Comparison of the maternal and neonatal outcomes for the cesarean section performed during 1st and 2nd stage of labor

Abstract

Objective: Comparison of maternal and fetal outcomes and complications in pregnant women who have a cesarean delivery in the 2nd stage of active labor with the 1st stage cesarean deliveries. Material & Methods: In this retrospective study, 50 cases who had term, singleton, uncomplicated pregnancy and gave birth by emergency cesarean section in the second stage of labor were compared cases (n=50) who gave birth in the first stage. Demographic characteristics of the cases, indications for cesarean section, intraoperative and postoperative surgical characteristics and complications (uterine incision lengthening, arterial and/or organ injuries, hemoglobin levels, bleeding, need for blood product transfusion, relaparotomy, operation times, postoperative hospital stay) and newborn outcomes were analyzed. A p value of <0.05 was considered statistically significant. Results: The demographic characteristics of the groups (age, number of pregnancies, body mass index, educational status) were similar (p>0.05). The rates of lengthening of the uterine incision, need for lengthening of the uterine incision, uterine artery and bladder injuries, and uterine atony were significantly higher in cesarean sections performed in the second stage (42% vs. 8%, p<0.001). Postoperative hospital stay was similar (p>0.05). Apgar scores, observation and intensive care unit needs were similar in both groups (p>0.05). No trauma or fracture occurred in newborns in either group. Conclusion: Cesarean deliveries in the second stage of active labor cause a significant increase maternal complication, although not in newborns. Performing cesarean deliveries in the second stage by experienced obstetricians is important for the prevention and management of complications.

Keywords

• second stage cesarean
• maternal
• neonatal
• morbidity

Aktif doğum eyleminin 1. ve 2. evresinde yapılan sezaryenlerde maternal ve neonatal sonuçların karşılaştırılması

Abstract

AMAÇ: Aktif doğum eyleminin 2. evresinde sezaryen ile doğum gerçekleştirilen gebelerde maternal, fetal sonuç ve komplikasyonların 1. evrede yapılan sezaryen doğumlarla karşılaştırılmasıdır. GEREÇ ve YÖNTEM: Retrospektif çalışmamızda gebelik komplikasyonu gelişmemiş, term, tekil gebeliği olan ve doğum eyleminin 2. evresinde acil sezaryen ile doğumu gerçekleştirilen 50 olgu çalışma grubu, 1. evrede sezaryen ile doğumu gerçekleştirilen aynı sayıda olgu (n=50) ise kontrol grubu olarak çalışmaya alındı. Olguların demografik özellikleri, sezaryen endikasyonları, intraoperatif ve postoperatif cerrahi özellikleri ve komplikasyonları (uterin insizyon uzaması, arter ve organ yaralanmaları, hemoglobin düzeyleri, kan ürünleri transfüzyonu ihtiyacı, relaparatomi, ameliyat süreleri, postoperatif hastanede kalış süresi) ile yenidoğan sonuçları incelendi. p<0.05 istatistiksel anlamlı kabul edildi. BULGULAR: Grupların yaş, gebelik sayıları, vücut kütle indeksi, eğitim durumu benzerdi (p>0.05). Uterin insizyonun uzaması, uterin insizyonun uzatılmasının gerekmesi, uterin arter ve mesane yaralanmaları ile atoni gelişimi oranları 2. evrede yapılan sezaryenlerde belirgin daha yüksekti (%42’ye karşı %8, p<0.001). Postoperatif hastanede kalış süreleri her iki grupta benzerdi (p>0.05). Apgar skorları, gözlem ve yoğun bakım ihtiyaçları her iki grupta benzerdi (p>0.05) ve hiçbir yenidoğanda travma ya da kırık meydana gelmedi. SONUÇ: Aktif doğum eyleminin 2. evresinde yapılan sezaryen doğumlar yenidoğanda olmasa da maternal komplikasyonlarda anlamlı artışa neden olur. 2.evrede sezaryen doğumların tecrübeli obstetrisyenler tarafından yapılması komplikasyonların önlenmesi ve yönetilebilmesi konusunda önemlidir.

Keywords

• 2.evrede sezaryen
• maternal
• neonatal
• morbidite

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