FETOMATERNAL OUTCOME IN CESAREAN SECTIONS DONE AT FULL DILATATION

Background: In recent years, a decline in the rate of operative vaginal delivery and increase in stage second cesarean sections has been noted. In addition to being technically more challenging than cesarean sections done during rst stage, maternal and fetal complications are greater as the head may be deeply impacted in the pelvis, liquor is less and lower uterine segment is thinner. Aretrospective cross-sectional study was conducted by collecting data from birth registries and hospital records. Materials and Methods:Atotal of 58 cases of cesarean sections at full dilatation were performed during this period which was analyzed. Out of 58 patients, 44(75.9%) were primigravida and 14(24.1%) were multigravida. The mean age of study population was 28.33 ranging from 20 to 38 years. Majority of patients were in ≥25 and < 30 year age group. Results: Maternal complications in the form of intraoperative hemorrhagic urine was found in 8(13.8%), extension of uterine incision in 2(3.4%), postpartum hemorrhage in 8(13.8%), postoperative fever in 8(13.8%), distension in 12(20.7%), prolonged catheterization in 21(36.2%), prolonged hospitalization in 12(20.7%) Neonatal complications in the form of Meconium stained liquour was found in 13(22.4%) , APGAR score <5 in 3(5.2%), NICU admission in 5(8.6%) and fresh stillbirth in 1(1.7%).Conclusion: In this study, the most common intraoperative maternal complication noted was hemorrhagic urine (13.8%) and postpartum hemorrhage (13.8%). The most common neonatal complication was meconium stained liquor (22.4%).Various steps can be taken to decrease rate of second stage cesarean sections which include proper monitoring of labor by partograph, detection of malpositions early in labor, proper referral system in periphery, increasing accountability by regular audit of second stage caesarean sections and proper counseling of patient and attendants.