Title: A Comparative Study of Maternal and Foetal Outcomes in Patients Undergoing Elective or Emergency Caesarean Section
Authors: P.Renuka, V.Suguna
DOI: https://dx.doi.org/10.18535/jmscr/v4i12.123
Abstract
A comprehensive study of maternal morbidity and mortality with perinatal outcome in patients undergoing elective or emergency caesarean section was carried out on 300 patients undergoing caesarean section, both elective and emergency and their new-borns in the Department of Obstetrics and Gynaecology in Mamata Medical College & Hospital, Khammam. The study was conducted in 150 consecutive patients from elective group & 150 consecutive patients from emergency group, who underwent caesarean section and a detailed history from the term gestation patients, were taken. The observations made were tabulated, analyzed and compared with earlier studies. The emergency C-section rates (62.7%) were more common in the age group of 18-24years than the elective C-section (49.3%).The pregnancy outcomes in booked mothers(84.7%) are far more successful than in unbooked mothers(15.3%). The most common risk factor is Previous LSCS. 42(28%) patients Elective C-section and 21(14%) patients in Emergency C-section had previous LSCS. BMI of 63 patients in Elective C-S was ranging between 24.9-29.9kg/m2 when compared to only 35 patients with similar BMI in Emergency C-S. Overweight patients underwent more Elective C-S when compared to Emergency C-S. There is a reduction of Hb% in both elective and emergency groups after caesarean section. In Elective C-sections, the indications in 47(31.3%), 17(11.3%) and 2(1.3%) cases were Previous LSCS, Previous 2 LSCS & Previous 3 LSCS respectively, accounting for total of 66/150(44%) cases. The 2nd common indication for Elective C-section was CPD, 45/150(30%). In Emergency C-sections, the most common indication was Foetal distress, 56/300(37.3%) and 2nd common indication was Previous LSCS, 36/150(24%) cases. Postpartum Haemorrhage -12(8%) was the most frequent intra-operative complication in Emergency C-S when compared to Elective C-S. Babies weighing 2.5kg or more in the Elective C-S were 119(77.8%), whereas in Emergency C-S were 97 (63.4%) with P value of <0.001**. This indicates better ANC in the Elective Group. Low birth weight babies (<2.5kg) were 22.2% and 36.6% in Elective and Emergency Group respectively (P=<0.001**).The Apgar score of <7 at 1 minute, in Elective C-S were in 25(16.3%) new-borns and Emergency C-S were in 28(18.3%) new-borns. Neonatal complications are more common in Emergency C-section accounting for about 48 (31.4%) new-borns. Sepsis is the most common neonatal complication in Emergency C-section accounting for 21/150(13.7%) new-borns. Hyperbilirubinemia is the most common complication in Elective C-section, accounting for 13/150(8.5%) new-borns.NICU stay of the new-born was in the range of 3-7days in 33(21.6%) new-borns in Emergency C-S and in 17(11.1%) new-borns in Elective C-S.
Keywords-Emergency, Elective, caesarean section, New-born ,morbidity ,mortality.
