Caesarean section at full cervical dilatation has many implications for maternal and neonatal morbidity as well as in subsequent pregnancy outcomes. However alarming rise in caesarean section has been reported with increase in concern for the rate of second stage caesarean section.
Aims of the study:
To compare the Fetomaternal outcome in nulliparous women undergoing cesarean section in first and second stage of Labour
Material and methods: This is a one year prospective study conducted at Mahatma Gandhi Medical College & Research Institute, Puducherry. Total number of patients who underwent caesarean delivery in first stage of labour are 400 (Group 1) and in second stage are 130 (Group 2) during the study period. These two groups were then compared in terms of maternal demographics, labour characteristics, maternal outcomes and neon`1qaZ1atal outcomes
Results: Caesarean delivery performed in the second stage were associated with increased maternal morbidity such as hemorrhage, uterine angle extension, blood transfusions, prolonged hospital stay, febrile morbidity, urinary system injury. Similarly neonatal morbidity was much higher in patients who underwent caesarean section in second stage of labour. There was increase in neonatal complications such as APGAR less than 7 at 5 minutes, NICU admissions for more than 24 hours, neonatal septicemia (p<0.001)
Conclusion: The present study suggests that women undergoing caesarean section in second stage of labour have increased maternal and fetal morbidity and they require special care. Hence appropriate selection of mode of birth should be decided carefully and judiciously to decrease maternal neonatal morbidity.