Comparison of short-term maternal and neonatal outcomes between elective and emergent Cesarean section: A single center experience

Abstract

Introduction/Aim: Increased rates of Cesarean section (CS) and subsequent short-term and long-term maternal complications (MC) and neonatal complications (NC) have been reported. The aim of this study was to compare short-term MC and NC between elective and emergent CS. Material and Methods: Data from medical records of pregnant women who had undergone CS at Gynecology and Obstetrics Clinic "Narodni front" were retrospectively collected. The inclusion criteria were as follows: low-risk, term monofetal pregnancies with obstetrical CS-indications and other non-life-threatening maternal conditions (ophthalmological, orthopedic, psychiatric, lower genital-tract infections). Short-term MC were the following: surgical complications, inflammatory syndrome, the need for blood transfusion, and hospital stay ≥5 days. NC were as follows: respiratory morbidity, asphyxia, sepsis, injuries/lacerations, admission to neonatal intensive-care-unit, hospital stay >4 days. Results: We included 1056 singleton pregnancies. Mean age was 32.63±5.38 years, mainly primipara 566 (53.6%). Of all CS, 774 (73%) were performed emergently. Cephalopelvic disproportion/fetal macrosomia and other CS indications carried a significantly high risk for emergent CS (OR=3.943, 95%CI 2.036-6.591; OR=7.560, 95%CI 3.994-8.327, respectively). Regardless of the urgency of CS there were no significant differences in the frequency of MC. Neonatal sepsis was significantly higher after emergent CS (p=0.027), with a two-times greater risk for its development (OR=2.070, 95% CI 1.072-3.997). There were no fatal maternal/neonatal outcomes and no need for additional care. Conclusion: There were no notable disparities in MC and NC among the individuals who had undergone emergent and elective CS. Neonates born by means of emergent CS had a higher risk of developing neonatal sepsis. Indications for CS had a greater impact on short-term maternal and fetal outcomes than the type of CS.