October 2014 Vol. 2 No. 10

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Original Research Article

Maternal and neonatal complications associated with caesarean section in the second stage of labour at Omdurman maternity hospital during 2012-2013
 

Umbeli T. MD, FCM, PhD^1*, Salah Ismail MD², Kunna A. MD³, Elmahgoub A. FRCOG⁴, Nasr A. MRCP⁵ and Rabaa Abdalwahab MD⁶
 

¹Consultant Obstetrician and Gynecologist and Community Physician, University (OIU), Sudan, Omdurman Maternity Hospital (OMH),
P.O. Box 149, Omdurman, Sudan.
²MD, Department of OBGYN, OIU.
³MD, Department of OBGYN University of Bahri
⁴FRCOG, Department of OBGYN, OIU.
⁵MRCP, Department of Paediatrics (neonatologist), University of Bahri, OMH
⁶MD, Department of Anesthesia, OIU.

*Corresponding Author's E-mail: umbeli_taha@hotmail.com or Umbeli2010@gmail.com; Tel: 00249 912360153

Accepted October 21, 2014

Abstract

Caesarean section (C/S) in the second stage of labour is associated with many maternal and neonatal complications, inspite of that little has been paid to its rise in obstetrical practice. This is a hospital- based study conducted at Omdurman maternity hospital (OMH) during the period from January 2012- December 2013 to assess maternal and neonatal complications associated with C/S performed in the second stage of labour. Records of all patients delivered by emergency C/S at full dilatation of cervix over two years were reviewed (10988). Women delivered by emergency C/S during second stage of labour included in this study were 470 out of 10988 (4.3%). All had term singleton pregnancy; of them 256 (54.5%) were primigravida. Labour started spontaneously in 428 (91.1%), 300 (63.8%) were augmented by oxytocin and decision for C/S was made by resident registrars for 427 (90.9%). Failure to progress in second stage of labour was the commonest indication for second stage C/S, in 459 women out 470 (97.7%). Unsuccessful instrumental delivery was 56 (11.9%). Intra-operative complications developed for 240 (51.1%), including; extended uterine tear, intra-operative bleeding, bowel, bladder, ureter and baby injuries. Post-operative complications reported in 142 (30.2%), mainly due to puerperal infection, post partum haemorrhage (PPH), paralytic ilius, wound dehiscence and one maternal death. Twenty three (4.9%) had fresh still birth (FSB) and seven (1.5%) perinatal deaths, 138 (29.4%) were admitted to neonatal unit. C/S in the second stage of labour carries a high maternal and neonatal mortality and morbidity, which necessitates involvement of senior obstetrician in decision – making and delivery.

Keywords: Caesarean section, maternal and neonatal complications, second stage of labour, Sudan