Maternal and fetal outcomes in emergency versus elective cesarean sections at a tertiary healthcare setting in southern india: A prospective observational study

Abstract

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.