
Aim: To evaluate the maternal and neonatal outcome of caesarean section in second stage of labour. Methods: This prospective observational study was carried out in the Department of Obstetrics and Gynecology, NSMCH, Amhara, Bihta,Patna, Bihar India . Total 100 patients were included into the study. All caesarean sections performed at full cervical dilatation over this time period. Results: During the study period, a total of 2400 women delivered by caesarean section, 1700 emergency and 700 elective cases. Of these 100 (2.27%) were at full cervical dilatation, >37 weeks gestation with a singleton fetus in cephalic presentation.The commonest indications for doing caesarean section in the second stage of labour was cephalo pelvic disproportion, fetal distress and obstructed labour. Incidence of PPH was 12 out of 100 cases (12%).There were no cases of bowel or bladder injury reported. Post-operative wound infection was seen in 8(8%) and Post-operative fever was seen in 17(17%) out of 100 cases. There were no cases of maternal deaths reported. The mean operative time was 52.2 min .The mean length of hospital stays was 6.6 days. Mean weight of the babies of the second stage caesarean section was 3.5kg. 6(6%) babies were admitted to the Neonatal Intensive Care Unit and 12 (12%) to neonatal nursery for management of respiratory distress, sepsis, jaundice, and observation. 14(14%) babies had Neonatal jaundice and There were 2 neonatal deaths reported. Conclusion: The women delivered by cesarean in second stage have a higher risk of post-partum hemorrhage, operative morbidity with visceral injury, sepsis and prolonged hospital stay. Hence it is recommended that second stage cesarean should ideally perform and supervised by an experienced obstetrician. Timely decision for cesarean section should be taken especially when risk factors for failure to progress are present and there should be good neonatology support.
Aim: To evaluate the maternal and neonatal outcome of caesarean section in second stage of labour. Methods: This prospective observational study was carried out in the Department of Obstetrics and Gynecology, NSMCH, Amhara, Bihta,Patna, Bihar India . Total 100 patients were included into the study. All caesarean sections performed at full cervical dilatation over this time period. Results: During the study period, a total of 2400 women delivered by caesarean section, 1700 emergency and 700 elective cases. Of these 100 (2.27%) were at full cervical dilatation, >37 weeks gestation with a singleton fetus in cephalic presentation.The commonest indications for doing caesarean section in the second stage of labour was cephalo pelvic disproportion, fetal distress and obstructed labour. Incidence of PPH was 12 out of 100 cases (12%).There were no cases of bowel or bladder injury reported. Post-operative wound infection was seen in 8(8%) and Post-operative fever was seen in 17(17%) out of 100 cases. There were no cases of maternal deaths reported. The mean operative time was 52.2 min .The mean length of hospital stays was 6.6 days. Mean weight of the babies of the second stage caesarean section was 3.5kg. 6(6%) babies were admitted to the Neonatal Intensive Care Unit and 12 (12%) to neonatal nursery for management of respiratory distress, sepsis, jaundice, and observation. 14(14%) babies had Neonatal jaundice and There were 2 neonatal deaths reported. Conclusion: The women delivered by cesarean in second stage have a higher risk of post-partum hemorrhage, operative morbidity with visceral injury, sepsis and prolonged hospital stay. Hence it is recommended that second stage cesarean should ideally perform and supervised by an experienced obstetrician. Timely decision for cesarean section should be taken especially when risk factors for failure to progress are present and there should be good neonatology support.
Uterine Incision Extension, Neonatal Morbidity, Neonatal Jaundice, Apgar score
Uterine Incision Extension, Neonatal Morbidity, Neonatal Jaundice, Apgar score
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