Citation Information :
Nag G, Padmalatha V, Rao SR. Maternal and Fetal Outcomes in Emergency versus Elective Cesarean Sections at a Tertiary Healthcare Setting in Southern India: A Prospective Observational Study. J South Asian Feder Obs Gynae 2018; 10 (4S2):413-418.
Introduction: The present study was conducted to evaluate the maternal and fetal outcomes in elective versus emergency cesarean section (CS), performed at a tertiary hospital in southern India.
Materials and methods: The study was a prospective observational study conducted at a tertiary referral center in Bangaluru, India. 500 consecutive CS, over 29 months (January 2011 to June 2013), were studied. The questionnaire-based tool was used to collect data from the patient\'s case sheet, labor record, intra-operative records, and treating clinician. The main outcomes were maternal and early neonatal (< 7 days) severe morbidity.
Results: Total of 3393 deliveries took place during the study period. The CS rate was 16%. The emergency CS was 58.4% of all sections. In the emergency CS group, 89 patients (30.4%) experienced at least one intra-operative difficulty/complication against 54 patients (25.9%) in the elective CS group (p = 0.31). The incidence of any postoperative complication was 30.3% and 24.3%, in the elective and emergency CS group, respectively (p = 0.20). The mean (SD) length of hospital stay was 4.57 (1.8) and 4.7 (1.2) days in the elective and emergency CS group, respectively (p = 0.30). There was no maternal mortality. In the emergency CS group, neonates tended to have significantly lower birth weight, APGAR scores at 1 and 5 minutes, had higher morbidity and required NICU more frequently.
Conclusion: Although maternal morbidity was similar between the emergency and elective CS patients, the fetal outcomes were worse in the emergency CS patients. Whether this is due to fetal distress or complication as an indication for emergency CS or the result of emergency CS is not clear and could be evaluated in future studies.
Betrán AP, Ye J, et al. The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014. PLoS One 2016;11(2):e0148343.
Anderson GM. Making sense of rising caesarean section rates: Time to change our goals BMJ 2004;329:696-697
Conroy K, Koenig AF, et al. Infectious Morbidity After Cesarean Delivery: 10 Strategies to Reduce Risk. Reviews in Obstetrics and Gynecology 2012;5(2):69-77.
Liu S, Liston RM, et al. Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term. CMAJ 2007; 176(4): 455-460.
Amirikia H, Zarewych B, et al. Caesarean section: a 15-year review of changing incidence, indications, and risks. Am J Obstet Gynecol 1981;140(1):81-90.
Saha PK, Gulati R, et al. Second stage caesarean section: evaluation of patwardhan technique. Journal of Clinical and Diagnostic Research JCDR 2014;8(1):93-95.
Bodian CA, Freedman G, et al. The visual analog scale for pain Clinical significance in postoperative patients. Anesthesiology: The Journal of the American Society of Anesthesiologists. 2001 Dec 1;95(6):1356-1361.
Maternal mortality ratio. http://www.who.int/healthinfo/statistics/indmaternalmortality/en/. Accessed on 6th May 2015.
Shabnam A. Caesarean section delivery in India: causes and concerns. https://iussp.org/sites/default/files/event_call_for_papers/Caesarean%20section%20delivery%20in%20India_0.pdf. Accessed on 6th May 2015.
Elvedi-Gasparović V, Klepac-Pulanić T, et al. Maternal and fetal outcome in elective versus emergency caesarean section in a developing country. Coll Antropol 2006;30(1): 113-118.
Suwal A, Shrivastava VR, et al. Maternal and fetal outcome in elective versus emergency cesarean section. JNMA J Nepal Med Assoc 2013 Oct-Dec;52(192):563-566.
Najam R, Sharma R. Maternal and fetal outcomes in elective and emergency caesarean sections at a teaching hospital in North India. A retrospective study. JARMS 2013;5(1):5-9
Daniel S, Viswanathan M, et al. Comparison of fetal outcomes of emergency and elective caesarean sections in a teaching hospital in Kerala. Academic Medical Journal of India 2014;2(1):32-36.
Gurunule A, Warke H. Maternal and foetal outcome in elective versus emergency caesarean sections. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2017;6(4):1222-1228.
Raees M, Yasmeen S, et al. Maternal morbidity associated with Emergency versus elective caesarean section. J Postgrad Med Inst 2012;27(1):55-62.
Al Nuaim L, Soltan MH, et al. Outcome in elective and emergency cesarean sections: A comparative study. Ann Saudi Med 1996;16(6):645-649.