Planned versus emergency cesarean delivery with previous one cesarean section: a prospective observational study

Partha P. Sharma; Dipak K. Giri; Surendra N. Bera

doi:10.18203/2320-1770.ijrcog20184156

Authors

Partha P. Sharma Department of Obstetrics and Gynecology, Midnapore Medical College, Paschim Medinipur, West Bengal, India
Dipak K. Giri Department of Obstetrics and Gynecology, Midnapore Medical College, Paschim Medinipur, West Bengal, India
Surendra N. Bera Department of Obstetrics and Gynecology, Midnapore Medical College, Paschim Medinipur, West Bengal, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20184156

Keywords:

Neonatal and maternal outcome, Planned and emergency cesarean section

Abstract

Background: Women presents with previous history of cesarean section (CS) is a ‘high risk pregnancy’ and requires regular antenatal check-ups. Planned CS at term done for perinatal interest. Post cesarean pregnancy admitted through emergency required direct CS, for those not fit for vaginal birth as per different guidelines. Main objective of this study is to know neonatal and maternal outcome at term for planned versus emergency CS with previous one CS.

Methods: Planned or emergency CS were done in 1003 pregnant women at term with previous one CS and outcome of both neonatal and maternal were noted. Emergency CS done in failed VBAC women were excluded from the study.

Results: Planned CS before onset of labor were done in 22.93% and emergency CS in 77.07% in the present study. A significant number of women has undergone planned CS in cephalo-pelvic disproportion (45.21%), contracted pelvis (24.34%) and fetal growth restriction (6.95%) where P=0.000. Scar tenderness (20.18%), fetal distress (16.04%) and cephalo-pelvic disproportion (15.52%) were major indications for emergency CS. Maternal complications in the emergency CS group were pyrexia (P=0.000) and blood transfusion, required in 1.81% (P=0.000). There were two maternal death and hysterectomy required in 0.38% in the emergency CS compared to 1.30% in the planned CS (P=0.274). Neonatal complications were significant(P=0.018) in the emergency CS group. Common complications were jaundice (2.84% versus 1.73%, P=0.489), sepsis (0.25% versus 0.86%, P=0.487) and early neonatal death (2.97% versus 0.86%, P=0.119) in emergency CS compared to planned CS.

Conclusions: Neonatal morbidity and mortality were significant in the emergency CS, compared to planned CS. Pyrexia and blood transfusion were significant maternal morbidity in the emergency CS group.

Metrics

Metrics Loading ...

References

Rossi AC, D’Addario V. Maternal morbidity following a trial of labor after cesarean section versus elective repeat cesarean delivery: a systematic review with metaanalysis. Am J Obstet Gynecol. 2008;199(3):224-31.

Alan TNT, Mark B L, Catherine YS, Lai Y, Leveno KJ, Varner MW, et al. Timing of elective repeat cesarean delivery at term and neonatal outcomes. N Engl J Med. 2009;360:111-20.

McCarthy FP, Rigg L, Cady L, Cullinane F. A new way of looking at caesarean section births. Aust N Z J Obstet Gynaecol. 2007;47(4):316-20.

Soukayna B, Mohamed El-mahdi B, Mustapha M, Chahid N, Kharbach A, Elhassani A, et al. Fetal outcome in emergency versus elective cesarean sections at Souissi Maternity Hospital, Rabat, Morocco. Pan Afr Med J. 2016;23:197-205.

Puri P, Abraham M, Grover S. Vaginal birth after one previous lower segment caesarean section. Jk Science. 2011;13(4):179.

Singh N, Tripathi R, Mala YM. Maternal and foetal outcomes in patients with previous caesarean section undergoing trial of vaginal birth at a tertiary care centre in north India. J Preg Child Health. 2014;1(102):2.

Lydon-Rochelle MT, Gardella C, Cardenas V, Easterling TR. Repeat cesarean delivery: what indications are recorded in the medical chart?. Birth. 2006;33(1):4-11.

Elvedi-Gasparovic V, Klepac-Pulanic T, Peter B. Maternal and fetal outcome in elective versus emergency caesarean section in a developing country. Coll Antropol. 2006;30(1):113-8.

Bujold E, Mehta SH, Bujold C, Gauthier RJ. Interdelivery interval and uterine rupture. AJOG. 2002;187:1199-202.

RCOG Birth after Previous Caesarean Birth. Green-top Guideline No.45. 2015. Available at: https://www.rcog.org.uk/globalassets/documents/guidelines/gtg_45.pdf.

Liu S, Liston RM, Joseph KS, Heaman M, Sauve R, Kramer MS. Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term. Canadian Med Assoc J. 2007;176(4):455-60.

Nuaim LA, Soltan MH, Khashoggi T. Outcome in elective and emergency cesarean section: a comparative study. Ann Saudi Med. 1996;16(6):645-9.

Bailit JL, Landon MB, Thom E, Rouse DJ, Spong CY, Varner MW, et al. The MFMU cesarean registry: impact of time of day on cesarean complications. Am J Obstet Gynecol. 2006;195:1132-7.

Durnwald CP, Rouse DJ, Leveno KJ. The Maternal-Fetal Medicine Units Cesarean registry: safety and efficacy of a trial of labor in preterm pregnancy after a prior cesarean delivery. Am J ObstetGynecol 2006;195:1119-26.

Alan TNT, Yinglei L, Mark BL, Catherine YS, Kenneth JL, MichealWV, et al. Timing of elective repeat cesarean delivery at term and maternal perioperative outcomes. Obstet Gynecol. 2011;117:280-6.

American College of Obstetricians and Gynecologists. Cesarean delivery on maternal request. ACOG Committee Opinion No.394. Obstet Gynecol. 2007;110:1501-4.

De Luca R, Boulvain M, Irion O, Berner M, Pfister RE. Incidence of early neonatal mortality and morbidity after late-preterm and term cesarean delivery. Pediatr. 2009;123(6):1064-71.