MATERNAL MORBIDITY ASSOCIATED WITH CAESAREAN SECTION IN SECOND STAGE OF LABOR
Keywords:
Caesarean section, Maternal morbidity, Postpartum haemmorage, Venous thromboembolism, Haematuria, Paralytic IleusAbstract
Objective: To determine the maternal morbidity associated with caesarean section done in second stage of labor.
Material and Methods: This prospective cross sectional study was done at Gynae Department of Khyber Teaching Hospital, Peshawar, Pakistan from January 2015 to December 2016. All pregnant women of any age or parity with singleton
pregnancy,who delivered by caesarean section in their second stage of labor were included. Any intraoperative or postoperative complication was taken into account by following them till discharge and for two weeks after discharge.
Results: Total caesarean sections performed at full cervical dilatation were 130,out of these,114(87.69%) subjects were primigravidae and 16(12.3%) were multigravidae. Seven (5.38%)patients were <20years, 56 (43%) were in 21-30 years age range,52(40%) were 31-40 years and 15(11.53%) were more than 40 years age. Average age was 29.53 ±6.3SD. Sixty one(47%) caesareans were done for deep transverse arrest,39(30%) for cephalopelvic disproportion and 30(23%) for nonreassuring fetal status. All the patients were followed for intraoperative complications i.e.,uterine incision extension(14.6%), postpartum haemmorhage (11.54%), blood transfusions (10.76%), gut injury (1.53%) and postoperative complications i.e., prolong catheterization (91.5%), fever (32%), prolong hospital stay (31.5%), paralytic ileus (22%), haematuria (21.5%), wound sepsis (13%).
Conclusion: Considerable maternal morbidity is associated with second stage caesarean section. Adequate supervised training opportunities and consultant input is necessary for these challenging surgeries.
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