MATERNAL AND FETAL OUTCOME

COMPARISON BETWEEN EMERGENCY CAESAREAN SECTION VERSUS ELECTIVE CAESAREAN SECTION

Abstract

Objective: To find the maternal and fetal morbidity and mortality in elective versus emergency
caesarean section. Design: Prospective Setting: Obstetrics and Gynaecology Unit-III, Nishtar Hospital, Multan.
Period: One year. Material and methods: 150 patients who underwent caesarean section were evaluated for maternal
and fetal complications. Results: Overall intra-operative complications rate was 8.67%. 12 out of 13 complications
occurred in emergency group. Postoperative complication was 34.66% and out of it emergency versus elective were
90.38% vs 9.62% respectively. Similarly maternal mortality was 666/100,000 in emergency group. Fetal complications
were also higher in emergency group in this study i.e. 22.2% vs 10.86% in emergency vs elective group. Similarly
prenatal morbidity was 15.04% in emergency group vs 8.10% in elective group. Fetal outcome was 100% in elective
vs 94.69% in emergency caesarean section group. In one year period of study caesarean birth rate turned out as
17.56% which is quite comparable to the rate in western countries but the rate does not reflect true caesarean birth
in a given population because of the fact that this hospital being a tertiary referral center drains only complicated cases
of the wide spread area of south Punjab. Higher incidence of caesarean birth can be reduced without increasing the
morbidity and mortality. Furthermore, proper sterilization and prophylactic antibodies can reduce the infectious morbidity
after both emergency and elective caesarean section. Conclusions: Higher incidence of emergency caesarean section
is a major contribution for increased rate of maternal and fetal morbidity and mortality in caesarean deliveries. This can
be reduced by improving the quality and availability of antenatal care of masses. We can also reduce the incidence
of caesarean birth without increasing perinatal morbidity and mortality.