Comparison Between Elective Versus Emergency Caesarean Section on Intra Operative Surgical Findings and Feto Maternal Outcomes

Abstract

Background:The cesarean section is one of the most common operative procedures throughout the world with global rate increasing both developed and developing countries. Objective: To compare and evaluate the intraoperative surgical findings on elective versus emergency caesarean section and fetomaternal outcomes. Methods and materials: This study was descriptive comparative carried out at obstetrics and gynecology department of Tripoli university hospital during 1st January to 31th March 2023. The selected sample included 130 pregnant women which divided into two groups (65 patients had delivered by elective CS and another 65 patients had delivered by emergency CS). The collected data was entered, coded and analyzed by using SPSS version 25. The P value of less than 0.05 was considered as statistically significant. Results: We studied 130 pregnant women who's evaluated and compared the feto maternal outcomes on elective verses emergency caesarean section aged between 21 to 48 years, the mean maternal age among elective CS was 33.46 ± 4.169 SD and the mean maternal age among emergency CS was 32.03 ± 5.598 SD. The main indication of CS had reported was previous caesarean section both for elective and emergency caesarean delivery which accounts (41/63.1%) and (15/23.1%) respectively with highly statistically significant results reported (P -value = 0.000). And on compare the intraoperative surgical findings, the rate of adhesion more prevalent on elective CS while the rate of bleeding was more frequently on emergency CS with statistically significant results (P -value = 0.001 and 0.011) respectively. Although, most of patients (83.1%) did not expressed intra operative complications but 6.9% (9) had hysterectomy (6 of 9 on emergency CS while 3 of 9 on elective CS) and 3.8% (5) had expressed urinary tract injury (3 of 5 on emergency CS while 2 of 5 on elective CS). And 19.2% (25) of neonates had admitted to neonatal intensive care unit which represented 15.3% (20) of them had delivered by emergency CS while 3.9% (5) of them had delivered by elective CS with statistically significant results (P-value=0.001). Conclusion: On summary, the raising rate of caesarean section either by elective or emergency manner had significant adverse impacts on feto maternal outcomes with high rate of maternal bleeding, adhesion, abnormal placentation and overall increase risk of neonatal and maternal intensive care unit admission. Therefore, optimal perinatal assessment throughout pregnancy period is essential to reduce rate of unnecessary caesarean section and minimize related morbidity and mortality of caesarean delivery particularly emergency type.