Comparative study of maternal and neonatal outcome of 1st stage and 2nd stage caesarean sections in a tertiary centre.

M. Swetha; Sonia H; Keerti Shivaputrappa

doi:10.51168/ypd6e208

Authors

Dr. Swetha K. M. Assistant Professor, Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India. Author
Dr. Sonia H Assistant Professor, Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India. Author
Dr. Keerti Shivaputrappa Assistant Professor, Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India. Author

DOI:

https://doi.org/10.51168/ypd6e208

Keywords:

caesarean section, first stage of labour, second stage of labour, maternal outcome, neonatal outcome

Abstract

Introduction

Caesarean delivery during the second stage of labour is technically more difficult because of deep fetal head engagement and prolonged labour, potentially increasing maternal and neonatal morbidity.

Materials and Methods

This hospital-based retrospective observational study included 120 women undergoing intrapartum caesarean section at a tertiary care centre, with 60 first-stage and 60 second-stage procedures. Demographic, obstetric, operative, maternal, and neonatal outcomes were extracted from hospital records. Group comparisons used independent-samples t-tests for continuous variables and chi-square tests for categorical variables, with p<0.05 considered significant.

Results

Maternal age was comparable between first-stage and second-stage groups (25.87 ± 3.42 vs. 26.43 ± 3.71 years; p=0.387). Second-stage caesarean sections were associated with longer labour (10.64 ± 2.87 vs. 7.82 ± 2.31 hours; p<0.001) and longer second-stage duration (89.27 ± 31.54 vs. 36.42 ± 18.61 minutes; p<0.001). Uterine incision extension (21.7% vs. 5.0%; p=0.008), difficult fetal head delivery (30.0% vs. 3.3%; p<0.001), and atonic postpartum haemorrhage (18.3% vs. 6.7%; p=0.044) were more frequent in the second-stage group. Operative duration (61.82 ± 14.71 vs. 48.63 ± 10.24 minutes; p<0.001) and estimated blood loss (781.83 ± 211.46 vs. 612.50 ± 143.72 mL; p<0.001) were also greater. Mean 1-minute and 5-minute Apgar scores were lower (6.93 ± 1.12 vs. 7.52 ± 0.86; p=0.002 and 8.19 ± 0.91 vs. 8.71 ± 0.62; p<0.001), while neonatal resuscitation (25.0% vs. 8.3%; p=0.013) and NICU admission (26.7% vs. 10.0%; p=0.017) were higher after second-stage caesarean section.

Conclusion

Second-stage caesarean section was associated with greater maternal operative morbidity and less favourable early neonatal outcomes than first-stage caesarean section.

Recommendations

Timely intrapartum decision-making and preparedness for difficult fetal extraction, haemorrhage, and neonatal resuscitation are essential when second-stage caesarean delivery is anticipated.

Author Biographies

Dr. Swetha K. M., Assistant Professor, Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India.

Assistant Professor, Department of Obstetrics and Gynaecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India. Dr. Swetha K. M. is engaged in clinical obstetric and gynaecological care and academic activities within the teaching hospital.
Dr. Sonia H, Assistant Professor, Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India.

Assistant Professor, Department of Obstetrics and Gynaecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India. Dr. Sonia H. contributes to clinical services and academic work in obstetrics and gynaecology at the institution.
Dr. Keerti Shivaputrappa, Assistant Professor, Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India.

Assistant Professor, Department of Obstetrics and Gynaecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India, and corresponding author of this manuscript. Dr. Keerti Shivaputrappa is involved in clinical obstetric and gynaecological care, teaching, and scholarly activities.

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