scholarly journals A prospective observational study of fetomaternal outcome in second stage caesarean section

2019 ◽  
Vol 8 (12) ◽  
pp. 4798
Author(s):  
Isha . ◽  
Prabha Lal ◽  
Vikram Dutta ◽  
Aayushi Kaushal
Keyword(s):  
Caesarean Section ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Caesarean Section Rate ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Bladder Injury ◽  
Intraoperative Complication ◽  
Second Stage ◽  
Second Stage Of Labour

Background: Incidence of caesarean section is rapidly rising over last two decades and one fourth is contributed by caesarean section in second stage. The objective of this study was to study of fetomaternal outcome in second stage caesarean section.Methods: Prospective observational study was done in 80 women undergoing second stage caesarean section from December 2015 to March 2017 at Lady Hardinge Medical Collage Delhi. These women observed from labour to caesarean section in second stage of labour till post-operative period for any complication. Intraoperative and postoperative complications were observed in these women.Results: Caesarean section rate was 22% in which 3.9% were done in second stage of labour. Most common gestational age being 39-40 weeks (47%). Most common indication being deep transverse arrest (41.25%). Intraoperative complication as bladder injury (5%), extension of uterine incision (23%), PPH (33%) and need for blood transfusion (31%) and post-operative complication as wound sepsis in 58% and 20% requiring resuturing, post-operative fever, prolong hospital stay, prolonged catheterization etc. neonatal complications as severe birth asphyxia (2.5%), respiratory distress (55%), need for mechanical ventilation.Conclusions: Thus, caesarean section done in second stage of labour is associated with increased maternal and neonatal morbidity.

scholarly journals FETO-MATERNAL OUTCOME OF CAESAREAN SECTION DURING SECOND STAGE OF LABOR IN A TERTIARY CARE HOSPITAL: AN OBSERVATIONAL STUDY

2020 ◽  
Vol 4 (11) ◽  
Author(s):  
Ruby Kumari
Keyword(s):  
Caesarean Section ◽  
Observational Study ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Cervical Dilatation ◽  
Care Hospital ◽  
Maternal Complications ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
The Mean

Aim: To highlights the maternal and neonatal outcome of caesarean section in second stage of labour. Methods: This prospective observational study was carried out in the Department of Obstetrics and Gynecology at Government Medical College and Hospital Bettiah, Bihar, India from December 2017 to December  2018. total of 24600 women delivered by caesarean section, 16800 emergency and 7800 elective cases. Of these 400 were at full cervical dilatation, >37 weeks gestation with a singleton fetus in cephalic presentation. All caesarean sections performed at full cervical dilatation over the time period of 1 year at a government hospital were included. Results: Among the 400 patient’s majority of them were in the age group of 20-30 years (72.5%). about 75.5% of the patients were primigravidae and only the remaining 24.5% were multigravida. The commonest indications for doing caesarean section in the second stage of labour were cephalo pelvic disproportion, fetal distress and obstructed labour. Incidence of PPH is 48 out of 400 cases (12%). Post-operative wound infection was seen in 23(5.75%) and Post-operative fever was seen in 70(17.5%) out of 400 cases. There were no cases of maternal deaths reported. The mean operative time was 52.9 min .The mean length of hospital stays was 6.6 days. Mean weight of the babies of the second stage caesarean section was 3.2 kg. Conclusions: Caesarean sections done in second stage of labour are associated with several intra-operative maternal complications and neonatal morbidity. Keywords: Caesarean complications; emergency caesarean section; maternal morbidity; neonatal morbidity

scholarly journals Study of fetomaternal outcome in second stage caesarean section

2019 ◽  
Vol 8 (6) ◽  
pp. 2169 ◽  
Author(s):  
Kamal D. Goswami ◽  
Manisha M. Parmar ◽  
Avnika N. Kunjadiya
Keyword(s):  
Caesarean Section ◽  
Prospective Observational Study ◽  
Febrile Illness ◽  
Neonatal Morbidity ◽  
Cervical Dilatation ◽  
Bladder Injury ◽  
Fetal Head ◽  
Second Stage ◽  
Uterine Incision ◽  
Tertiary Teaching

Background: The incidence of second stage caesarean section is more in developing countries. Caesarean sections done at full cervical dilatation with impacted fetal head are difficult and associated with an increased incidence of maternal and fetal complications.Methods: This was prospective observational study conducted at a tertiary teaching institute. All second stage caesarean sections performed between September 2017 to August 2018 were analysed in terms of incidence, indications of caesarean-section, intra-operative  and postoperative complications, maternal and fetal outcome.Results: During the study period there were total 7270 deliveries. Out of this 1884 deliveries were done by caesarean section. Out of them 50 were 2nd stage caesarean sections contributing to 2.65% of total sections. Patwardhan method was used in 50% cases for deliveryof deeply engaged head. Intra-operative complications were higher in terms of atonic pph (8%), extension of uterine incision (16%), in 3 cases bladder injury was noticed. Obstetric hysterectomy was required  in 4% cases. 14% cases had postoperative febrile illness and 8% cases had wound infection. 44% babies required NICU admissions and neonatal death was 18%.Conclusions: Caesarean section in the 2nd stage of labour is associated with significantly increased maternal morbidity. Neonatal morbidity and mortality also increases. A proper judgement is required by a skilled obstetrician to take a decision for caesarean section at full cervical dilatation.

Study on Maternal and Neonatal Outcome of women undergoing Caesarean Section using Nice Classification in a Tertiary Care Hospital in Rural Area of Central India - An Observational Prospective Study

2021 ◽  
Vol 17 ◽  
Author(s):  
Shuchi M. Jain ◽  
Ketki. Thool ◽  
Manish A. Jain ◽  
Poonam V. Shivkumar
Keyword(s):  
Caesarean Section ◽  
Prospective Study ◽  
Neonatal Outcome ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Central India ◽  
Neonatal Morbidity ◽  
Bladder Injury ◽  
Care Hospital ◽  
Chi Square

Background : Caesarean section is often perceived to be safer than vaginal delivery for mothers and neonates, and thus has become increasingly common around the globe. However, it may actually be detrimental to maternal and neonatal health while consuming valuable resources. Objective : The objective of this study was to categorize the caesarean sections performed in our rural institute into various categories using NICE classification and to study the maternal and neonatal outcome in them. Method : This was a prospective study of all women who underwent caesarean section over a period of 18 months. Data was retrieved from the files of women for morbiditiy and mortality in mothers and babies. Data was entered in MS excel sheet and analyzed with percentages and chi square test using SPSS ver.17. Results: Caesarean section rate (CSR) was 36.88%. All CS were classified into four categories based on urgency as per NICE guidelines. There were 22.62% women in Category I, 38.61% in category II, 28.37% in category III and 10.40% in Category IV. Adhesions, extension of angle, lacerations in lower segment, scar dehiscence, atonic PPH and bladder injury were noted in (12.83%), 11.81%, 6.83%, 4.08% , 1.53% and 0.08% CS respectively. Caesarean hysterectomy was done in 0.24% cases. Postoperative morbidity was febrile morbidity (11.93%), postdural puncture headache (13.85%), paralytic ileus (11.49%), wound infection (8.83%), ARDS (0.70%), sepsis (0.78%), pulmonary edema (0.47%) and pulmonary embolism (0.03%). Maternal mortality was 0.03%. Neonates born were 2577 (29 were twin deliveries). 82.46% neonates were healthy, 16.80% had morbidities and 0.74% were still born. Apgar score of less than 7 was in 10%. 16.80% neonates were admitted in NICU during their hospital stay. Neonatal mortality was 1.47%. Conclusion : Intraoperative and post-operative complication were more in caesarean sections of category I and II as compared to category III and category IV. Neonatal morbidity, mortality and admissions to NICU were more in caesarean sections of category I and II as compared to category III and category IV. Thus though caesarean section is an emergency lifesaving procedure for mother and baby it may prove detrimental to their health.

scholarly journals Exploring caesarean delivery in the second stage of labour at a tertiary care hospital: a retrospective study

2021 ◽  
Vol 10 (10) ◽  
pp. 3929
Author(s):  
Pravinkumar A. Jadav ◽  
Palak M. Dabhi ◽  
Dhruti A. Rathod
Keyword(s):  
Retrospective Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Transfusion Rate ◽  
Care Hospital ◽  
Intraoperative Complication ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Second Stage Of Labour

Background: Caesarean section (CS) performed in the second stage of labour has many implications for maternal and neonatal morbidity as well as for subsequent pregnancies. The objectives of this study were to determine the rates of CS at full dilatation, their indications, associated maternal and neonatal complications.Methods: This retrospective study assessed all the women with a singleton fetus in cephalic presentation at term (≥37 weeks) who underwent CS in the second stage of labor between 1 August 2019 and 31 March 2020 at a tertiary care hospital. Maternal demographics, labour and delivery details as well as neonatal outcomes were collected.Results: During the study period, 2124 (36%) babies were born by CS. Of these, 49 (2.3%) were performed in the second stage of labour at ≥37 weeks of gestation. The most common indication of CS was non-descent of head in 38 (77.55%) of cases. The majority of women 38 (77.55%) delivered by CS in the second stage of labor were primiparous. The 27 (55.10%) women were in the age group of 20-25 years. Most common intraoperative complication was blood-stained urine in 20 (40.81%) women. Overall transfusion rate was 18.36%. Maximum number of babies born 44 (89.79%) were having birth weight between 2.5-3.5 kg. Out of 65 babies born, 17 (34.69%) were admitted to neonatal intensive care unit.Conclusions: Formulation of an institutional protocol and training and supervision of trainees to improve the skill of operative vaginal delivery and second stage cesarean is needed.

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

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.

scholarly journals Maternal and foetal outcome in second stage caesarean section: a prospective study

2021 ◽  
Vol 10 (4) ◽  
pp. 1644
Author(s):  
Shuchi Sharma ◽  
Poojan Dogra ◽  
Reena Sharma ◽  
Suraj Bhardwaj
Keyword(s):  
Caesarean Section ◽  
Prospective Study ◽  
Cervical Dilatation ◽  
Bladder Injury ◽  
Fetal Head ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Adjacent Structures ◽  
A Prospective Study

Background: Caesarean section is the most commonly performed abdominal operation in women all over the world. Caesarean sections during the second stage labour accounts for approximately one fourth of all primary caesareans.  Caesarean section at full cervical dilatation is technically difficult and is associated with increased trauma to the lower uterine segment and adjacent structures, as well as increased haemorrhage and infection. Aims and objectives were to determine the indications, maternal and foetal morbidity associated with caesarean section in the second stage of labour.Methods: This prospective study included consecutive 50 cases of caesarean section deliveries conducted in second stage of labor for singleton live pregnancies at term. The data collected in the study was analyzed in terms of maternal demographics, indications of caesarean section, intra-operative and postoperative complications and neonatal outcomes.Results: In our series of 50 deliveries, arrest of descent of fetal head due to malposition was the most common indication of caesarean section accounting for 74% and average procedure time was 45-70 minutes. PPH (62%) was the most common complication. Bladder injury was found in 14% cases. Neonatal outcome variables like APGAR<3 at 5 minutes, respiratory distress and neonatal death were observed in 7, 26 and 2 deliveries respectively.Conclusions: Women undergoing cesarean section in second stage of labour are associated with increased maternal and fetal morbidity. They require special care and hence operation should ideally be performed and supervised by an experienced obstetrician. A proper judgement is required to take a decision for caesarean section at full cervical dilatation.

scholarly journals The maternal and fetal outcome of repeat previous one caesarean section

2021 ◽  
Author(s):  
Uma Jain ◽  
Deepali Jain ◽  
Shaily Sengar ◽  
Preeti Gupta
Keyword(s):  
Caesarean Section ◽  
Placenta Previa ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Bladder Injury ◽  
History Of ◽  
Caesarean Hysterectomy ◽  
Placenta Accrete

Background: The rates of adverse maternal and neonatal outcomes have increased significantly in the last decade. Patients with repeated caesarean deliveries also have a greater risk of placenta previa, placenta accrete, uterine rupture, bowel and bladder injury, and unplanned hysterectomy.Methods: This retrospective study was performed between 01 April 2017 to 31 March 2021, at a private hospital to know about the surgical difficulties and maternal and neonatal complications encountered in cases of repeated LSCS. The outcome of 1028 women admitted with a history of previous LSCS was studied.Results: The 613 patients were given a trial of labour. 40.07% of patients delivered normally. The most common indication for repeat LSCS was CPD in 20.94% and fetal distress 20.12%. The most common complication observed was adhesion in 37.65%. Scar dehiscence in 8.92 %, scar rupture in 0.64%, uterine atony in 4.8%, placenta previa in 3.57%, placenta accrete in 0.64%, injury to the bladder was seen in 0.97%, caesarean hysterectomy was done in only 2 cases and gaped wound was found in 1.13% of cases. 19.15% of neonates were admitted to NICU. Apgar score <7 at 5 minutes in 14.77%. premature neonates were 8.44% RDS was found in 7.62%, birth asphyxia was found in 2.92% cases and neonatal sepsis was found in 1.13%.Conclusions: The dramatic increase in caesarean section rates over the past three decades has been associated with a corresponding increase in maternal morbidity but there a continuous decrease in neonatal morbidity and mortality rates because of advances in neonatal medicine.

scholarly journals Caesarean Section During Second Stage of Labor in a Tertiary Centre

2017 ◽  
Vol 15 (2) ◽  
pp. 178-181 ◽  
Author(s):  
Padma Gurung ◽  
Sameer Malla ◽  
Sushma Lama ◽  
Anagha Malla ◽  
Alka Singh
Keyword(s):  
Caesarean Section ◽  
Post Partum ◽  
Caesarean Section Rate ◽  
Neonatal Morbidity ◽  
Adverse Outcomes ◽  
Perinatal Complications ◽  
Maternal Complications ◽  
Postoperative Fever ◽  
Second Stage Of Labor ◽  
Second Stage

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. Within this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlight the feto-maternal outcome of caesarean section in second stage of labour.Methods: This was a retrospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between April 1, 2013 and March 30, 2017 at Patan Academy of Health Sciences. The main outcome measures were second stage caesarean section, indications and its maternal and fetal morbidity.Results: During the study period, there were 40,860 deliveries. A total of 18,011 (44%) babies were born by caesarean section, 10484 emergency and 7527 elective. Out of the emergency caesarean section, 200 (1.9 %) were performed in second stage of labor. In this study, the most common indication was cephalopelvic disproportion. (92.4%) were delivered without a trial of instrumental delivery. In terms of maternal complications, atonic post partum haemorrhage uterine incision extension 18 (12.5%), postoperative fever 27(18.8%), wound infection 7 (4.8%) were observed. In perinatal complications, meconium stained amniotic fluid 49(34.2%), neonatal hyperbilirubinemia 14(9.7%) and increased nursery admission 2(15.3%) and 2(1.3%) perinatal mortality were seen.Conclusions: Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and neonatal morbidity.

scholarly journals Review of caesarean sections at full dilatation

2017 ◽  
Vol 6 (6) ◽  
pp. 2491 ◽  
Author(s):  
Vijaya Monish Babre ◽  
Kirti Rajesh Bendre ◽  
Geeta Niyogi
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Maternal Morbidity ◽  
Intraoperative Complications ◽  
Febrile Illness ◽  
Neonatal Morbidity ◽  
Bladder Injury ◽  
Second Stage ◽  
Uterine Incision ◽  
Tertiary Teaching

Background: To study indications of second stage caesarean section. To study intraoperative and postoperative complications. To review maternal and perinatal outcome.Methods: This retrospective study was conducted at a tertiary teaching Institute. All second stage caesarean sections performed between a period 2008 to 2012 were analysed in terms of duration of 2nd stage of labour, instrumentation attempted prior to caesarean section, indication of caesarean-section, Intraoperative complications, maternal and perinatal outcome.Results: During the study period 2760, caesarean sections were performed out of them 61 were 2nd stage caesarean section. Out of 61 Caeserean 14 were given prior instrumental trial, followed by 2nd stage caesarean section. Intraoperative complications were higher in terms of blood loss, primary PPH, extension of uterine incision, in one case bladder injury was noticed. Patwardhan method was used in 23% cases for delivery deeply engaged head. Atonic PPH was seen in 11.5% of patiants.3.3% of patients had extension of uterine incision. 54% baby’s required NICU care. Increased incidence of post-operative febrile illness and wound infection were noted.Conclusions: Caeseraen section in the 2nd stage of labour is associated with significantly increased maternal morbidity. Neonatal morbidity and mortality also increases. A proper judgement is required by a skilled obstetrician to take a decision for instrumental delivery or ceaseraen section at full cervical dilatation.

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