Feto-maternal outcome of second stage cesarean section in B. P. Koirala institute of health sciences: a retrospective study

Background: Cesarean section (CS) is a common surgical procedure performed in obstetrics. The rate of rise of CS can be attributed to the increase in safety of the procedure, enhanced surgical techniques, improved antibiotics, increase in number of women requesting for CS. In general, caesarean delivery is associated with more severe maternal complications compared to vaginal deliveries. The stage of labour at which CS is undertaken has been shown to influence the rate/risk of complication. Methods: It was an observational and retrospective study that depended on some clinical records related to more than 37 weeks’ gestation. The study was conducted in BP Koirala institute of health sciences, Dharan Nepal from 2021 December to 2022 December. The neonatal as well as maternal outcomes have been evaluated for CS among those who were observing the second stage in their labor period. The test statistics used to analyse the data were descriptive statistics chi-square test. Results: The total delivery was 16131 out of which there were 6748 cesarean deliveries. Out of 6748 CS 65 patients had cesarean in second stage of labour. The most common cause of CS in second stage of labor was arrest of descent and dilatation (40%), followed by meconium-stained liquor (15.38%), occipito-posterior position (12.30%), and obstructed labour (3.07%) Being the least cause. One patient had to undergo peri-partum hysterectomy and the most common complication of second stage CS was prolong foleys catheterization (15 patients), post-partum febrile illness (20 patients out of 65), followed by wound infection, PPH, blood transfusion. The neonatal admission for NICU were birth asphyxia and respiratory distress were 50% each. Conclusions: CS in the second stage of labor is correlated with considerably improved neonatal and maternal rate of morbidity along with expanded neonatal mortality. A proper judgment and skilled obstetrician are required to perform a second-stage CS. CS in the second stage of labor is a technically demanding procedure with an increased risk of maternal and neonatal morbidity compared to the CS in the first stage of labor.