Elective caesarean section and neonatal outcome: an observational study from a tertiary hospital in Mysore, Karnataka, India

Mamatha Shivanagappa; Vinutha K. Veerabhadrappa; Deepthi Thandaveshwar; Madhumitha Mahesh

doi:10.18203/2320-1770.ijrcog20185127

Authors

Mamatha Shivanagappa Department of Obstetrics and Gynecology, JSS Medical College, JSS Academy of Higher Education and Research (Deemed to be University), Mysore, Karnataka, India
Vinutha K. Veerabhadrappa Department of Obstetrics and Gynecology, JSS Medical College, JSS Academy of Higher Education and Research (Deemed to be University), Mysore, Karnataka, India
Deepthi Thandaveshwar Department of Pediatrics, JSS Medical College, JSS Academy of Higher Education and Research (Deemed to be University), Mysore, Karnataka, India
Madhumitha Mahesh Department of Obstetrics and Gynecology, JSS Medical College, JSS Academy of Higher Education and Research (Deemed to be University), Mysore, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20185127

Keywords:

Caesarean Section, Elective LSCS, Neonatal outcomes

Abstract

Background: Globally 18.6 percent of all births occur by Caesarean Section (CS) and the trend is increasing. In India CS rates have risen from 2.9% in 1992 to 17.2% in 2015. The optimal timing of CS is still being investigated. Data with regard to elective CS and neonatal outcome from India is sparse and this study aimed to obtain the same in the setting of a South Indian Hospital. The objective was to evaluate neonatal outcome and NICU admissions in elective CS

Methods: This was a retrospective study conducted at a tertiary care referral hospital and data collected was of deliveries conducted from Jan 2017 to July 2018. All term singleton pregnancies (>37 gestational weeks) scheduled for elective CS were included in the study.

Results: A total of 3174 Caesarean Sections were performed during the study period of which 1087 were elective CS and 2087 were done on an emergent basis. Of these elective CS, 425 (39%) were performed at early term (37+0 until 38+6) and 662 (61%) were performed at full term (>39 weeks). Analysis of adverse neonatal outcomes revealed that a significantly higher rate of NICU admission, low birth weight, respiratory complications in newborns delivered at early term than in those delivered at full term.

Conclusions: In the present study newborns delivered at 37- 38 weeks of gestation had a higher rate of NICU admission, low birth weight and respiratory complications compared to newborns delivered after 39 weeks of gestation. Neonatal outcome was found to be better in those elective CS done after 39 weeks in comparison to those delivered at early term (< 39 weeks).

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References

Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. The increasing trend in caesarean section rates: Global, regional and national estimates: 1990-2014. PLoS ONE 2016;11(2):e0148343.

International Institute for Population Sciences, Mumbai (2017)National Family Health Survey (NFHS-4) 2015-16 India Fact sheet

Hamilton BE, Martin JA, Ventura SJ. Births: preliminary data for 2006. National Vital Stat Rep. 2007;56(7):1-8.

MacDorman MF, Menacker F, Declercq E. Cesarean birth in the United States: epidemiology, trends, and outcomes. Clin Perinatol. 2008;35(2):293-307.

WHO. Appropriate technology for birth. Lancet. 1985;326(8452):436-7.

WHO. 1994. Indicators to Monitor Maternal Health Goals. Report of a Technical Working Group, Geneva, 8-12 Nov, 1993.

National Institutes of Health. NIH Consensus Development Program. NIH State-of-the-Science Conference: cesarean delivery on maternal request. 2006 Mar 27–29; Available Online :http://consensus.nih.gov/2006/2006CesareanSOS027main.htm.

Zupancic JA. The economics of elective cesarean section. Clin Perinatol. 2008;35(3):591-9.

Sinnott S-J, Brick A, Layte R, Cunningham N, Turner MJ. National Variation in Caesarean Section Rates: A Cross Sectional Study in Ireland. PLoS One.2016;11(6):e0156172.

National Institute for Health and Care Excellence (NICE). CG132 Caesarean section. Available at https://www.nice.org.uk/guidance/cg132.

Royal College of Obstetricians and Gynecologists (RCOG). Birth after Previous Caesarean Birth 2015. Available at https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg45/.

Salim R, Shalev E. Health implications resulting from the timing of elective cesarean delivery. Reprod Biol Endocrinol: RB&E. 2010;8(1):68.

Prediger B, Polus S, Mathes T, Bühn S, Louwen F,2 Neugebauer EAM et al. Systematic Reviews (2018) 7:119.

Spong CY, Landon MB, Gilbert S, Rouse DJ, Leveno KJ, Varner MW, et al. Risk of uterine rupture and adverse perinatal outcome at term after cesarean delivery. Obstet Gynecol. 2007;110(4):801-7.

Smith GC, Pell JP, Cameron AD, Dobbie R. Risk of perinatal death associated with labor after previous cesarean delivery in uncomplicated term pregnancies. JAMA. 2002;287(20):2684–90.

American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 97: fetal lung maturity. Obstet Gynecol. 2008;112(3):717-26.

Salim R, Shalev E. Health implications resulting from the timing of elective cesarean delivery. Reprod Biol Endocrinol: RB&E. 2010;8(1):68.

Glavind J, Kindberg SF, Uldbjerg N, Henriksen TB. Timing of elective cesarean section and neonatal morbidity: a randomized controlled trial. Int J Gynaecol Obstet. 2012;119:S358.