Maternal and Fetal Outcomes Following Caesarean Section in Second Stage of Labour
DOI:
https://doi.org/10.51985/Keywords:
Caesarean Section, Fetal Health,“Labor Stage, Second”, Pregnancy Outcome, Fetomaternal Outcome, MaternalAbstract
Objectives: The primary objectives of this study were to establish the frequency of caesarean sections conducted during the second stage of labour, identify the reasons leading to this intervention, and evaluate the maternal and fetal outcomes associated with second-stage caesarean deliveries.
Study Design and Setting: Cross sectional study in Combined Military Hospital Abbottabad.
Methodology: After approval from ethical committee, this study was conducted from 1st January 2024 to 30th June 2024. Via non-probability consecutive sampling, pregnant women between ages 20-45 years, with a singleton pregnancy, and gestation age greater than 37 weeks were included. The study evaluated indications for caesarean section, preoperative instrumentation, intraoperative complications (uterine incision extension, haemorrhage, atonic post-partum haemorrhage), and postoperative complications (wound infection, febrile illness, and neonatal morbidity and mortality).
Results: There were a total of 1195 deliveries over the research period. 642 (54%) babies born via cesarean section. Amongst these, 25 (3.8%) cesarean sections were performed in the second stage. The most common indication for secondstage CS in the present study was non-progress of labour (36%). Among women undergoing second-stage CS, the most common maternal complication was atonic PPH (32%), followed by blood transfusion (28%). In our study, there was no case of maternal and neonatal deaths. For neonates, the most common causes of NICU admission were RDS (36%) and HIE (32%)
Conclusion: Several intra-operative maternal problems and neonatal morbidity are linked to cesarean sections that are performed during the second stage of labour
References
1. Rahim A, Lock G, Cotzias C. Incidence of second stage (fully
dilated) caesarean sections and how best to represent it: a
multicentre analysis. Int J Gynaecol Obstet. 2022;156(1):
119–123. https://doi.org/10.1002/ijgo.13672.
2. Archibong MS, Adenikinju WS, Olayemi OJ, Amuda M.
Caesarean section in second stage of labour: a commentary
on principles and techniques. Int J Reprod Contracept Obstet
Gynecol. 2021;10(10):4038–4040. https://doi.org/10.18203
/2320-1770.ijrcog20213888..
3. Bhatia S, Revankar VM. Study of maternal and perinatal
outcome of caesarean delivery in late first stage and second
stage of labour. Int J Reprod Contracept Obstet Gynecol.
2021;10(4):1503–1508. https://doi.org/10.18203/2320-
1770.ijrcog20211128.
4. Gurashi A, Osman A, Suliman H, Eltigani A, Siralkatim I, et
al. Second Stage of Labor Cesarean Section Maternal and
Fetal Outcomes. Clin J Obstet Gynecol. 2024;7:25–33.
10.29328/journal.cjog.100115.
5. Dahiya P, Agarwal S, Najam R. Retrospective analysis of
second stage of cesarean section and pregnancy outcomes:
an observational study. J South Asian Feder Obstet Gynaecol.
2022;14(1):54–58. https://doi.org/10.5005/jp-journals-10006-
1991
6. Vashi CA, Vijay N, Bhalerao A, Shetty A, Vashi C. Obstetrics
outcomes in women undergoing second-stage cesarean section:
a cross sectional study. Cureus. 2023;15(6):e39911.
https://doi.org/10.7759/cureus.39911 ouci.dntb.gov.ua+13
pubmed.ncbi.nlm.nih.gov+13ijmedph.org+13
7. Cegolon L, Mastrangelo G, Maso G, Dal Pozzo G, Ronfani
L, Cegolon A, et al. Understanding factors leading to primary
cesarean section and vaginal birth after cesarean delivery in
the Friuli Venezia Giulia Region (North Eastern Italy),
2005–2015. Sci Rep. 2020;10(1):380.DOI: 10.1038/s41598-
019-57037-y
8. Second stage of labor cesarean section showed more
complications of postpartum hemorrhage, sepsis, and extended
tears, as well as more fetal complications. Clin J Obstet
Gynecol. 2024;7:025–033.DOI: 10.29328/journal .cjog.
1001159.
9. Cornthwaite K, Bahl R, Lenguerrand E, Winter C, Kingdom
J, Draycott Impacted foetal head at caesarean section: a
national survey of practice and training. J Obstet Gynaecol.
2021;41(3):360–6. https://doi.org/10.1080/ 01443615.
2020.1780422.
10. Anusha S. Our experience of maternal and foetal outcomes
in 2nd stage caesarean deliveries tertiary care centre study.
Blood Transfus. 2020;29:58.DOI: https://doi.org/10.33545/
gynae.2020.v4.i3a.566
11. Vousden N, Cargill Z, Briley A, Tydeman G, Shennan AH.
Caesarean section at full dilatation: incidence, impact and
current management. Obstet Gynaecol. 2014;16(3):199–205.
https://doi.org/10.1111/tog.12112.
12. Sabir SF, Baig FS, Safdar Z, Zeb S, Tariq F, Shehzadi K.
Rising Cesarean Section Rate, Need to Revisit Cesarean
Section Indications. Pakistan J Med Heal Sci. 2022;16(4)
:687–90.
13. Mahfooz A, Reza TE, Uzam Q et al. A review of Cesarean
section Rates and associated Factors in Pakistan Using
Anderson Health Behaviour Model. J Gynecol Womens
Health.2023;25(5):001-006.
14. Sarwar S, Bibi N, Ashraf N. Increasing Trends of Cesarean
Section in Pakistan. P J M H S.2021; 15:626-628.
15. Rami BD, Kaul S, Sailor A, Jindani S. A study of caesarean
section at full cervical dilatation. Int J Reprod Contracept
Obstet Gynecol. 2020;9(4):1672–6.
16. Riaz M, Mehdi M, Kulsoom S, Khairunnisa, Mushtaq I, Alam
K. Risk Fcators , Causes, and Management of Primary Post
Partum Hemorrhage at POF Hospital Wah Cantt. J Soc Obstet
Gynaecol Pak.2023;13(2):177-180.
17. Mandar O, Hassan B, Abdelbagi O, Eltayeb R, Alhabardi N,
Adam I. Prevalance and Associated Factors for Post Caesarean
Delivery Blood Transfusion in Eastern Sudan: A CrossSectional Study. Journal of Blood Med.2022;13:219-227.
18. Rami BD et al. A study of Caesarean Section at Full Cervical
Dilatation. Int J Reprod Contracept Obstet Gynecol.2020;
9:1672-1675.
19. Ergani SY et al. Postoperative Care in the Caesarean Intensive
Care Unit: experience from a Tertiary Maternity Hospital. J
Turk Ger Gynecol Assoc.2023; 24:42-47.
20. Saba N, Khokhar O K, Waheed U. Rational use of Blood in
Obstetrics and Gynaecology in Pakistan: Perspective from a
Developing Country. J Soc Obstet Gynaecol Pak.2024; 14:373-
376.
21. Fatima N, Ellahi A, Shawita. Surgical Site Infection and
Factors Responsible for It After Emergency Caesarean section.
Journal of Surg Pak.2020; 25:27-30.
22. Karawani G et al. Risk factors for Uterine Incision Extension
During Caesarean delivery.2020. DOI:10.1080/14767058
.2020.1783230.
23. Renan WS et al. Unintended Uterine Extension at the time
of Caesarean Delivery-risk factors and associated adverse
maternal and neonatal outcomes. The Journal of MaternalFetal & Neonatal Medicine.2023;36:1
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0
