Obstetric complications and cesarean delivery in Nepal. Issue 1 (2nd January 2014)

• Record Type: Journal Article
• Authors: Karkee, Rajendra; Lee, Andy H.; Khanal, Vishnu; Pokharel, Paras K.; Binns, Colin W.
• Is Part Of: International journal of gynaecology and obstetrics. Volume 125:Issue 1(2014)
• Page Start: 33
• Page End: 36
• Publication Date: 2014-01-02
• Subjects: Cesarean delivery -- Nepal -- Obstetric complications -- Pregnancy outcomes -- Stillbirth; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1016/j.ijgo.2013.09.033
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: To determine the incidence of obstetric complications, the stillbirth rate, and the factors associated with cesarean delivery in central Nepal. Methods: A community‐based prospective cohort study was undertaken in the Kaski district during 2011–2012. In total, 701 women who were at least 5 months pregnant were recruited and interviewed. Participants were followed‐up and interviewed again within 45 days after delivery. Results: Of the 658 women who remained in the cohort after 43 were lost to follow‐up, 12 (1.8%) had stillbirths. Cesareans accounted for 13.3% of the total deliveries. Age, urban residency, college‐level education, and particularly presence of intrapartum symptoms significantly increased the likelihood of cesarean delivery. Prepartum, intrapartum, and postpartum symptoms were reported by 21.1%, 24.4%, and 10.2% of women, respectively. Common danger signs included prolonged labor, severe abdominal pain, swollen hand and body, and heavy bleeding. Conclusion: Obstetric complications and stillbirth rates were relatively high in central Nepal. Cesarean delivery appeared to meet obstetric need and was performed with medical indication, particularly after the onset of labor.