Maternal and Fetal Complications during Cesarean Section Done in Second Stage of Labour
Authors/Creators
- 1. Junior Resident, Department of Obs & Gynae GMC Amritsar
- 2. Associate Professor Obs & Gynae GMC Amritsar
- 3. Professor Obs & Gynae GMC Amritsar
- 4. Assistant Professor Obs & Gynae GMC Amritsar
- 5. Medical Officer Civil Hospital Jalandhar
Description
Introduction: Second Stage of labor begins with complete dilatation of cervix and ends with fetal delivery. Prolonged second stage of labour is diagnosed if the duration exceeds 2 hrs in nullipara and 1 hr in multipara, when no regional anaesthesia is used. Cesarean section at full dilatation, with or without attempt at operative vaginal delivery, is a more challenging surgical procedure than a first stage cesarean section and carries a higher rate of maternal morbidity. Material & Method: This Prospective Study was conducted in the Department of Obstetrics and Gynaecology, BNMCC, GNDH, Government Medical College, Amritsar from March, 2020 to March, 2021. Inclusion Criteria: All women at term and preterm with singleton pregnancies willing to participate. Exclusion Criteria: Patients refusing / not willing to participate in the study, Multi fetal gestation, History of Previous caesarean section, Abnormal Placentation e.g. Vasa previa and complete placenta previa, Active genital herpes infection, Cervical Cancer, Prior Myomectomy. Duration of labor & Indication for LSCS was noted. Maternal and fetal complications were observed. Results: In our study 150 women, who underwent cesarean section during second stage of labour, were selected according to exclusion and inclusion criteria. Most of women (66%) were referred patients and rest were booked patients who ended up in cesarean section. It was observed that labour dystocia was most common indication seen in our patients followed by fetal distress. Majority of them were referred patients, and from rural background who did not have proper antenatal checkup. Conclusion: This implies good antenatal checkup and recognition of complications can reduce the risk of prolonged second stage of labour. Difficult access to the healthcare facility, delay in referring the patient to the tertiary care centre increases the rate of cesarean section in second stage of labour. Timely decision for cesarean section and neonatal facilities can reduce the number of fetal complications.
Abstract (English)
Introduction: Second Stage of labor begins with complete dilatation of cervix and ends with fetal delivery. Prolonged second stage of labour is diagnosed if the duration exceeds 2 hrs in nullipara and 1 hr in multipara, when no regional anaesthesia is used. Cesarean section at full dilatation, with or without attempt at operative vaginal delivery, is a more challenging surgical procedure than a first stage cesarean section and carries a higher rate of maternal morbidity. Material & Method: This Prospective Study was conducted in the Department of Obstetrics and Gynaecology, BNMCC, GNDH, Government Medical College, Amritsar from March, 2020 to March, 2021. Inclusion Criteria: All women at term and preterm with singleton pregnancies willing to participate. Exclusion Criteria: Patients refusing / not willing to participate in the study, Multi fetal gestation, History of Previous caesarean section, Abnormal Placentation e.g. Vasa previa and complete placenta previa, Active genital herpes infection, Cervical Cancer, Prior Myomectomy. Duration of labor & Indication for LSCS was noted. Maternal and fetal complications were observed. Results: In our study 150 women, who underwent cesarean section during second stage of labour, were selected according to exclusion and inclusion criteria. Most of women (66%) were referred patients and rest were booked patients who ended up in cesarean section. It was observed that labour dystocia was most common indication seen in our patients followed by fetal distress. Majority of them were referred patients, and from rural background who did not have proper antenatal checkup. Conclusion: This implies good antenatal checkup and recognition of complications can reduce the risk of prolonged second stage of labour. Difficult access to the healthcare facility, delay in referring the patient to the tertiary care centre increases the rate of cesarean section in second stage of labour. Timely decision for cesarean section and neonatal facilities can reduce the number of fetal complications.
Files
IJPCR,Vol14,Issue8,Article23.pdf
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Additional details
Dates
- Accepted
-
2022-08-10
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/14/IJPCR,Vol14,Issue8,Article23.pdf
- Development Status
- Active
References
- 1. DC Dutta chapter normal labour. In: Textbook of Obstetrics, 9 th edition. 2019:115-17. 2. Friedman EA. Primigravida labour; a graphicostatistical analysis. Obstet Gynecol. 1955; 6:567–89. 3. McKelvey A, Ashe R, McKenna D, Roberts R. Caesarean section in the second stage of labour: a retrospective review of obstetric setting and morbidity. J Obstet Gynaecol 2010; 30 (3): 264–267. 4. Loudon JA, Groom KM, Hinkson L, Harrington D, Paterson-Brown S. Changing trends in operative delivery performed at full dilatation over a 10- year period. Journal of Obstetrics and Gynaecology. 2010;30(4): 370-5. 5. Govender V, Panday M, Moodley J. Second stage caesarean section at a tertiary hospital in South Africa. J Matern Fetal Neonatal Med 2010; 23(10):1151–5. 6. Sung JF, Daniels KI, Brodzinsky L, El-Sayed YY, Caughey AB, Lyell DJ. Cesarean delivery outcomes after a prolonged second stage of labor. American journal of obstetrics and gynecology. 2007;197(3):306- e1. 7. Alexander JM, Leveno KJ, Rouse DJ, Landon MB, Gilbert S, Spong CY, et al. Comparison of maternal and infant outcomes from primary cesarean delivery during the second compared with first stage of labor. Obstetrics & Gynecology. 2007;109(4):917-21. 8. Murphy DJ, Liebling RE, Verity L, Swingler R, Patel R. Early maternal and neonatal morbidity associated with operative delivery in second stage of labour: a cohort study. The Lancet. 2001 Oct 13;358(9289):1203-7. 9. Cunningham FGLK, Bloom SL, Hauth JC, Gilstrip LC III, Wenstrom KD. Cesarean delivery and peripartum hysterectomy. In: Cunningham FGLK, Bloom SL, Hauth JC, Gilstrip LC III, Wenstrom KD editors. Williams. Obstetrics. New York: McGraw‐Hill, 2005. pp 587–606.10. Sinha A. Incidence causes and fetomaternal outcomes of obstructed labour in a tertiary health care centre. Int J Reprod Contracept Obstet Gynecol. 2017;6(7):2817-2821 11. Gupta K, Garg A. Fetomaternal outcome in caesarean section at full dilatation. Int J Reprod Contracept Obstet Gynecol. 2019;8(8):3098- 3101 12. Bhargava S, Hooja N, Kala M, Mital P, Tulani K, Arora S, Kumavat B, Gupta S. Caesarean delivery in the 2019;69 (6):558-60. 13. Asicioglu O, Güngördük K, Yildirim G, Asıcıoglu BB, Güngördük OÇ, Ark C, Günay T, Yenigül N. Second-stage vs first-stage caesarean delivery: comparison of maternal and perinatal outcomes. J Obstet Gynaecol. 2014; 34(7):598-604. 14. Fantu S, Segni H, Alemseged F. Incidence, causes and outcome of obstructed labor in jimma university specialized hospital. Ethiopian journal of health sciences. 2010;20(3):1-7 15. Alhamdani, F., & Abdulla, E. H. Influence of Patient's Age and Gender on Dental Implant Treatment Five Year retrospective study. Journal of Medical Research and Health Sciences, 2021:4(9), 1461–1467.