Comparative analysis of maternal and neonatal outcomes between elective and emergency caesarean section at a single tertiary hospital: a retrospective COHORT study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20232713Keywords:
Caesarean section, Pregnancy complications, Pregnancy outcome, Risk factorsAbstract
Background: Caesarean section rates have been increasing worldwide despite it’s known complications. The aim of this study was to determine maternal and neonatal complications related to caesarean section at Sultan Qaboos University Hospital (SQUH) and to compare the outcomes between emergency and elective caesarean sections.
Methods: This retrospective cohort study was conducted in the department of obstetrics and gynecology at SQUH from 1st January 2016 to 31st December 2016. This comparative study involved 300 women who underwent caesarean section, 150 in elective caesarean section group and 150 in emergency caesarean section group.
Results: The mean maternal age was 29.66 (±4.96) and 33.22 (±4.63) years in the elective and emergency caesarean section groups respectively (p=001). The main risk factor for both the groups was maternal diabetes and the most common indication was previous caesarean section. Hypotension related anesthetic complication was noted more in elective caesarean section (15.3%) than in emergency caesarean section group (4.0%) with p value=0.002. Post-partum fever was seen in 12.0% of women in emergency group as compared to 4% in elective group (p=0.019). Anemia was observed in 79.2% and 65.3% in emergency and elective groups respectively (p=0.011). Respiratory distress syndrome and transient tachypnea of the newborn were the main neonatal complications in both groups.
Conclusions: There was no significant difference between emergency and elective caesarean section related maternal and neonatal complications except for transient intraoperative hypotension, maternal postoperative febrile morbidity and anemia. Future prospective studies including larger sample size and multiple centers is recommended.
References
Yang X and Sun S. Comparison of maternal and fetal complications in elective and emergency caesarean section: a systematic review and meta-analysis. Arch Gynecol Obstet. 2017;296(3):503-12.
Dempsey A, Diamond K, Bonney E, Myers J. Caesarean section: techniques and complications. Obstet Gynaecol Reprod Med. 2017;27(2):37-43.
World Health organization. WHO Statement on Caesarean Section Rates. 2021. Available from: https://www.who.int/caesaren section. Accessed on 2 June 2022.
Al Busaidi I, Al-farsi Y, Ganguly S, Gowri V. Obstetric and non-obstetric risk factors for caesarean section in Oman. Oman Med J. 2012;27(6):478-81.
Kazmi T, Saiseema S, Khan S. Analysis of caesarean section rate- according to Robson’s 10-group classification. Oman Med J. 2012;27(5):415-7.
Oladapo O, Lamina M, Sule-Odu A. Maternal morbidity and mortality associated with elective caesarean delivery at a university hospital in Nigeria, Aust N Z J Obstet Gynaecol. 2007;47(2):110-4.
Simões R, Bernardo W, Salomão A, Baracat E. Birth route in case of caesarean section in a previous pregnancy. Rev Assoc Med Bras. 2015;61(3):196-202.
Olsen NS. Abnormal Labor. Available from: https://emedicine.medscape.com/article/273053-overview?form=fpf. Accessed on 4 October 2022.
Louis, HS. Caesarean Delivery. Available from: https://emedicine.medscape.com/article/263424-overview. Accessed on 13 December 2018.
Soren R, Maitra N, Patel PK, Sheth T. Elective versus emergency caesarean section: maternal complications and neonatal outcomes. J Nurs Health Sci. 2016;5(5):1-4.
Raees M, Yasmeen S, Jabeen S, Utman N, Karim R. Maternal morbidity associated with emergency versus elective caesarean section. JPMI. 2012;27(1):55-62.
Daniel S, Viswanathan M, Simi B, Nazeema A. Comparison of fetal outcomes of emergency and elective caesarean sections in a teaching hospital in Kerala. Acad Med J India. 2014;II(1):32-6.
Benzouina S, Boubkraoui M, Mrabet M, Chahid N, Kharbach A, El-Hassani A, et al. Fetal outcome in emergency versus elective caesarean sections at Souissi Maternity Hospital, Rabat, Morocco. Pan Afr Med J. 2016;15(23):197.
Daniel S, Viswanathan M, Simi B, Nazeema A. Study of maternal outocmes of emergency and elective caesarean section in a semirural tertiary hospital. Nat J Med Res. 2014;4(1):14-8.
Chongsuvivatwong V, Bachtiar H, Chowdhury ME, Fernando S, Suwanrath C, Kor-Anantakul O, et al. Maternal and fetal mortality and complications associated with caesarean section deliveries in teaching hospitals in Asia. J Obstet Gynaecol Res. 2010;36(1):45-51.
Bergholt T, Stenderup JK, Vedsted-Jakobsen A, Helm P, Lenstrup C. Intraoperative surgical complication during caesarean section: an observational study of the incidence and risk factors. Acta Obstet Gynecol Scand. 2003;82(3):251-6.