International Journal of Clinical Obstetrics and Gynaecology

Background: The second stage of labour, extending from full cervical dilatation to fetal delivery, represents a critical interval during which surgical intervention may become necessary. Cesarean sections performed at full dilatation encounter formidable technical challenges due to deep fetal head engagement within the maternal pelvis, substantially elevating the risk of maternal haemorrhage, tissue trauma, and neonatal hypoxic injury compared with first-stage procedures.?
Objectives: This study aimed to systematically characterise the clinical indications, maternal perioperative complications, and neonatal outcomes associated with second-stage cesarean delivery in a tertiary obstetric centre.
Materials and Methods: A cross-sectional observational investigation was conducted at the Department of Obstetrics and Gynaecology, Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur, India, enrolling 100 consecutive women undergoing cesarean section during the second stage of labour. Structured data collection incorporated demographic variables, obstetric history, intraoperative events, and both maternal and neonatal outcomes.?
Results: Non-progression of labour (28%) and fetal distress (19%) constituted the predominant indications for surgical intervention. Maternal morbidity affected 54% of the cohort, with atonic postpartum haemorrhage (20%), blood transfusion requirement (22%), and uterine incision extension (18%) representing principal intraoperative complications. Postoperative sequelae included prolonged hospitalisation (28%) and paralytic ileus (18%). Neonatal outcomes revealed that 39% required neonatal intensive care unit admission, predominantly for meconium aspiration syndrome (48.7%) and hypoxic–ischaemic encephalopathy (17.9%), whilst perinatal mortality remained low at 3%.?
Conclusion: Second-stage cesarean sections are accompanied by substantial fetomaternal morbidity, necessitating meticulous surgical technique, skilled operative teams, and comprehensive perioperative preparation to optimise outcomes in this high-risk obstetric scenario.