A comparative study of socio demographic profile, clinical profile and maternal outcome of caesarian section done in second stage of labour with elective caesarean section
Keywords:Caesarean section, Elective caesarean section, Labour, Maternal outcome, Post-operative morbidity, Second stage
Background: Today caesarean section is one of the most commonly performed surgical procedures. But caesarean section is associated with a great deal of maternal and fetal morbidity and mortality. In general unplanned or emergency caesarean section has increased risk than elective caesarean section. Objectives of the study were to compare the socio demographic and clinical profile of antenatal women undergoing caesarian section in second stage of labour with elective caesarian section and to compare the maternal outcomes (morbidity and mortality) when caesarian section is done in second stage of labour with elective caesarean section.
Methods: This was a comparative study done at a tertiary care centre in south Kerala for a period of 18 months which compared two groups. Group 1 which included pregnant women who required emergency caesarean section during second stage of labour and group 2 including pregnant women who required elective caesarean. Demographic and clinical profile collected. Sample size was 145 each from both groups with total of 290.
Results: Intra operative complications (31% versus 17.9%), febrile morbidity (15% versus 10%), urinary retention (2.1% versus nil) PPH (2.8% versus 0.7%), post op infections (19.3% versus 9.7%), Blood transfusions (13% versus 0.4%) were significantly more with emergency caesarean sections done in second stage of labour. However increased maternal risks associated with unplanned caesarean sections do not in general justify, elective caesarean to avoid the risks of emergency surgery.
Conclusions: It is concluded that postoperative morbidity are more with emergency caesarean done at full cervical dilatation. The commonest one being febrile morbidity and then urinary retention.
Rai N, Reddy P. Caesarean delivery in the second stage of labour. An Indian perspective. 2006.
Leigh DA, Emmanuel FXS, Dean R. post op urinary tract infection and wound infection in women undergoing caesarean section .a comparison of 2 study groups in 1985 and 1987. J Hosp Infect. 1990:15:107-16.
Saxena S, Lyons GR. National sentinel caesarean section audit in UK. Int J Obstetric Anaesthesia. 2002;11(4):270-4.
Allen VM, O’connell CM, Baskett TF. Maternaland perinatal morbidity of caesarean section at second stage with first stage. BJOG. 2005;112:986-90.
Cebekulu L, Nicjamm EJ. Complications associated wih second stage cs .International J Gyne Obst. 2006;95(2):110-14.
Bergholt T, Stenderup JK, Vedsted-Jakobsen A, Helm P, Lenstrup C. Intraoperative surgical complication during caesarean section :an observational study of the incidence and risk factors. Acta Obstetrics Gynecology Scand. 2003;82(3):251-6.
Feinstein U, Sheiner E, Levy A. Risk factors for arrest of descent in second stage of labour. Int J Gyn Obst. 2002;77(1):7-14.