Pregnancy outcome of elective and emergency caesarean section in uncomplicated term pregnancies: an observational comparative study

Abstract

Background: The most performed surgical procedure in obstetrics is cesarean section. Purpose of this study is to establish the maternal and neonatal outcome after emergency and elective cesarean section, and identifying preventable risk factors wherever possible.Methods This is n observational comparative study done at Al Azhar medical college Thodupuzha, Kerala, India on 185 pregnant women who underwent cesarean section and who fulfilled the inclusion criteria in the department of obstetrics and gynecology. After taking consent patients were identified into two groups based on type of cesarean section that is elective or emergency. In elective cesarean section group 79 women were studied whereas emergency cesarean section group 106 women were studied. Maternal parameters like indication of cesarean section, intra operative and post-operative complications were analyzed. Neonatal parameters like respiratory distress syndrome, NICU admissions, APGAR score were analyzed.Results: Most number of cases in elective cesarean section group underwent cesarean section for prior cesarean section for maternal request (89%) and for emergency cesarean section for fetal distress (32%). Intraoperative, post-operative complications and adverse neonatal outcome were more with emergency CS group.Conclusions: Adverse maternal and neonatal outcome was found to be more in emergency cesarean section compared to elective cesarean section. Inducing labor with proper indication, assessment of cephalopelvic disproportion and intrapartum monitoring using partogram are some of the preventable factors identified to reduce adverse outcome.