The study of fetomaternal outcome in second stage caesarean section

Background: Caesarean section is commonly perceived as a simple alternative to difficult vaginal birth and in the recent years its prevalence during the second stage is increasing. Caesarean section in second stage of labor has additional associated risks for the mother such as obstetric hemorrhage, extended uterine tear, bladder injury and longer hospital stay. It is also associated with increased neonatal morbidity in terms of NICU admissions, fetal acidemia, hypoxemia and prolonged NICU stay. This study was conducted to know the indications of second stage caesarean section and to assess maternal and neonatal outcomes in second stage caesarean section. Methods: We conducted a prospective observational study conducted at a tertiary perinatal care center from August 2021 to August 2022. All second stage caesarean sections performed during this period were analyzed in terms of indication for caesarean section, intraoperative, postoperative complications and fetal outcomes. Results: During the study period there were a total of 10433 deliveries. Out of this, 5392 deliveries done by caesarean section, in which 67 were second stage caesarean section. Deep transverse arrest was the most common indication for caesarean section in second stage of labor. Most common intra operative complication was uterine atony, seen in 32.5% cases. 16 (24%) NICU admission were noted with respiratory distress being the most common indication. 15 (23%) had post operative complications like febrile illness. Conclusions: Second stage caesarean section is associated with significant maternal and neonatal morbidity. A skilled obstetrician and proper training are required to take appropriate decisions for caesarean section at full dilatation of cervix.