A Retrospective Study on Fetomaternal Outcome in Second Stage Cesarean-Section

Introduction:Second stage C-section are associated with poor fetomaternal outcome due to deeply engaged head ,less liquor,and thinned out LUS.This can lead to maternal morbidities like thinned out the lower uterine segment. This can lead to a high risk of maternal morbidities like an extension of the lower uterine segment incision, uterine atony, and injury to urinary bladder as well as neonatal morbidities such as birth asphyxia, NICU admission, and meconium aspiration syndrome. This study aims to observe the maternal and neonatal outcomes of cesarean delivery performed in the second stage of labor. Materials and Methods:This is a retrospective observational study conducted in a tertiary health center to study the fetomaternal outcome of all women with singleton, a cephalic fetus at term delivered by cesarean section in the second stage of labor over one year duration. Results:During this study period, there were 6200 deliveries C-section. Among emergency LSCS 50 (0.8%)were performed in the second stage of labor. Most common indication was NPOL A/W fetal distress 24 (44%)followed by Obstructed labor 10(20%). Most common Intraoperative complication noted was extension of uterine segment 8(16%) followed by atonic PPH. Postoperative maternal who had complications were prolong catheterization:25(50%), postoperative fever : 4(8%), haemorrhagic urine8(16%). In perinatal complications, meconium stained liquor: 22(44%),NNU admission8(16%), Apgar score <5 at 5 min : 8(16%), NICU admission : 12(24%), fresh stillbirth : 1(2%) were observed. Conclusion: Cesarean section in the 2nd stage of labor is associated with significantly increased maternal morbidity. Neonatal morbidity and mortality also increases. A proper judgment is required by a skilled obstetrician to take a decision for cesarean section at full cervical dilatation.