Abstract

Sandya MR*, Shirley George and Lissy Varghese

Caesarean section (CS) at full dilatation of cervix has many implications for maternal & neonatal morbidity and mortality. The objective of the study was to analyse the indication for second stage CS & its associated fetomaternal outcome. This cohort study was carried out in the Department of Obstetrics & Gynaecology for a period of one year during which we analysed 42 women who underwent second stage CS. Data was obtained by reviewing medical records. During the study period total number of CS performed were 1951 (36.42%), of these 42 (2.15%) was performed at full dilatation of cervix. Majority were primigravidae (92.8%), mean age was 25.38 ± 3.72 years and mean gestational age was 38.8 ± 1.16 wks. Duration of second stage was 2hrs in 26.2%. Significant caput was present in 85.7%. The most common indication for second stage CS was secondary arrest of descent seen in 54.7%. Commonest maternal complications were haematuria 76.1%, atonic PPH 26.1% and extension of uterine incision in 14.3%. Fourteen babies (33.3%) required NICU care. There was no maternal or perinatal mortality in the present study. Involvement of skilled obstetrician in decision making and delivery is crucial to minimise the complications.