FETOMATERNAL OUTCOME IN SECOND STAGE CAESAREAN SECTION IN A TERTIARY CARE CENTRE – A RETROSPECTIVE STUDY
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Abstract
BACKGROUND: A caesarean section done at full cervical dilatation, thinned out lower segment, deeply engaged head is considered as second stage caesarean section. Most common indication for second stage caesarean section is deep transverse arrest. In the present obstetrics practice, one of the major difficulties is to make a firm decision for caesarean section during second stage of labour. Second stage of labour is associated with severe maternal and neonatal outcome. This study aims to observe the maternal and neonatal outcome in second stage caesarean section.
METHOD: This was a retrospective observational study in which 50 second stage caesarean section patients were observed. The indication for the caesarean section, intraoperative period, post operative period and neonatal outcome were recorded and analysed.
RESULTS: Out of the 50 second stage caesarean sections observed, most common indication was arrest of descent (50%) followed by thick meconium-stained liquor with fetal distress (28%), Right occipitoposterior (10%), Failed instrumental delivery (4%) and deep transverse arrest (2%) being the least probable cause. Second stage CS is associated with increased intra operative complications like transient blood-stained urine (60%), extension of uterine angle (40%), PPH (40%) and Bladder injury (4%). Post operative complications like prolonged catheterisation (80%), wound infection (16%) was observed. Neonatal morbidity was observed in 20% of babies out of which the complications were respiratory distress syndrome (50%) and Neonatal hyperbilirubinemia (50%)
CONCLUSION: Second stage caesarean section requires great expertise and timely judgement. It is associated with high incidence of maternal and neonatal complications. Hence, second stage of caesarean section must be done by well versed and experienced obstetrician.