Rising rates of second stage caesarean section and its impact on maternal outcome
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20182751Keywords:
Caesarean complications, Emergency caesarean section, Maternal morbidity, Neonatal morbidity, Second stage of laborAbstract
Background: There is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. With this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlights includes the rate of caesarean deliveries in the second stage of labour, the indications for delivery and the associated maternal morbidity in this cohort of women.
Methods: This was a prospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between July, 2016 and December 31, 2017 at government medical college hospital Dharmapuri. The main outcome measures were second stage caesarean section, indications and its maternal morbidity.
Results: 250 women underwent caesarean delivery in the advanced labor. Among the 250 patient’s majority of them were in the age group of 21-30 yrs. about 76% of the patients were primigravidae and only the remaining 24% were multigravida. The commonest indications for doing caesarean section in the second stage of labor was cephalo pelvic disproportion and non-reassuring fetal heart rate patterns. The difficult task was delivery of the deeply engaged head, the increased likelihood of intraoperative and post-operative complications.
Conclusions: Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and morbidity.
References
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. BJOJ. 2005;112:986-90.
Cebekulu L, Buchman EJ. Complications associated with caesarean section in the second stage of labour. Int J Gynecol Obstet. 2006;95:110-4.
Landesman R, Graber EA. Abdominovaginal delivery: modification of the cesarean section operation to facilitate delivery of the impacted head. Am J Obstet Gynecol. 1984;148:707-10.
Fasubaa OB, Ezechi OC, Orji EO, Ogunniyi SO, Akindele ST, Loto OM, et al. Delivery of the impacted head of the fetus at caesarean section after prolonged obstructed labour: a randomised comparative study of two methods. J Obstet Gynaecol. 2002;22:375-8.
Levy R, Chernomoretz T, Appelman Z, Lein D, OR Y, Hagay ZJ. Head pushing versus reverse breech extraction in cases of impacted fetal head during cesarean section. Eur J Obstet Gynecol Reprod Biol. 2005;121:24-6.
Fasubaa OB, Ezechi OC, Orji EO, Ogunniyi SO, Akindele ST, Loto OM, Okogbo FO. Delivery of the impacted head of the fetus at caesarean section after prolonged obstructed labor, a randomized comparative study of two methods. J Obstet Gynecol. 2002;22:375-8.
Sung JF, Daniels KI, Brodzinsky L, El-Sayed YY, Caughey AB, Lyell DJ. Caesarean delivery outcome after a prolonged second stage of labor. Am J of Obstet Gynecol. 2007;197(306):e1-5.
A retrospective comparative study of feto-maternal outcome in first and second stage caesarean section. Int J Reprod Contracept Obstet Gynecol. 2016;5:2282-6.
Philipps MG, Watabe B, Clemons JL, Weitzen S, Myers DL. Risk factors for bladder injury during caesarean delivery. Obstet Gynecol. 2005 ;105(1):156-60.
Malathi J, Sunita V. Comparison of obstetric outcome between first and second stage caesarean section in rural tertiary hospital. Int J Pharma Biomed Res. 2012;3:222-5.
Saha PK, Gulati R, Goel P, Tandon R, Huria A, Second Stage Caesarean Section: Evaluation of Patwardhan Technique. J Clinic Diag Res. 2014;8(1):93-5.
Alexander JM, Leveno KJ, Rouse DJ, Landon MB, Sponge CY, Varner MW, et al. Comparison of maternal and infant outcomes from primary caesarean delivery during the second compared with first stage of labor. Obstet Gynecol. 2007;109:917-21.