Early Puerperal Complications Following Emergency Caesarean Section
Jesmin Banu *
Department of Obstetrics and Gynaecology, International Medical College Hospital (IMCH), Dhaka, Bangladesh.
Ferdousi Begum Flora
Department of Obstetrics and Gynaecology, Ashulia Women and Children Hospital, Dhaka, Bangladesh.
Sohana Siddika
Department of Obstetrics and Gynaecology, International Medical College Hospital (IMCH), Dhaka, Bangladesh.
Anjumman Ara Rita
Department of Obstetrics and Gynaecology, Ashulia Women and Children Hospital, Dhaka, Bangladesh.
Anjana Rani Ghosh
Department of Obstetrics and Gynaecology, Combined Military Hospital, Dhaka, Bangladesh.
Rifat Binte Alam
Department of Obstetrics and Gynaecology, Combined Military Hospital, Dhaka, Bangladesh.
*Author to whom correspondence should be addressed.
Abstract
Background: The puerperium is the period of adjustment after delivery when the anatomic and physiologic changes of pregnancy are reversed to the normal non pregnant state. There are so many complications in early puerperium which was predominant in surgical intervention. Due to lack of maternity care in early postoperative period maternal mortality and morbidities in developing countries is still higher than the developed countries.
Objective: To find out the common complication encountered during 7 days following emergency caesarean section.
Material and Methods: It was a Prospective observational type of study carried out in the Department of Obstetrics & Gynaecology in Dhaka Medical College, Dhaka during the period of January 2013 to June 2013. Total 300 pregnant women were included who underwent emergency caesarian section. Sample interval was 2700\300= 9. In first 9 patient lottery method was done and 8ᵗʰ patient was taken for the case, the next number was 8+9=17ᵗʰ and in this way 300 patients were selected. Data were collected in predesigned data collection sheet and data were analyzed using statistical package for social science (SPSS).
Result: This study found that most of the patients were in 20–30 years in age group. Most of the population in my study group belongs to para 1 to 2 (54%). Most predisposing factors were lower socioeconomic status (32%), no antenatal check-up (32%). Common complications in early puerperal period were wound infection (61.66%), sepsis (19%), UTI (44.20%), RTI (32.70%), thrombosis (7.69%), thrombophlebitis (9.62%), PPH (9.66%) and eclampsia (19.20%). There was no maternal mortality within the study period.
Conclusion: Infectious state was the major morbidity in early puerperium following caesarean section because many of the study subjects had already developed associated risk factors for which emergency surgery indicated. So, the magnitude of morbidities were also quite high in this study. Public health awareness, the education of primary health workers and improvement of socioeconomic circumstances can also help to improve maternal and neonatal prognosis.
Keywords: Puerperium, caesarean section, postoperative complications, maternal morbidity, infection