Maternal and Neonatal Outcomes in Elective versus Emergency Cesarean Section: A Comparative Study

Abstract

Aim: The aim of this study was to compare the Maternal and Neonatal Outcomes in Elective versus Emergency Cesarean Section

Material and Methods: The current prospective comparative study was carried out at the department of Gynaecology Department, Khalifa Gulnawaz Teaching Hospital Bannu from January 2023 to June 2023 following permission from the ethical committee of the hospital.  Pregnant women who had one previous cesarean delivery, gestational age ≥37 weeks, delivery by repeat cesarean section and with singleton pregnancy were included in this stud. The study participants were divided in to group A (Emergency caesarean section) and group B (elective caesarean section). Both groups of participants had had one previous cesarean. Group A included women who selected trial of labor after cesarean (TOLAC) who needed an emergency cesarean section owing to fetal distress or labor progression issues. The study excluded individuals who delivered normally. Group B included women who selected elective repeat cesarean section after a previous cesarean delivery. They did not engage in any labor. The study evaluated maternal and newborn outcomes both during and after surgery. Possible outcomes included, postpartum hemorrhage (PPH),  uterine rips, extended hospital stay, blood transfusions, thrombosis, bladder damage and  wound infection  Neonatal outcomes included  NICU admissions ,  poor Apgar score ,respiratory distress, perinatal mortality and  aspiration of liquor. Both variables were changed to categorical and coded as yes/no.  SPSS verion 16 was used for data analysis.

Results: A total of 150 individuals were evaluated in this study which were equally divided in to group A and B.  Both groups contained 75 participants .Group A underwent emergency and group B underwent elective caesarean section. Prolonged hospital stay was the most common maternal complication in emergency group 18 (24.0%) as compared to elective group 7 (9.3%). Similarly postpartum hemorrhage, wound infection, uterine tears were high in emergency group. Blood transfusions were needed in 14 (18.7%) emergency patients vs. just 4 (5.3%) elective patients. One maternal fatality was observed in the emergency group, but none in the elective group. In the emergency group, the most common undesirable neonatal outcome was a low Apgar score, NICU hospitalization, respiratory distress, perinatal death was most common as compared to elective patients.

Conclusion: Our study concluded that maternal and neonatal adverse outcomes were more common in emergency cesarean section as compared to elective cesarean Section.

Keywords: maternal and neonatal adverse outcomes, elective cesarean Section, emergency cesarean section