COMPARISON OF MATERNAL AND FETAL OUTCOMES IN EMERGENCY AND ELECTIVE CESAREAN SECTIONS: A RETROSPECTIVE STUDY

Abstract

OBJECTIVE: Emergency cesarean section is a high-risk operation which is associated with morbidity and even mortality. This study has been designed to compare elective and emergency cesarean deliveries in aspect of maternal and neonatal outcomes. MATERIAL AND METHODS: This is a retrospective cross-sectional review of 1337 women who had a live birth by cesarean section at term during a six-month-long period. Two groups were determined: emergency and elective. Women were compared in terms of age, parity, cesarean indications, cesarean complications, and blood transfusion needs. Newborns were compared in terms of APGAR score at first and fifth minute, birth weights, and neonatal intensive care needs. RESULTS: There were 297 emergency (22.2%) and 1040 planned (77.8%) cesarean sections over the study period. The women who delivered by emergency cesarean section had significantly younger ages and lower gravidity and parity (p=0.001, p=0.023 and p=0.001, respectively). Fetal distress and umbilical cord prolapsus were significantly more frequent, while previous cesarean section and cephalopelvic disproportion were significantly less frequent in women who delivered by emergency cesarean delivery (p=0.001 for all). The need for transfusion, bladder injury, and wound infection was significantly higher in women who underwent emergency cesarean delivery (p=0.001, p=0.001 and p=0.014 respectively). The neonates delivered by emergency cesarean section had significantly lower birth weight and APGAR score at the first minute but a significantly higher need for an intensive care unit (p=0.002, p=0.009 and p=0.001, respectively). CONCLUSIONS: Emergency cesareans increase maternal and neonatal complications. That is why , elective cesarean section should be performed as early as possible to avoid the onset of spontaneous labor which would require emergency cesarean delivery.

Keywords

• Cesarean Section
• Emergency
• Elective
• Fetal
• Maternal.

Ethical Statement

This study was approved by the Umraniye Training and Research Hospital Ethics Committee with decision number 114 dated 28.09.2017.

ACİL VE ELEKTİF SEZARYEN AMELİYATLARINDA MATERNAL VE NEONATAL SONUÇLARIN KARŞILAŞTIRILMASI: RETROSPEKTİF BİR ÇALIŞMA

Abstract

AMAÇ: Acil sezaryen, morbidite ve hatta mortalite ile ilişkili, yüksek riskli bir ameliyattır. Bu çalışma, elektif ve acil sezaryen doğumlarını anne ve yenidoğan sonuçları açısından karşılaştırmak amacıyla tasarlandı. GEREÇ VE YÖNTEM: Bu, altı aylık bir süre boyunca miadında sezaryen ile canlı doğum yapan 1337 kadının kesitsel retrospektif bir incelemesidir. Acil ve elektif olarak iki gruba ayrıldı. Kadınların yaş, parite, sezaryen endikasyonları, sezaryen komplikasyonları ve kan transfüzyon ihtiyaçları karşılaştırıldı. Yenidoğanlar ise birinci ve beşinci dakika APGAR skorları, doğum ağırlıkları ve yenidoğan yoğum bakım ihtiyacı açısından karşılaştırıldı. BULGULAR: Çalışma süresi boyunca 297 acil (%22,2) ve 1040 planlı (%77,8) sezaryenle doğum gerçekleşti. Acil sezaryen ile doğum yapan kadınların yaşı, gravidası ve paritesi anlamlı olarak daha azdı (sırasıyla p=0,001, p=0,023 ve p=0,001). Acil sezaryenle doğum yapan kadınlarda fetal distres ve kordon sarkması anlamlı olarak daha sık görülürken, daha önce sezaryen geçirmiş olma ve baş-pelvis uyumsuzluğu anlamlı olarak daha azdı (tümü için p=0,001). Acil sezaryen yapılan kadınlarda transfüzyon ihtiyacı, mesane yaralanması ve yara yeri enfeksiyonu anlamlı olarak daha yüksekti (sırasıyla p=0,001, p=0,001 ve p=0,014). Acil sezaryenle doğurtulan yenidoğanların doğum ağırlığı ve birinci dakika APGAR skoru anlamlı derecede düşük, yoğun bakım ihtiyacı ise anlamlı derecede yüksekti (sırasıyla p=0,002, p=0,009 ve p=0,001). SONUÇ: Acil sezaryenler maternal ve yenidoğan komplikasyonlarını arttırmaktadır. Bu nedenle acil sezaryen gerektirecek durumlar mümkün olduğunca öngörülmeli ve spontan doğum eylemi başlamadan mümkün olduğunca erken yapılmalıdır.

Keywords

• Sezaryen
• Acil
• Elektif
• Fetal
• Maternal

Ethical Statement

Etik kurul onayı, Ümraniye Eğitim Araştırma Hastanesi'nde 28 Eylül 2017 tarihinde 114 numaralı olarak onaylanmıştır.

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