Caesarean Section During Second Stage of Labor in a Tertiary Centre

Gurung, Padma; Malla, Sameer; Lama, Sushma; Malla, Anagha Pradhan; Singh, Alka

doi:10.3126/jnhrc.v15i2.18210

Cited by 23 publications

(38 citation statements)

References 8 publications

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“…In the study by Kumaresan S et al, most common indications were also cephalopelvicdisproportion (34.8%) and non-reassuring fetal heart rate patterns (18.4%). 12 Same results were also observed in study by Gurung P et al 13 As the duration for second stage increases, there would be more difficulties in delivering the baby because of edematous lower segment, overstretched and thinned out lower segment and more impaction of presenting part in pelvis. In our study, 44% of the babies were delivered by vertex followed by Patwardhan (31%).…”

Section: Discussionsupporting

confidence: 61%

Fetomaternal outcome in caesarean section at full dilatation

Gupta

Garg

2019

Int J Reprod Contracept Obstet Gynecol

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Background: To study indications, intraoperative and postoperative complications and fetomaternal outcome in cesarean sections done at full dilatation.Methods: This is a prospective cross-sectional study which was conducted in the department of obstetrics and gynecology, RNT medical college, Udaipur from November 2018 to April 2019. 100 cases of caesarean sections at full dilatation which were performed during this period were analyzed for indications and maternal and fetal morbidity.Results: Among these 100 cesarean sections, majority of cases were in the age group of 21-30 years (46%), booked and Primigravida(81%).Most common indications were cephalo-pelvic disproportion (27%) and fetal distress (21%). Most commonly baby was delivered either by vertex (44%) or by Patwardhan (31%). Intraoperative complications were higher in terms of hematuria in 41%, Atonic PPH in 35%, uterine incision extension in 28% of cases. In one case bladder injury was noticed. Increased incidence of post-operative febrile illness and wound infection were noted. 44% baby’s required nursery admission, most commonly due to birth asphyxia (16%) and RDS (11%).Conclusions: Cesarean section in the 2nd stage of labor is associated with significantly increased maternal morbidity, Neonatal morbidity and mortality. So proper monitoring during labor and involvement of skilled obstetrician in decision making and delivery is crucial to minimize fetomaternal complications.

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Section: Discussionsupporting

confidence: 61%

Fetomaternal outcome in caesarean section at full dilatation

Gupta

Garg

2019

Int J Reprod Contracept Obstet Gynecol

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“…NICU admission rate was 68.57% in CS. Other studies show a rate of 3.4 to 14.3% [13,14]. High rates of NICU admission in this study could be due to delayed presenta ons to the hospital from referral sites.…”

Section: Resultsmentioning

confidence: 46%

“…Being a referred case (OR=1. 14) and a primigravida (OR=1.45) were risk factors for perinatal morbidi es in vacuum delivery. Referred cases (OR=1.52), primigravidas (OR=5.90), head sta on lower than zero (OR=1.26) and birth weight of more than 3500 gms (OR=2.60) were associated with more number of morbidi es in caesarean at full cervical dilata on.…”

Section: Resultsmentioning

confidence: 98%

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Operative Deliveries at Full Cervical Dilatation; 'Choosing Between Lesser of Two Evils': A Comparative Study of Morbidities of Vacuum Delivery and Caesarean Section

Aryal¹,

Shrestha²,

Mahato³

2020

Birat J. Health Sci.

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Introduction: Operative delivery at full cervical dilatation can be either a caesarean section or instrumental deliveries. Instrumental deliveries are well debated options for reducing caesarean section rates but they have their own set of maternal and fetal morbidities. CS at full dilatation of cervix is also demanding due to impacted fetal head. Choice between the two depends on the treating obstetrician. Objective: To assess perinatal morbidities between vacuum delivery and caesarean section at full cervical dilatation. Methodology: This is an observational cross-sectional comparative study done for the duration of one year from January to December 2019. Women undergoing vacuum delivery or caesarean section in full cervical dilatation were compared for maternal and neonatal morbidities. Risk factors associated with these morbidities were also assessed. The morbidities in each group were compared using Pearson's chi square test. Likelihood of morbidities in relation to risk factors was calculated using univariate logistic regression. Results: Prevalence of maternal complications in vacuum delivery was 33.3% (28) and in caesarean was 42.9% (15). Neonatal complications in vacuum delivery was 50% (42) and in caesarean was 48.6% (17). Being a referred case (OR=1.14) and a primigravida (OR=1.45) were risk factors for perinatal morbidities in vacuum delivery. Referred cases (OR=1.52), primigravidas (OR=5.90), head station lower than zero (OR=1.26) and birth weight of more than 3500 gms (OR=2.60) were associated with more number of morbidities in caesarean at full cervical dilatation. Conclusion Operative deliveries at full cervical dilatation, either vacuum or CS carry risk of maternal and neonatal morbidities. Obstetrician should make a decision keeping in mind certain risk factors like referred cases, parity, head station, number of pulls, method of delivery of head and fetal weight so that severe morbidities can be prevented.

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“…The contributory factors that lead to a birth resulting in a non-spontaneous birth have been shown to be multifactorial [37]. Our results suggest that the length of exposure to EA influences the birth mode.…”

Section: Implication For Practice and Conclusionmentioning

confidence: 65%

Relation between Length of Exposure to Epidural Analgesia during Labour and Birth Mode

García-Lausín

Perez-Botella

Duran

et al. 2019

IJERPH

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Objective: To appraise the relationship between the length of exposure to epidural analgesia and the risk of non-spontaneous birth, and to identify additional risk factors. This study is framed within the MidconBirth project. Study design: A multicentre prospective study was conducted between July 2016 and November 2017 in three maternity hospitals in different Spanish regions. The independent variable of the study was the length of exposure to epidural analgesia, and the dependent variable was the type of birth in women with uncomplicated pregnancies. The data was analyzed separately by parity. A multivariate logistic regression was performed. The odds ratios (OR), using 95% confidence intervals (CI) were constructed. Main outcome measures: During the study period, 807 eligible women gave birth. Non-spontaneous births occurred in 29.37% of the sample, and 75.59% received oxytocin for augmentation of labour. The mean exposure length to epidural analgesia when non-spontaneous birth happened was 8.05 for primiparous and 6.32 for multiparous women (5.98 and 3.37 in spontaneous birth, respectively). A logistic regression showed the length of exposure to epidural during labour was the major predictor for non-spontaneous births in primiparous and multiparous women followed by use of oxytocin (multiparous group). Conclusions: The length of exposure to epidural analgesia during labour is associated with non-spontaneous births in our study. It highlights the need for practice change through the development of clinical guidelines, training programs for professionals and the continuity of midwifery care in order to support women to cope with labour pain using less invasive forms of analgesia. Women also need to be provided with evidence-based information.

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Caesarean Section During Second Stage of Labor in a Tertiary Centre

Cited by 23 publications

References 8 publications

Fetomaternal outcome in caesarean section at full dilatation

Fetomaternal outcome in caesarean section at full dilatation

Operative Deliveries at Full Cervical Dilatation; 'Choosing Between Lesser of Two Evils': A Comparative Study of Morbidities of Vacuum Delivery and Caesarean Section

Relation between Length of Exposure to Epidural Analgesia during Labour and Birth Mode

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