Background: Morbidity of caesarean section still persist in terms of pain, infection and adhesion. This study will focus on different morbidities associated with ECS.Methods: A retrospective analysis of 29 ECS were included from June to September 2018, done at Midnapore Medical college, West Bengal, India.Results: Contracted pelvis (12/29, 41.37%) and cephalopelvic disproportion (10/29,34.48%) were common indications for ECS. Mean gestational age was 39.65±1.31 weeks and birth weight were 3.01±0.40 kg. Time taken for ECS was 33.06±10.85 minutes. Extension of uterine incision and mild distension of abdomen occurred in 3.44% each. Post-operative period was uneventful and all discharged after 72 hours of operation.Conclusions: ECS can be performed safely by experienced hands with less feto-maternal morbidity and early discharge of mother and baby.

Background: Post cesarean pregnancies are high risk pregnancy and main concern is uterine scar rupture with increasing maternal and perinatal risks, for vaginal birth after cesarean delivery (VBAC). Objective of this study is to know neonatal and maternal outcome at term who attempt vaginal delivery with previous one cesarean section presenting in active stage of labor.Methods: A total of 277 pregnant women with single live fetus at term, cephalic presentation with previous one cesarean section, underwent a trial of labor and outcome of successful and failed vaginal birth were noted.Results: Trial of labor was successful in 52.3% and failed in 47.7% (p=0.269). VBAC was successful where the previous cesarean section indications were fetal distress (79% versus 21%, p=0.000), pregnancy induced hypertension (77.3% versus 22.7%, p=0.000) and fetal growth restriction (81.8% versus 18.2%, p=0.000), when compared with failed trial of labor who required emergency cesarean section in pre-labor rupture of the membranes (8.3% versus 91.7%, p=0.000) and dystocia (3.3% versus 96.7%, p=0.000). VBAC was successful at gestational age of 37 0/7-38 6/7 weeks (p=0.000). In the failed VBAC women who required emergency cesarean section there was significant early neonatal death (p=0.025). Scar dehiscence and hospital stay with or without complications were more in the failed VBAC group.Conclusions: Early neonatal death and duration of hospital stay were significantly more in the failed VBAC, who were posted for emergency cesarean delivery. Scar dehiscence occurred in the failed VBAC group. Women presenting at 37 0/7 to 38 6/7 weeks of gestation with cephalic presentation in active stage of labor who had previous cesarean section done for fetal distress, pregnancy induced hypertension and fetal growth restriction with inter pregnancy interval of > 24 months can be planned and counselled for VBAC trial of labor.

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Background: Women presents with previous history of cesarean section (CS) is a ‘high risk pregnancy’ and requires regular antenatal check-ups. Planned CS at term done for perinatal interest. Post cesarean pregnancy admitted through emergency required direct CS, for those not fit for vaginal birth as per different guidelines. Main objective of this study is to know neonatal and maternal outcome at term for planned versus emergency CS with previous one CS.Methods: Planned or emergency CS were done in 1003 pregnant women at term with previous one CS and outcome of both neonatal and maternal were noted. Emergency CS done in failed VBAC women were excluded from the study.Results: Planned CS before onset of labor were done in 22.93% and emergency CS in 77.07% in the present study. A significant number of women has undergone planned CS in cephalo-pelvic disproportion (45.21%), contracted pelvis (24.34%) and fetal growth restriction (6.95%) where P=0.000. Scar tenderness (20.18%), fetal distress (16.04%) and cephalo-pelvic disproportion (15.52%) were major indications for emergency CS. Maternal complications in the emergency CS group were pyrexia (P=0.000) and blood transfusion, required in 1.81% (P=0.000). There were two maternal death and hysterectomy required in 0.38% in the emergency CS compared to 1.30% in the planned CS (P=0.274). Neonatal complications were significant(P=0.018) in the emergency CS group. Common complications were jaundice (2.84% versus 1.73%, P=0.489), sepsis (0.25% versus 0.86%, P=0.487) and early neonatal death (2.97% versus 0.86%, P=0.119) in emergency CS compared to planned CS.Conclusions: Neonatal morbidity and mortality were significant in the emergency CS, compared to planned CS. Pyrexia and blood transfusion were significant maternal morbidity in the emergency CS group.