Abstract
COMPARISON OF FETOMATERNAL OUTCOMES IN SECOND STAGE VERSUS FIRST STAGE CAESAREAN SECTIONS

Dr. Musarrat*, Anjali Mantri, Latika Sahu, Preeti Singh, Shalini Shakarwal and Nasreen Fatima

ABSTRACT

Background: The second stage caesarean section delivery occurs at the full dilatation of cervix, which is associated with more risk of maternal and fetal complications. Purpose: To study the fetomaternal outcomes in second stage caesarean sections and comparing them with first stage caesarean sections. Material and methods: This cross sectional study was conducted in Department of Obstetrics and Gynaecology at Lok Nayak Hospital, New Delhi for a period of one year, after approval from Institutional Ethical Committee. Sixty women after applying the inclusion and exclusion criteria were included from those women undergoing first and second stage caesarean sections respectively from operation theatres and post-operative wards. Informed written consent was taken. Most of the second stage caesarean sections were done in the emergency hours by the residents. Various maternal and fetal complications were compared between the two groups. Impact of method of delivery of baby and surgical time on maternal and neonatal complications were also seen in second stage caesarean sections separately. Results: In the present study, indications for second stage caesarean sections were arrest of descent of head (73.33%), fetal distress (23.33%), and CPD (3.33%) while indications for first stage caesarean were meconium stained liquor with fetal distress (88.33%), failed inductions (8.33%) and primi breech (3.33%). Most of the labour was induced and augmented. Labour only augmented had higher chances of second stage caesarean sections. Maternal complications such as extension of uterine angles, PPH, pyrexia, bladder injury, postoperative stay, haematuria, wound sepsis, blood transfusion, features of obstructed labour, all were more in second stage caesarean section. Neonatal complications such as having GCA in baby, NICU admissions, need for resuscitation, having APGAR<7, hyperbilirubinemia and HIE were more in second stage caesarean sections. Among various delivery methods used in second stage caesarean sections, breech extraction technique was associated with more Maternal and fetal complications. Similarly more surgical time taken leads to more complications. Conclusion: Second stage labour caesarean section showed more Maternal and fetal complications as compared to first stage caesarean sections.

Keywords: Second stage caesarean section, labour, fetomaternal complication.


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