Fetal outcome in emergency versus elective cesarean sections at Souissi Maternity Hospital, Rabat, Morocco

Abstract

IntroductionPerinatal mortality rates have come down in cesarean sections, but fetal morbidity is still high in comparison to vaginal delivery and the complications are more commonly seen in emergency than in elective cesarean sections. The objective of the study was to compare the fetal outcome and the indications in elective versus emergency cesarean section performed in a tertiary maternity hospital.MethodsThis comparative cross-sectional prospective study of all the cases undergoing elective and emergency cesarean section for any indication at Souissi maternity hospital of Rabat, Morocco, was carried from January 1, to February 28, 2014. Data were analyzed with emphasis on fetal outcome and cesarean sections indications. Mothers who had definite antenatal complications that would adversely affect fetal outcome were excluded from the study.ResultsThere was 588 (17.83%) cesarean sections among 3297 births of which emergency cesarean section accounted for 446 (75.85%) and elective cesarean section for 142 cases (24.15%). Of the various factors analyzed in relation to the two types of cesarean sections, statistically significant associations were found between emergency cesarean section and younger mothers (P < 0.001), maternal illiteracy (P = 0.049), primiparity (P = 0.005), insufficient prenatal care (P < 0.001), referral from other institution for pregnancy complications or delivery (P < 0.001), cesarean section performed under general anesthesia (P < 0.001), lower birth weight (P < 0.016), neonatal morbidity and early mortality (P < 0.001), and admission in neonatal intensive care unit (P = 0.024). The commonest indication of emergency cesarean section was fetal distress (30.49%), while the most frequent indication in elective cesarean section was previous cesarean delivery (47.18%).ConclusionThe overall fetal complications rate was higher in emergency cesarean section than in elective cesarean section. Early recognition and referral of mothers who are likely to undergo cesarean section may reduce the incidence of emergency cesarean sections and thus decrease fetal complications.

Elective versus emergency caesarean section: differences in maternal outcome

“…Similarly, in the study conducted by Benzouina S et al the most frequent indications of elective caesarean section were previous caesarean section delivery and fetal macrosomia and the most frequent indications for emergency caesarean section were fetal distress and previous caesarean section in labour. 5…”

An investigation of the effect of placental growth factor on intrapartum fetal compromise prediction in terminduced high risk pregnancies

“…There also are papers where the fetal cerebroplacental ratio (CPR) has been used to identify IFC in this patient group [24][25][26][27]. The purpose of all of these studies, similar to the current study, was to predict pregnant women who will develop IFC, and thereby reduce the rates of emergency caesarean section (CS), as there is a significant increase in maternal and neonatal complications following emergency CS compared to elective CS [28,29]. In the current study, the sensitivity of the test in identifying IFC+ cases in this patient group according to the PIGF 32 pg/ml cut-off point value was 74.4%.…”

Materno-fetal and neonatal outcomes associated with caesarean section delivery in private and public hospitals in low- and middle-income countries: a systematic review

“…We argue that the comparatively high adverse outcome associated with CSD in SSA is associated with vigorous policies, including, for instance, general practitioners, non-MD training [74] or free or the levying of a nominal fee by governments for CSDs [75,76]. Unfortunately, some countries like Morocco, rapidly lead to an alarming peak rate [77] Hopeful Results in the Reduction of the CSD Trend: Lessons from China China, in particular, is paving the way to address the CSD epidemic. Very recent initiatives have shown CSD rates decline, particularly in supercities, by as much as 30% between 2008 and 2014 [79].…”