European Journal of Molecular & Clinical Medicine

Abstract

Background:Second stage caesarean is technically more difficult due to deep
engagement of fetal head, and this is associated with increased risk of maternal
morbidity such as surgical injuries and intra operative excessive haemorrhage as well as
fetal morbidity such as asphyxia and fetal injury. A Prospective study was done to
compare the maternal and neonatal complications of caesarean sections performed in
second stage compared to first stage of labour. Objective: To determine the maternal
and perinatal outcome associated with caesarean sections performed in second stage
versus first stage of labour.
Materials and Methods: It is an observational cross-sectional study where 7033 women
were enrolled in the study, out of them 1272underwent C- section in first stage of labour
where as rest152 underwent caesarean section in second stage of labour for various
indications.
Results: It was found that the women who underwent caesarean section in second stage
of labour had a higher risk of maternal morbidity than those who underwent caesarean
in first stage of labour The rate of intraoperative bleeding is>1000ml,uterineatony,
longer duration of surgery,adhesions, fetalhypoxia, neonatal admissions toNICU,
neonatal sepsis and early neonatal death were more common in second stage of labour
as compared to first stage.
Conclusion: In conclusion, Present study suggests that women undergoing c-section in
second stage of labour have increased chance of Uterineatony, rate of excessive
bleeding, postoperative fever, wound infection, fetal hypoxia compared to first stage of
labour and therefore require special care and should be handled and operated by
experienced obstetricians’ The rate of complications can be avoided by proper antenatal
care, proper usage of partograph, pelvic assessment in early labour and timely
intervention.