Feto-maternal outcome in second versus first stage caesarean delivery in a tertiary medical care centre

Background: The aim is to study neonatal and maternal outcomes of the caesarean sections performed in first stage versus second stage of labour. Methods: The retrospective analysis of data were done of caesarean section done at Department of Obstetrics and Gynaecology at ESI PGIMSR Basaidarapur New Delhi between January 2016 to December 2016. 45 women, who underwent second stage caesarean section were studied. For each case, two consecutive cases, who underwent caesarean delivery during the first stage of labour were taken as control for the study. Primary maternal outcomes of interest were uterine atonia, transfusion requirement, urinary system injury and postoperative complications. Results: Out of 4477 deliveries, 1466 had caesarean section with a rate of 32%. The rate of second stage caesarean section was 3% of total caesarean section and 1% of total deliveries. Second stage caesarean section had higher maternal and perinatal morbidity like atonic PPH (33.3%), lower uterine segment extension (7%), febrile morbidity (10%), and need for blood transfusion (15%). There were 15.5% NICU admission in second stage caesarean group while none in first stage group. Conclusions: Caesarean section in the second stage of the labour is associated with increased maternal and neonatal morbidities. Special attention is required to the patients undergoing caesarean section in the second stage of the labour. They should be handled by senior and experienced obstetrician. Neonatologist should be present for every second stage caesarean section.

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Management of prolonged second stage of labor

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182855 ◽

2018 ◽

Vol 7 (7) ◽

pp. 2527

Author(s):

Sanjay Singh ◽

Uttara Aiyer Kohli ◽

Shakti Vardhan

Keyword(s):

Caesarean Section ◽

Perinatal Morbidity ◽

Management Options ◽

Second Stage Of Labor ◽

Second Stage ◽

Second Stage Of Labour ◽

Definition Of

Second stage of labour has been often neglected leading to increased maternal and perinatal morbidity. Recognising and managing prolonged second stage is a challenge even to an experienced obstetrician. This article reviews the changes in the definition of prolonged second stage over the years. It discusses the causes, recognition and management options along with the difficulties in delivering a patient with prolonged second stage of labour. Though adding an extra hour to the definition of second stage in patients may reduce the rate of caesarean section but some studies also show a rise in maternal and perinatal morbidity. Obstetricians are familiarized to the different techniques of delivery of the impacted head. Once diagnosis of prolonged second stage is confirmed, causes should be identified and addressed, and treatment should be individualised, and timing and mode of intervention planned.

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Demographic profile in women undergoing second stage caesarean section

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20200338 ◽

2020 ◽

Vol 9 (2) ◽

pp. 570

Author(s):

Isha . ◽

Prabha Lal ◽

Vikram Dutta ◽

Aayushi Kaushal

Keyword(s):

Caesarean Section ◽

Middle Class ◽

Prospective Observational Study ◽

New Delhi ◽

Age Group ◽

Lower Middle Class ◽

Medical College ◽

Second Stage ◽

Factors Influencing ◽

Obstetrics And Gynaecology

Background: Incidence of caesarean section is rapidly rising over the last two decades and 25% is contributed by second stage caesarean section. Demographic factors influencing fetomaternal outcome in second stage caesarean section include BMI, socioeconomic status, booking/ unbooking status, gravidity and maternal height.Methods: The present study was prospective observational study conducted in the department of obstetrics and gynaecology at Lady Hardanger Medical College New Delhi from December 2015 to March 2017. 80 women were enrolled in the study. A detailed history and examination of each patient was carried out. Women were observed during lab our till second stage caesarean section.Results: Mean age of population was 25.26±3.75 ranging from 19-40 year. 76.25% included in study were booked and 11.25% were unbooked, 42.5% belonged to lower middle class and 31.25% belonged to upper middle class. 47% women had height of <150 cm and 70% had a BMI between (25-29.9) kg/m. 43% women had gestational age between 39-40 weeks.Conclusions: Second stage caesarean section was more common in young age group and primigravidae. Higher BMI was not only operative but obstetrical risk as well.

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A STUDY OF POSTPARTUM INTRAUTERINE CONTRACEPTIVE DEVICE INSERTIONS IN CAESAREAN SECTIONS AND FOLLOWING VAGINAL DELIVERIES

10.36106/ijsr/8922651 ◽

2021 ◽

pp. 1-3

Author(s):

Shweta Pathak ◽

Manaswita Samanta ◽

Debarshi Jana

Keyword(s):

Caesarean Section ◽

Prospective Study ◽

Clinical Outcomes ◽

Vaginal Delivery ◽

Caesarean Delivery ◽

Contraceptive Device ◽

Obstetrics And Gynaecology ◽

Vaginal Deliveries ◽

Intrauterine Contraceptive

Aim: To study clinical outcomes of immediate postpartum IUCD insertion and to compare immediate postpartum IUCD insertion as a factor of route of insertion (caesarean vs. vaginal). Material and methods: This prospective study was conducted in a Department of Obstetrics and Gynaecology, College of medicine and JNM Hospital, Kalyani, Nadia. Duration of the study was one and half years [ 15 months inclusion, 3 months follow up]. Total 100 cases are included [50 vaginal and 50 caesarean]. Women who were attending or referred to OPD or ER of Dept. of Obst and Gynae, College of medicine and JNM Hospital and delivering either vaginally or by caesarean section, have received counseling for postoperative contraception and have consented to PPIUCD insertion Result:It was found that in Caesarean, 26(52.0%) patients had bleeding P/V 6 weeks. In Vaiginal, 28(56.0%) patients had bleeding P/V 6 weeks. Association of bleeding P/V 6 weeks vs. group was not statistically signicant (p=0.61968). In Caesarean, 11(22.0%) patients had bleeding P/V 3 weeks. In Vaiginal, 13(26.0%) patients had bleeding P/V 3 weeks. Association of bleeding P/V 3 weeks vs. group was not statistically signicant (p=0.6395). Conclusion:Infection was not statistically signicant in two groups at 6 week and 3 month.Missing thread was signicantly higher caesarean delivery compared to vaginal delivery.It was also found that refusal/ continuation was more common in vaginal delivery compared to caesarean delivery, which was not statistically signicant.

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Trial of scar in post caesarean pregnancies

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180913 ◽

2018 ◽

Vol 7 (3) ◽

pp. 1173

Author(s):

G. Kuppulakshmi ◽

S. Saranya

Keyword(s):

Caesarean Section ◽

Caesarean Delivery ◽

Uterine Wall ◽

Perinatal Morbidity ◽

Surgical Incision ◽

Medical College ◽

Caesarean Birth ◽

Obstetric Management ◽

One Year ◽

Present Pregnancy

Background: The term caesarean delivery used to describe the delivery of a fetus through a surgical incision of the intact anterior uterine wall. The objective of this study was to analyse the maternal and perinatal morbidity between successful VBAC and failed vaginal delivery in cases selected for trial of labour.Methods: Prospective study conducted in Government RSRM Lying In Hospital, Government Stanley Medical College, Chennai over a period of one year from January 2017 to December 2017.Results: Trial of labour in previous caesarean section was more successful when the interval between previous caesarean and present pregnancy was between two to four years 86.40%. Conclusions: Most patients with a prior caesarean birth are candidates for VBAC. In properly selected women, a trial of labour after one previous low transverse caesarean section constitutes the best and safest form of obstetric management.

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Maternal outcomes following second stage caesarean section in a tertiary hospital in Malaysia: A 6-year retrospective review

Polish Annals of Medicine ◽

10.29089/2020.20.00163 ◽

2021 ◽

Author(s):

Nurul Nafizah Mohd Rashid ◽

Nik Mohamed Zaki Nik Mahmood ◽

Mohd Pazudin Ismail ◽

Adibah Ibrahim ◽

W Fadhlina W Adnan ◽

...

Keyword(s):

Risk Factors ◽

Caesarean Section ◽

Post Partum ◽

Neonatal Morbidity ◽

Tertiary Hospital ◽

Outcome Data ◽

High Rate ◽

Maternal Outcomes ◽

Total Blood ◽

Second Stage

Introduction: The trend for second stage caesarean section (SSCS) has been rising, and it carries a high rate of maternal and neonatal morbidity. Aim: To determine the prevalence of caesarean section (CS) performed during the second stage of labour and identify maternal outcomes and associated risk factors in these women. Material and methods: This retrospective study was performed in the Hospital University Sains Malaysia (HUSM). Medical records of 207 women with singleton cephalic pregnancies at term who underwent a SSCS between January 1, 2010 and December 31, 2015 were reviewed, and demographic and outcome data were collected. Results and discussion: During the study period, 8,197 (19.3%) out of 42,546 babies were delivered by CS, including 257 (4.1%) SSCSs. Nearly half (49.3%) the women were nulliparous, 182 (87.9%) experienced spontaneous labour and 123 (59.4%) received oxytocin augmentation. Furthermore, 26 (12.6%) of women had post-partum haemorrhage (≥1000 mL), of whom 22 (10.6%) required blood transfusion. Only 1 (0.5%) woman was admitted to the intensive care unit postoperatively, but 163 (78.7%) had an overall hospital stay length of 3 days. Furthermore, 38 (18.4%) and 33 (15.9%) of women experienced extended uterine tear and uterine atony, respectively. Parity (P < 0.001), attempted instrumentation (P < 0.001) and baby’s weight (P < 0.004) were statistically significantly associated with total blood loss. Parity (P < 0.012) and attempted instrumentation (P < 0.001) were risk factors for extended uterine tear. Conclusions: The overall outcomes from SSCS were better compared with studies performed in other centres. Current practices must be maintained or improved to provide the best patient caree.

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Rising rates of second stage caesarean section and its impact on maternal outcome

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182751 ◽

2018 ◽

Vol 7 (7) ◽

pp. 2681

Author(s):

Shanmugapriya Kumaresan ◽

Malarvizhi Loganathan

Keyword(s):

Caesarean Section ◽

Caesarean Section Rate ◽

Adverse Outcomes ◽

Cesarean Sections ◽

Maternal Complications ◽

College Hospital ◽

Second Stage Of Labor ◽

Medical College ◽

Second Stage ◽

Second Stage Of Labour

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.

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