Maternal and Fetal Outcome in Second Stage Caesarean Section

Background: Second-stage CS is riskier than first-stage CS due to complications like a deeply engaged fetal head, limited amniotic fluid, and a thin uterine segment, making fetal extraction difficult. Maternal risks include uterine tears, hemorrhage, and bladder injuries, while neonatal risks include asphyxia and NICU admissions.

Aim of the study: The study aims to evaluate obstetric outcomes in women undergoing second-stage cesarean sections, focusing on maternal and fetal.
Methods: This cross-sectional study, conducted in the Department of Obstetrics and Gynecology, 250 Bed Gaibandha District Hospital, Gaibandha, Bangladesh., examined obstetric outcomes in 60 women undergoing second-stage cesarean sections (CS) from January 2023 to June 2023. Ethical approval was obtained from the hospital’s Ethical Review Committee. Women aged 18-39 years without medical comorbidities or fetal abnormalities were included. The study assessed labor characteristics, intraoperative complications, fetal outcomes, and postoperative complications. Data were recorded in Excel and analyzed using IBM SPSS Statistics (version 26.0).

Result: The mean age was 28.34 years (SD=4.8). Primigravida women made up 70%, and 30% were multigravida. Delivery gestational age was distributed as 45% at 37-38 weeks, 53.33% at 39-40 weeks, and 1.67% at 41 weeks. Labor was spontaneous in 66.67% and induced in 33.33%. Labor duration varied, with 46.67% experiencing 1-12 hours. The most common delivery mode was Modified Patwardhan (35%), followed by Vertex (28.33%). The most frequent cesarean indication was non-reassuring fetal status (35%). The most common intra-operative complication was uterine angle extension (20%), and the most frequent postoperative complication was postpartum hemorrhage (6.67%). Hospital stays ranged mostly from 3-5 days (86.67%).

Conclusion: The study underscores the significant maternal and fetal risks of second-stage cesarean sections, with non-reassuring fetal status and labor progression issues being the primary indications. Uterine angle extension was the most common intraoperative complication, while postpartum hemorrhage and infections were frequent challenges. Fetal outcomes included low APGAR scores, respiratory distress, and NICU admissions.

Keywords: Second Stage Caesarean Section, Maternal and Fetal Outcome.