Second-stage vs first-stage caesarean delivery: Comparison of maternal and perinatal outcomes

Aşıcıoğlu, Osman; Güngördük, Kemal; Yıldırım, Gökhan; Bb, Asıcıoglu; Oç, Güngördük; Ark, Cemal; Günay, Taner; Yenigül, Nefise Nazlı

doi:10.3109/01443615.2014.920790

Cited by 36 publications

(35 citation statements)

References 20 publications

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“…Adverse prognostic impact on fetal outcome was noted in the studies conducted by Sucak 7 and Asicioglu et al 8 However this was contradicted by other studies. 3,9,10 The most common fetal complication was meconium stained amniotic fluid, seen in 34.2% cases which is comparable to other studies.…”

Section: Discussioncontrasting

confidence: 42%

Caesarean Section During Second Stage of Labor in a Tertiary Centre

Gurung

Malla

Lama

et al. 2017

J Nepal Health Res Council

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Background:There is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. Within this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlight the feto-maternal outcome of caesarean section in second stage of labour.Methods: This was a retrospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between April 1, 2013 and March 30, 2017 at Patan Academy of Health Sciences. The main outcome measures were second stage caesarean section, indications and its maternal and fetal morbidity.Results: During the study period, there were 40,860 deliveries. A total of 18,011 (44%) babies were born by caesarean section, 10484 emergency and 7527 elective. Out of the emergency caesarean section, 200 (1.9 %) were performed in second stage of labor. In this study, the most common indication was cephalopelvic disproportion. (92.4%) were delivered without a trial of instrumental delivery. In terms of maternal complications, atonic post partum haemorrhage uterine incision extension 18 (12.5%), postoperative fever 27(18.8%), wound infection 7 (4.8%) were observed. In perinatal complications, meconium stained amniotic fluid 49(34.2%), neonatal hyperbilirubinemia 14(9.7%) and increased nursery admission 2(15.3%) and 2(1.3%) perinatal mortality were seen. Conclusions:Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and neonatal morbidity.

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Section: Discussioncontrasting

confidence: 42%

Caesarean Section During Second Stage of Labor in a Tertiary Centre

Gurung

Malla

Lama

et al. 2017

J Nepal Health Res Council

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“…Similar findings were reported by Asicioglu et al and Das S. 14,15 Maternal morbidity as reported by Allen VM, Asicioglu et al, Sucak A, Rabiu KA is greater in group 2 than group 1.…”

Section: Discussionsupporting

confidence: 81%

First versus second stage caesarean section: a comparison of maternal and neonatal outcomes

Sinha¹,

Malik²,

Dixit³

2017

Int J Reprod Contracept Obstet Gynecol

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Background: A retrospective study was done to compare the maternal and neonatal complications of caesarean delivery performed in the second stage compared with the first stage of labor.Methods: This is a one year retrospective study done in a 100-bedded hospital, govt of NCT OF Delhi, New Delhi from 1st November 2015 to 31st October 2016. Total number of deliveries in this one year duration were 1785, including both normal and caesarean deliveries. Total number of patients who underwent caesarean delivery in the first stage of labor were 159, and in 2nd stage of labor were 15 during this time period. These were designated into two groups, group 1 and group 2. These two groups were then compared in terms of maternal demographics, labor characteristics, maternal outcomes and neonatal outcomes. Numerical variables were compared between groups by calculating P-value for each variable. P-value <0.05 was considered statistically significant.Results: Caesarean deliveries performed in the second stage were associated with increased maternal morbidity in terms of blood loss, unintended extensions, blood transfusions, prolonged hospital stay, febrile morbidity. Similarly, Neonatal morbidity was much higher in the patient who underwent LSCS in 2nd stage of labor compared to 1st stage. There was increase in neonatal complications, for e. g. –5 minute Apgar <7, NICU admissions >24 hrs, neonatal septicaemia, (P-value <0.05).Conclusions: In conclusion, present study suggests that women undergoing caesarean section in the second stage of labor have increased maternal and fetal morbidity. Therefore, selection of birthing method should be made very carefully and meticulously to decrease maternal and neonatal morbidity.

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“…In this large retrospective cohort study, conducted in a health system with one of the lowest rates of CD among the countries of the OECD [5] we observed that large fetal size and POP presentation increased the odds of UCD being performed in the second stage of labor, while prematurity and induction of labor led more often to UCD being performed in the first stage of labor. The rates of complications with second-stage UCD observed in our cohort did not differ from those reported in other health systems with high CD rates [7,8,11,13]. Furthermore, in this cohort comprising 7,635 singleton UCDs at all weeks of gestation, we found that only a minority of these UCDs were performed in the second stage, comprising 4% of primiparous laboring women and 0.7% of multiparas.…”

Section: Discussionsupporting

confidence: 43%

“…CD performed in the second stage is a more challenging surgical procedure than in the first stage or before labor [8][9][10]. When performed in the second stage of labor, it is known that CD carries higher risks of maternal and fetal complications, including maternal intraoperative trauma and hemorrhage, prolonged operation time, a neonatal 5-min Apgar score < 3 or < 7, neonatal intensive care unit (NICU) admission, and other intraoperative complications [6][7][8][9][11][12][13][14]. CD performed during the second stage can affect future deliveries; higher rates of spontaneous preterm delivery were found to be associated with pregnancies after a previous second-stage CD [15].…”

Section: Introductionmentioning

confidence: 99%

Unplanned Cesarean Delivery in the Second Stage of Labor Holds Higher Odds of Complications than in the First Stage, while Similar in Primiparas and Multiparas

et al. 2020

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Background: While endeavors to reduce cesarean delivery (CD) rates are given priority worldwide, it is important to evaluate if these efforts place parturients and neonates at risk. CD performed in the second stage of labor carries higher risks of maternal and fetal complications and is a more challenging surgical procedure than that performed in the first stage or before labor. In a population with a low CD rate, we sought to evaluate the rate of maternal and fetal complications associated with unplanned CD (UCD) performed in the second vs. the first stage of labor, in primiparas and multiparas, as well as the risk factors leading to and the complications associated with UCD in the second stage of labor in this low-CD rate setting. Methods: This was a retrospective, electronic medical record-based study of 7,635 term and preterm singletons born via UCD in the period 2003-2015. Maternal and neonatal background and outcome parameters were compared between groups. Logistic regression modeling was applied to adjust for clinically and statistically significant risk factors. Results: UCD was more likely to be performed in the second stage of labor in mothers delivering larger fetuses (head circumference and body weight ≥90 centile) and those with persistent occiput posterior (POP) presentation. UCD in the second stage was strongly associated with serious maternal complications (excessive hemorrhage and fever) compared to UCD performed in the first stage, in both primiparas and multiparas. Conclusions: UCD performed in the second stage of labor, while less frequent than first-stage UCD, is more likely with larger neonates and POP presentation, and is associated with a higher rate of maternal complications in primiparas and multiparas. Complication rates in our low-CD-rate population did not exceed those reported in the literature from high-CD-rate areas.

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Second-stage vs first-stage caesarean delivery: Comparison of maternal and perinatal outcomes

Cited by 36 publications

References 20 publications

Caesarean Section During Second Stage of Labor in a Tertiary Centre

Caesarean Section During Second Stage of Labor in a Tertiary Centre

First versus second stage caesarean section: a comparison of maternal and neonatal outcomes

Unplanned Cesarean Delivery in the Second Stage of Labor Holds Higher Odds of Complications than in the First Stage, while Similar in Primiparas and Multiparas

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