Indication & Outcome of Second Stage Caesarean Section; A Longitudinal Study

Abstract

Background: Caesarean section is one of the common surgical interventions to save lives of the mothers and/or the newborns. However there is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. Within this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. Due to a limited literature regarding this topic in the Indian scenario, the present study was done to assess the predisposing factors, indications of second stage caesarean section and its fetomaternal outcome. Material and Methods: In Present descriptive longitudinal study 211 patient’s undergone caesarean sections at full cervical dilatation were included as per inclusion and exclusion criteria. A pilot study was done for validation, practicality and applicability of questionnaire. Results: In present study most cases were in the age group of 26 to 30 years (38.38%). The most common indication for emergency second stage caesarean section was non-progression of labour followed by obstructed labour. Atopic PPH, hematuria was the commonest intraoperative complications while pyrexia, prolong catheterization was the predominant post-operative complications NICU admission needed for 16.11% babies due to birth asphyxia and respiratory distress. Conclusions: Caesarean section in the 2nd stage of labor is associated with maternal and neonatal morbidity and mortality. These factors needs to be anticipated to reduce mortality and morbidity associated with it. A proper judgment is required by a skilled obstetrician to take a decision for caesarean section at full cervical dilatation.

Maternal and fetal outcome in second stage caesarean section: a retrospective study

“…In the present study 20.83% babies required NICU admission due to birth asphyxia (08) and respiratory distress (20) and two babies were found to be stillbirth. These results were similar to study done by Balasaheb et al 13…”

“…Least common indication was found to be fetal distress. The results were similar to study done by Balasaheb et al and Yadav et al 13,14 Delivery of deeply engaged head is challenge to obstetrician, this can be done by various methods as Vertex method, pull method i.e. Patwardhan's method, modified Patwardhan method, push method in this method head is pushed vaginally and then head is delivered through uterine incision.…”

Feto-maternal outcome of second stage cesarean section in B. P. Koirala institute of health sciences: a retrospective study

“…Least common indication was found to be fetal distress (2.84%). 14 Similarly the present study shows the most common indication for CS is arrest of descent and dilatation (40%) followed by meconiumstained liquor (15.38%), occipito posterios position (12.3%). Least common was for obstructed labor (3.07%).…”