Fetomaternal outcome in caesarean section at full dilatation


  • Kavita Gupta Department of Obstetrics and Gynecology, RNT Medical College, Udaipur, Rajasthan, India
  • Apurva Garg Department of Obstetrics and Gynecology, RNT Medical College, Udaipur, Rajasthan, India




Caesarean section, Maternal morbidity, Neonatal morbidity, Patwardhan method, Second stage of labor


Background: To study indications, intraoperative and postoperative complications and fetomaternal outcome in cesarean sections done at full dilatation.

Methods: This is a prospective cross-sectional study which was conducted in the department of obstetrics and gynecology, RNT medical college, Udaipur from November 2018 to April 2019. 100 cases of caesarean sections at full dilatation which were performed during this period were analyzed for indications and maternal and fetal morbidity.

Results: Among these 100 cesarean sections, majority of cases were in the age group of 21-30 years (46%), booked and  Primigravida(81%).Most common indications were cephalo-pelvic disproportion (27%) and fetal distress (21%). Most commonly baby was delivered either by vertex (44%) or by Patwardhan (31%). Intraoperative complications were higher in terms of hematuria in 41%, Atonic PPH in 35%, uterine incision extension in 28% of cases. In one case bladder injury was noticed. Increased incidence of post-operative febrile illness and wound infection were noted. 44% baby’s required nursery admission, most commonly due to birth asphyxia (16%) and RDS (11%).

Conclusions: Cesarean section in the 2nd stage of labor is associated with significantly increased maternal morbidity, Neonatal morbidity and mortality. So proper monitoring during labor and involvement of skilled obstetrician in decision making and delivery is crucial to minimize fetomaternal complications.


Asicioglu O. Second stage vs first-stage cesarean delivery: comparison of maternal and perinatal outcomes. J Obstet Gynecol. 2014:1-7.

Murray SF, Pradenas FS. Health sector reform and rise of cesarean birth in Chile. The Lancet. 1997;64.

Vousden N, Cargill Z, Briley A, Tydeman, G, Shennan AH. Caesarean section at full dilatation: incidence, impact and current management. The Obstet Gynaecol. 2014;16:199-205.

McKelvey A, Ashe R, McKenna D, Roberts R. Caesarean section in the second stage of labour: a retrospective review of obstetric setting and morbidity. J Obstet Gynaecol. 2010;30(3):264-7.

Panday GV. Second stage caesarean section at a tertiary centre in South Africa, Journal of Maternal- Fetal Neonat Medic. 2010;23(10)1151-5.

Unterscheider J, McMenamin M, Cullinane F. Rising rates of caserean deliveries at full cervical dilatation: A concerning trend. Eur J Obstet Gynaecol Reprod Boil. 2011;157:141-4.

Alexander JM, Leveno KJ, Rouse DJ. Comparison of maternal and infant outcomes from primary caesarean delivery during the second compared with the first stage of labor. Obstet Gynecol. 2007;109(4):917-21.

Govender V, Panday M, Moodley J. Second stage caesarean section at a tertiary hospital in South Africa. J Matern Fetal Neonatal Med. 2010;23(10):1151-5.

Malathi J, Sunita V. Comparison of obstetric outcome between first and second stage cesarean sections in rural tertiary hospital. Int J Pharm Biomed Res. 2012:222-25.

Feinstein U, Sheiner E, Levy A, Hallak M, Mazor M. Risk factor for arrest of descent during the second stage of labour. Int J Gynaecol Obstet. 2002;77(1):7-14.

Sandya MR, George S, Varghese L. Fetomaternal outcome in second stage Caesarean section - An audit. Int J Obstet Gynecol. 2018;6(2):207-10.

Kumaresan S, Loganathan M. Rising rates of second stage caesarean section and its impact on maternal outcome. Int J Reprod Contracept Obstet Gynecol. 2018;7:2681-5.

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(36):178-81.

Babre VM, Bendre KR, Niyogi G. Review of caesarean sections at full dilatation. Int J Reprod Contracept Obstet Gynecol. 2017;6:2491-3.

Jayaram J, Mahendra G, Vijayalakshmi S. Fetomaternal outcome in cesarean sections done in second stage of labor. Indian J Obstet Gynaecol Res. 2016;3(1):51-4.






Original Research Articles