than three-fold risk of infection (aOR-3.45, 95% CI, 1.82-6.56, p-value<0.001). Babies born through caesarean section had more than two-fold risk (aOR-2.06, 95% CI, 1.48-2.87, p-value<0.00) and babies with birth asphyxia had more than three-fold risk for infection (aOR-3.51, 95% CI, 1.71-7.20, p-value=0.001).Conclusion Antepartum factors, such as antenatal care attendance, and intrapartum factors such as mode of delivery and birth asphyxia, were risk factors for neonatal infections. These findings highlight the importance of ANC visits and the need for proper care during resuscitation in babies with birth asphyxia.

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“…In the present study, similar to the Mazimpaka study, patients 24 and 72 hours after discharge did not have significant post-operative complications. 18 In about our study limitation, we can say that due to COVID-19 pandemic the referral of mother changed from onsite interview to call interview and during this call follow-up we invited women to come to the clinical examination if they had symptoms.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the consequences of early permission of mothers with cesarean delivery

Jalilvand

Sadat-Razavi

Sharghi

et al. 2021

Int J Contemp Pediatr

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Background: In Iran, there is a high tendency to give birth by cesarean section, while about 75% of them are unnecessary and selective. In many hospitals in the country, mothers who have undergone cesarean section are permission 24 hours after the operation if they have stable vital signs and are in good general condition. The aim of this study was to evaluate the consequences of early discharge in mothers who underwent cesarean section.Methods: This descriptive case-series study was performed on 400 pregnant women aged 18-40 years with a gestational age of 37 weeks and more who were admitted to the hospital in Ardabil city for cesarean section at year 2019. Patients without any preference were divided into two groups. The first group was discharged 24 hours and second group was discharged 72 hours after surgery. Individuals in both groups were followed up by telephone 1 and 6 weeks after permission. The relevant checklist was completed for all of them. Other necessary data were collected through a questionnaire containing demographic and clinical information.Results: Two groups were matched in terms of age and body mass index. At one and six weeks after discharge; there was no significant difference between two groups in terms of fever, readmission, symptoms of infection and use of antibiotics.Conclusions: The results of the present study showed that after cesarean section, if the patient's vital signs are stable, the patient can be discharged after 24 hours.

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Perioperative Management and Outcomes After Cesarean Section—A Cross-Sectional Study From Rural Rwanda

Cited by 15 publications

References 21 publications

Epidemiology of neonatal infections in hospitals of Nepal: evidence from a large- scale study

Epidemiology of neonatal infections in hospitals of Nepal: evidence from a large- scale study

Epidemiology of neonatal infections in hospitals of Nepal: Evidence from a large- scale study

Evaluation of the consequences of early permission of mothers with cesarean delivery

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