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


  • Jyotsna Yadav Department Of Obstetrics and Gynecolgy, BPKIHS, Dharan, Nepal
  • Ramesh Shrestha Department Of Obstetrics and Gynecolgy, BPKIHS, Dharan, Nepal
  • Archana Sah Department Of Obstetrics and Gynecolgy, BPKIHS, Dharan, Nepal
  • Reena Bhagat Department of Maternal Health Nursing, BPKIHS, Dharan, Nepal




CS, Second stage, Labour


Background: Cesarean section (CS) is a common surgical procedure performed in obstetrics. The rate of rise of CS can be attributed to the increase in safety of the procedure, enhanced surgical techniques, improved    antibiotics, increase in number of women requesting for CS. In general, caesarean delivery is associated with more severe maternal complications compared to vaginal deliveries. The stage of labour at which CS is undertaken has been shown to influence the rate/risk of complication.

Methods: It was an observational and retrospective study that depended on some clinical records related to more than 37 weeks’ gestation. The study was conducted in BP Koirala institute of health sciences, Dharan Nepal from 2021 December to 2022 December. The neonatal as well as maternal outcomes have been evaluated for CS among those who were observing the second stage in their labor period. The test statistics used to analyse the data were descriptive statistics chi-square test.

Results:  The total delivery was 16131 out of which there were 6748 cesarean deliveries. Out of 6748 CS 65 patients had cesarean in second stage of labour. The most common cause of CS in second stage of labor was arrest of descent and dilatation (40%), followed by meconium-stained liquor (15.38%), occipito-posterior position (12.30%), and obstructed labour (3.07%) Being the least cause. One patient had to undergo peri-partum hysterectomy and the most common complication of second stage CS was prolong foleys catheterization (15 patients), post-partum febrile illness (20 patients out of 65), followed by wound infection, PPH, blood transfusion. The neonatal admission for NICU were birth asphyxia and respiratory distress were 50% each.

Conclusions: CS in the second stage of labor is correlated with considerably improved neonatal and maternal rate of morbidity along with expanded neonatal mortality. A proper judgment and skilled obstetrician are required to perform a second-stage CS. CS in the second stage of labor is a technically demanding procedure with an increased risk of maternal and neonatal morbidity compared to the CS in the first stage of labor.


Rahim A, Lock G, Cotzias C. Incidence of second-stage (fully dilated) cesarean sections and how best to represent it : A multicenter analysis. Int J Gynaecol Obstet. 2022;(2020):119-23.

Archibong MS, Adenikinju WS, Olayemi OJ, Amuda M. Caesarean section in second stage of labour : a commentary on principles and techniques. ResearchGate. 2021;10(10):4038-40.

Khaniya B. Fetomaternal Outcome in Second Stage Caesarean Section. Nepalese Med J. 2020;3:279-81.

Bhatia S, Revankar VM. Study of maternal and perinatal outcome of caesarean delivery in late first stage and second stage of labour. Int J Reproduct Contrac Obstetr Gynecol. 2021;10(4):1503-8.

Nambiar J, Rema T. Second Stage Cesarean Section. Current Topics in Caesarean Section. 2021. Available at: http://dx.doi.org/10.5772/intechopen.97722. Accessed on 7 October 2022.

Gurung P, Malla S, Lama S, Malla A, Singh A. Caesarean Section During Second Stage of Labor in a Tertiary Centre. J Nepal Health Res Counc. 2017;15(2):178-81.

Bhutta ZA. Caesarean delivery in the second stage of labour. BMJ. 2006;333:613-4.

Govender V, Panday M, Moodley J. Second stage caesarean section at a tertiary hospital in South Africa Second stage caesarean section at a tertiary hospital in South Africa. J Matern Fetal Neonatal Med. 2010;(3).

Dahiya P, Agarwal S, Najam R. Retrospective Analysis of Second Stage of Cesarean Section and Pregnancy Outcomes : An Observational Study. J South Asian Feder Obs Gynae 2022;14(1):54-8.

Karunanithi PA, Ak C, Punithavathi J. Fetomaternal outcomes of cesarean delivery performed in the first and second stage of labor-an analytical prospective observational study. N Indian J OBGYN. 2022;9(2021).

Wyn N, Mitchell EJ, Wakefield N, Knight M, Dorling J, Thornton JG et al. European Journal of Obstetrics and Gynecology and Reproductive Biology Impacted fetal head during second stage Caesarean birth : A prospective observational study. Eur J Obstet Gynecol Reprod Biol. 2022;272(2021):77-81.

Thirukumar M. Feto-Maternal Outcome In Caesarean Sections Performed In Second Stage of Labour. Jaffna Med J. 2020;(2):18-22.

Moodley J, Devjee J. Second-stage primary Caesarean deliveries : Are maternal complications increased? SA Fam Pract. 2009;51(4):328-31.

Khadbade B, Kale P, Mane S. Indication and Outcome of Second Stage Caesarean Section ; A Longitudinal Study. Sch Int J Obstet Gynec. 2022;8235:573-7.

Patra KK, Chattopadhyay S, Roy A, Bhattacharyya SK. Indications and outcomes of caesarean section in the second stage of labour at a tertiary care hospital in West Bengal. J Cardiovasc Dis Res. 2022;13(5):768-79.






Original Research Articles