Elective versus emergency caesarean section: differences in maternal outcome

Authors

  • Anshu Sharma Department of Obstetrics and Gynecology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
  • Rajiv Acharya Department of Obstetrics and Gynecology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
  • Yashika Pehal Department of Obstetrics and Gynecology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
  • Bhawna Sharma Department of Obstetrics and Gynecology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20193536

Keywords:

Cross match transfusion ratio, Elective caesarean section, Fetal distress, Maternal morbidity, Previous caesarean section, Transfusion ratio

Abstract

Background: Caesarean section is a life-saving surgical procedure when certain complications arise during pregnancy or labour. The use of CS worldwide has increased worldwide unprecedented levels although the gap between higher- and lower-resource settings remains. The present study evaluates the difference in maternal outcome in elective versus emergency caesarean sections in our institute.

Methods: The study included first 65 cases of emergency caesarean section (group A) and during the study period, first 65 elective caesarean section (group B) if they fulfilled the inclusion criteria. Various intra operative and postoperative events were recorded which included intra operative complications, postpartum haemorrhage and transfusion indices.

Results: The most common indication of caesarean section in group A was fetal distress (27.7%). In group B most caesarean sections were classified under 5 followed by class 6, the most common indication being previous caesarean section (27.6%). It was observed that pre-operative mean haemoglobin in group A was 10.6 g/dl and in group B was 11.2g/dl. A drop of 1.36 g/dl in group A and 1.10 g/dl in group B was observed in the post-op period. Cross match / transfusion ratio 1.5 in group A and  2 in group B, transfusion probability ratio was 60 % in group A and  66.7%  in group B and transfusion index was 1 in group A and  group B. There was significantly higher contraception acceptance in group B compared to group A.

Conclusions: Elective caesarean section has more favourable maternal outcome as compared to emergency caesarean section as the former is done under controlled and planned circumstances.  However, there should be stringent audit to scrutinise indication of caesarean section, outcome of caesarean and blood transfusion practices.

References

Khawaja NP, Yousaf T, Tayyeb R. Analysis of caesarean delivery at a tertiary hospital in 17. Phipps MG, Watabe B, Clemons JL, Weitzen Pakistan. J Obstet Gynaecol. 2004;24:139-41.

Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal S, Willan AR. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial: Term Breech Trial Collaborative Group. Lancet. 2000;356(9239):1375-83.

Bergholt T, Stenderup JK, Vedsted-Jakobsen A, Helm P, Lenstrup C. Intraoperative surgical complication during cesarean section: an observational study of the incidence and risk factors. Acta Obstet Gynecol Scand. 2003;82(3):251-6.

Betran AP, Ye J, Moller A-B, Zhang J, Gülmezoglu AM, Torloni MR. The increasing trend in caesarean section rates. Global Regional National Estimates. 1990-2014.PLoSONE11(2):e0148343.

Benzouina S, Boubkraoui Mel-M, Mrabet M. Fetal outcome in emergency versus elective cesarean sections at Souissi Maternity Hospital, Rabat, Morocco. Pan Afr Med J. 2016;23:197.

Ali M, Hafeez R, Ahmad M. Maternal and fetal outcome; comparison between emergency caesarean section versus elective caesarean section. Prof Med J. 2005;12(1):32-9.

Najam R, Sharma R. Maternal and fetal outcomes in elective and emergency caesarean sections at a teaching hospital in North India: a retrospective study. JARBS. 2013;5(1):5-9.

Singh B, Adhikari N, Ghimire S, Dhital S. Post-operative drop in hemoglobin and need of blood transfusion in cesarean section at Dhulikhel Hospital, Kathmandu University Hospital. Kathmandu Univ Med J (KUMJ). 2013;11(42):144-6.

Suwal A, Shrivastava VR, Giri A. Maternal and fetal outcome in elective vs emergency caesarean section. J Nepal Med Assoc. 2013;52(192):563-6.

Sripunlom N, Ratchanon S, Ouitrakul S. Appropriateness of routine crossmatch in elective caesarean section for low risk postpartum hemorrhage pregnancies. Clinics Mother Child Health. 2018;15:283.

Khan FA, Khan M, Ali A, Chohan U. Estimation of blood loss during Caesarean section: an audit. J Pak Med Assoc. 2006;56(12):572-5.

Downloads

Published

2019-07-26

Issue

Section

Original Research Articles