Exploring caesarean delivery in the second stage of labour at a tertiary care hospital: a retrospective study


  • Pravinkumar A. Jadav Department of Obstetrics and Gynecology, B. J. Medical College, Ahmedabad, Gujarat, India
  • Palak M. Dabhi Department of Obstetrics and Gynecology, General Hospital, Mansa, Gujarat and College of Physicians and Surgeons of Mumbai, Mumbai, Maharashtra, India
  • Dhruti A. Rathod Department of Obstetrics and Gynecology, B. J. Medical College, Ahmedabad, Gujarat, India




CS, Second stage of labour, Maternal morbidity, Neonatal morbidity


Background: Caesarean section (CS) performed in the second stage of labour has many implications for maternal and neonatal morbidity as well as for subsequent pregnancies. The objectives of this study were to determine the rates of CS at full dilatation, their indications, associated maternal and neonatal complications.

Methods: This retrospective study assessed all the women with a singleton fetus in cephalic presentation at term (≥37 weeks) who underwent CS in the second stage of labor between 1 August 2019 and 31 March 2020 at a tertiary care hospital. Maternal demographics, labour and delivery details as well as neonatal outcomes were collected.

Results: During the study period, 2124 (36%) babies were born by CS. Of these, 49 (2.3%) were performed in the second stage of labour at ≥37 weeks of gestation. The most common indication of CS was non-descent of head in 38 (77.55%) of cases. The majority of women 38 (77.55%) delivered by CS in the second stage of labor were primiparous. The 27 (55.10%) women were in the age group of 20-25 years. Most common intraoperative complication was blood-stained urine in 20 (40.81%) women. Overall transfusion rate was 18.36%. Maximum number of babies born 44 (89.79%) were having birth weight between 2.5-3.5 kg. Out of 65 babies born, 17 (34.69%) were admitted to neonatal intensive care unit.

Conclusions: Formulation of an institutional protocol and training and supervision of trainees to improve the skill of operative vaginal delivery and second stage cesarean is needed.


NHS Digital. National Health Service Maternity Statistics-England 2019-2020. Available at: https://digital.nhs.uk/data-and-information/publications/statistical/nhs-maternity-statistics/2019-20. Accessed on 4 August 2021.

Centre for Disease Control and Prevention (CDC)/National Centre for Health Statistics (US). Faststats: Births-Methods of Delivery. Available at: https://www.cdc.gov/nchs/fastats/delivery.htm. Accessed on 4 August 2021.

Vousden N, Cargill Z, Briley A, Tydeman G, Shennan AH. Caesarean section at full dilatation: incidence, impact and current management. Obstet Gynecol. 2014;16(3):199-205.

Thomas J, Paranjothy S. Royal College of Obstetricians and Gynaecologist Clinical Effectiveness Support Unit. London: The national sentinel caesarean section audit. RCOG Press. 2001.

Unterscheider J, McMenamin M, Cullinane F. Rising rates of cesarean deliveries at full cervical dilatation: a concerning trend. Eur J Obstet Gynecol Repro Biol. 2011;157(2):141-4.

Stavrou EP, Ford JB, Shand AW. Epidemiology and trends for caesarean section births in New South Wales, Australia: a population-based study. BMC Pregnancy Childbirth. 2011;11:8.

Loudon JA, Groom KM, Hinkson L. Changing trends in operative delivery performed at full dilatation over a 10-year period. J Obstet Gynaecol. 2010;30(4):370-75.

Allen VM, O’Connell CM, Baskett TF. Maternal and perinatal morbidity of caesarean delivery at full cervical dilatation compared with caesarean delivery in the first stage of labour. BJOG. 2005;112(7):986-90.

Babre VM, Bendre KR, Niyogi G. Review of caesarean sections at full dilatation. Int J Reprod Contracept Obstet Gynecol. 2017;6(6):2491-3.

Baloch S, Khaskheli M, Khushk IA, Sheeba A. Frequency of second stage intervention and its outcome in relation with instrumental vaginal delivery versus caesarean section. J Ayub Med Coll Abbottabad. 2008;20(1):87-90.

Gupta K, Garg A. Fetomaternal outcome in caesarean section at full dilatation. Int J Reprod Contracept Obstet Gynecol. 2019;8:3098-101.

Bhargava S, Hooja N, Kala M, Mital P, Tulani K, Arora S et al. Caesarean delivery in the second stage of labour at a tertiarry care hospital. J Obstet Gynecol India. 2019;69(6):558-60.






Original Research Articles