CAESAREAN DELIVERY DURING SECOND STAGE OF LABOR- A STUDY OF FETOMATERNAL OUTCOME IN A TERTIARY CARE HOSPITAL

Background: There is an alarming rise in Caesarean section (CS) leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery despite the efforts to limit operative abdominal deliveries. Within this increasing CS rate, there is a concerning increase in the rate of second stage cesarean section. Cesarean sections performed at full dilatation (FDCS) are becoming increasingly common in obstetric practice Aim: To analyze the indications and assess feto-maternal outcomes in caesarian section in second stage of labor. Material And Methods: This was a retrospective hospital based observational study assessed all caesarean sections performed at full cervical dilatation between September 2020 and September 2021 at King George hospital, Visakhapatnam, Andhra Pradesh. Caesarean section cases were identified through the operating theatre data log. The medical record, specifically the record of labor and operation reports, was reviewed for all CS cases over the study period. Results: During the index period, a total of 3800 women delivered by caesarean section, (2900 emergency and 900 elective cases) .A total of 340 women were at full cervical dilatation, >37 weeks gestation with a singleton fetus in cephalic presentation were studied. Mean duration of surgery was 57.68 min. Secondary arrest of descent was seen in 53.8% of cases and NICU admission in 6.76%,APGAR <7 at birth in 9.11% cases. Conclusion: Although second stage of labor was sometimes appropriate, there are no specific guidelines for safe practice. It is a technically demanding procedure. It has additional associated risks for mother and fetus due to the nature of emergency situation.