Journal of South Asian Federation of Obstetrics and Gynaecology

Register      Login

VOLUME 14 , ISSUE 1 ( January-February, 2022 ) > List of Articles

RESEARCH ARTICLE

Retrospective Analysis of Second Stage of Cesarean Section and Pregnancy Outcomes: An Observational Study

Prachi Dahiya, Shubhra Agarwal, Rehana Najam

Keywords : Cesarean section, Labor, Second stage

Citation Information : Dahiya P, Agarwal S, Najam R. Retrospective Analysis of Second Stage of Cesarean Section and Pregnancy Outcomes: An Observational Study. J South Asian Feder Obs Gynae 2022; 14 (1):54-58.

DOI: 10.5005/jp-journals-10006-1991

License: CC BY-NC 4.0

Published Online: 05-04-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Background: A cesarean section (CS) at second stage occurs when mother requires delivery at full dilatation of cervix, which poses a risk to mother and the fetus. In the present obstetric practice, one of the huge challenges is to make a firm decision regarding CS during the second stage of labor periods. The present study was done for the retrospective analysis in regard to second stage in terms to the CS along with its association with the pregnancy outcomes. Materials and methods: It was an observational and retrospective study that depended on some clinical records related to more than 37 weeks’ gestation. The neonatal as well as maternal outcomes have been evaluated for CS among those who were observing the second stage in their labor period. Dichotomous variables were compared to that of the χ2 test, and the Mann–Whitney U test was applied to analyze differences in continuous variables. Results: The most common indications for the cesarean category was arrest in the second stage of their labor (56.1%), and the most common technique of delivery of engaged head was modified Patwardhan method (28.3%). The most common intraoperative complications reported was extension of uterine incision (16.0%), and postoperative complications were febrile illness (14.1%). The neonatal complications that required NICU admission were birth asphyxia (16%), meconium aspiration (14.1%), neonatal jaundice (4.7%), respiratory distress syndrome (11.3%), and fresh stillbirth (5.6%). Conclusion: CS's that have been performed during the second stage of the labor period reflect to be a very undesirable phenomenon which is linked to the maternal as well as fetal complications.


PDF Share
  1. Lawani LO, Anozie OB, Ezeonu PO, et al. Comparison of outcomes between operative vaginal deliveries and spontaneous vaginal deliveries in Southeast Nigeria. Int J Gynecol Obstet 2014;125(3): 206–209. DOI: 10.1016/j.ijgo.2013.11.018.
  2. Opoku B. A review of vacuum deliveries at komfo anokye teaching hospital, Kumasi. Ghana Med J 2006;40(1):14–17. PMID: 17299558.
  3. Vousden N, Cargill Z, Briley A, et al. Caesarean section at full dilatation: incidence, impact and current management. Obstet Gynaecol 2014;16(3):199–205. DOI: 10.1111/tog.12112.
  4. Unterscheider J, McMenamin M, Cullinane F. Rising rates of caesarean deliveries at full cervical dilatation: a concerning trend. Eur J Obstet Gynecol Repro Biol 2011;157(2):141–144. DOI: 10.1016/j.ejogrb.2011.03.008.
  5. Khaniya B. Fetomaternal outcome in second stage caesarean section. NMJ 2020;3(1):279–281. DOI: 10.3126/nmj.v3i1.28923.
  6. Govender V, Panday M, Moodley J. Second stage caesarean section at a tertiary hospital in South Africa. J Maternal-Fetal Neonatal Med 2010;23(10):1151–1155. DOI: 10.3109/14767051003678002.
  7. Sung JF, Daniels KI, Brodzinsky L, et al. Cesarean delivery outcomes after a prolonged second stage of labor. Am J Obstet Gynecol 2007;197(3):306.e1. DOI: 10.1016/j.ajog.2007.07.005.
  8. Alexander JM, Leveno KJ, Rouse DJ, et al. National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units Network (MFMU). Comparison of maternal and infant outcomes from primary cesarean delivery during the second compared with first stage of labor. Obstet Gynecol 2007;109(4):917–921. DOI: 10.1097/01.AOG.0000257121.56126.fe.
  9. Selo-Ojeme D, Sathiyathasan S, Fayyaz M. Caesarean delivery at full cervical dilatation versus caesarean delivery in the first stage of labour: comparison of maternal and perinatal morbidity. Arch Gynecol Obstet 2008;278(3):245–249. DOI: 10.1007/s00404-007-0548-5.
  10. Murphy DJ, Liebling RE, Verity L, et al. Early maternal and neonatal morbidity associated with operative delivery in second stage of labour: a cohort study. Lancet 2001;358(9289):1203–1207. DOI: 10.1016/S0140-6736(01)06341-3.
  11. Davis G, Fleming T, Ford K, et al. Caesarean section at full cervical dilatation. Aust NZ J Obstet Gynaecol 2015;55(6):565–571. DOI: 10.1111/ajo.12374.
  12. Kant A, Mendiratta S. Classification of cesarean section through Robson criteria: an emerging concept to audit the increasing cesarean section rate. Int J Reprod Contracept Obstet Gynecol 2018;7(11): 4674–4677. DOI: 10.18203/2320-1770.ijrcog20184528.
  13. Wilson-Leedy JG, DiSilvestro AJ, Repke JT, et al. Reduction in the cesarean delivery rate after obstetric care consensus guideline implementation. Obstet Gynecol 2016;128(1):145–152. DOI: 10.1097/AOG.0000000000001488.
  14. Zipori Y, Grunwald O, Ginsberg Y, et al. The impact of extending the second stage of labor to prevent primary cesarean delivery on maternal and neonatal outcomes. Am J Obstet Gynecol 2019;220(2):191.e1–191.e7. DOI: 10.1016/j.ajog.2018.10.028.
  15. Rosenbloom JI, Stout MJ, Tuuli MG, et al. New labor management guidelines and changes in cesarean delivery patterns. Am J Obstet Gynecol 2017;217(6):689.e1–689.e8.
  16. Goswami KD, Parmar MM, Kunjadiya AN. Study of fetomaternal outcome in second stage caesarean section. Int J Reprod Contracept Obstet Gynecol 2019;8(6):2169–2171. DOI: 10.18203/2320-1770.ijrcog20192129.
  17. Belay T, Yusuf L, Negash S. A comparative study on first stage versus second stage caesarean section on maternal and perinatal outcome. Ethiop Med J 2014;52(1):1–8. PMID: 25069208.
  18. Allen VM, O'Connell CM, Baskett TF. Maternal and perinatal morbidity of caesarean delivery at full cervical dilatation compared with caesarean delivery in the first stage of labour. BJOG 2005;112(7): 986–990. DOI: 10.1111/j.1471-0528.2005.00615.x.
  19. Babre VM, Bendre KR, Niyogi G. Review of caesarean sections at full dilatation. Int J Reprod Contracept Obstet Gynecol 2017;6(6): 2491–2493. DOI: 10.18203/2320-1770.ijrcog20172337.
  20. Vitner D, Bleicher I, Levy E, et al. Differences in outcomes between cesarean section in the second versus the first stages of labor. J Matern Fetal Neonatal Med 2019;32(15):2539–2542. DOI: 10.1080/14767058.2018.1440545.
  21. Pergialiotis V, Vlachos DG, Rodolakis A, et al. First versus second stage C/S maternal and neonatal morbidity: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2014;175:15–24. DOI: 10.1016/j.ejogrb.2013.12.033.
  22. Mukhopadhyay P, Naskar T, Dalui R, et al. Evaluation of Patwardhan's technic–a four year study in a rural teaching hospital. J Obstet Gynecol India 2005;55:244–246.
  23. Lipschuetz M, Guedalia J, Cohen SM, et al. 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. Fetal Diagn Ther 2020;47(7):565–571. DOI: 10.1159/000504573.
  24. Saunders N, Paterson CM, Wadworth J. Neonatal and maternal morbidity in relation to the length of the second stage of labour. BJOG 1992;99(5):381–385. DOI: 10.1111/j.1471-0528.1992.tb13753.x.
  25. Cheng YW, Hopkins LM, Caughey AB. How long is too long: does a prolonged second stage of labor in nulliparous women affect maternal and neonatal outcomes? Am J Obstet Gynecol 2004;191(3):933–938. DOI: 10.1016/j.ajog.2004.05.044.
  26. Janni W, Schiessl B, Peschers U, et al. The prognostic impact of a prolonged second stage of labor on maternal and fetal outcome. Acta Obstet Gynecol Scand 2002;81(3):214–221. DOI: 10.1034/j.1600-0412.2002.810305.x.
  27. Cebekulu L, Buchmann EJ. Complications associated with caesarean section in second stage of labor. Int J Obstet Gynecol 2006;95(2): 110–114. DOI: 10.1016/j.ijgo.2006.06.026.
  28. Jayaram J, Mahendra G, Vijayalakshmi S. Fetomaternal outcome in cesarean sections done in second stage of labor. International Journal of Gynecology and Obstetrics 2016;3(1):51–54.
  29. Umbeli T, Ismail S, Kunna A, et al. Maternal and neonatal complications associated with cesarean section in the second stage of labour. Merit Res J Med Medical Sci 2014;2(10);225–228.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.