Patient profile and unmet needs of labour analgesia in the parturients undergo caesarean delivery on maternal request
Journal Title: The New Indian Journal of OBGYN - Year 2016, Vol 2, Issue 2
Abstract
Background: Caesarean delivery on maternal request (CDMR) is becoming all too prevalent in present day practice. However, the questions on its justifiability and ethical issues have lead to the recommendation, to explore, discuss and record the specific reasons for the request. Objective: The present study was aimed at exploring the patient profile and the unmet needs of labor analgesia in relation to CDMR as a reason for it. Methodology: The departmental electronic database was searched for all the CDMR cases and was included. The anesthetic management chart, pre-anesthetic assessment chart, verbal interview records were reviewed for the study to complete the data as far as possible. Data were analyzed as percentage and mean and standard deviation as applicable using INSTAT software. Results: There were 38 (2.64%) CDMR among the 1437 LSCS evaluated. Twenty four out of 38 (63.16%) of the patients were primigravida. 57.89% of CDMR had reason related to pain, fear and anxiety. Medical comorbidity was associated and probably contributed as a reason for choosing CDMR in association with pain in 48.57% cases. 5.26% had received antenatal counselling for painless labor and 23.68% had prior knowledge of labor analgesia while only 2.63% asked voluntarily for it. Conclusion: Lack of knowledge about painless delivery & facilities, fear, anxiety and previous bad experience are major reason for choosing “knife” than normal route of delivery. Higher education, parturients related to health care services and primigravida are more inclined to CDMR and needs to be targeted both for labor analgesia and for psychological counselling.
Authors and Affiliations
Habib Md Rezaul Karim, Prithwis Bhattacharyya, Md. Yunus
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