ABSTRACT
Background: Incidence of caesarean section is rapidly rising over the last two decades and 25% is contributed by second stage caesarean section. Demographic factors influencing fetomaternal outcome in second stage caesarean section include BMI, socioeconomic status, booking/ unbooking status, gravidity and maternal height.Methods: The present study was prospective observational study conducted in the department of obstetrics and gynaecology at Lady Hardanger Medical College New Delhi from December 2015 to March 2017. 80 women were enrolled in the study. A detailed history and examination of each patient was carried out. Women were observed during lab our till second stage caesarean section.Results: Mean age of population was 25.26±3.75 ranging from 19-40 year. 76.25% included in study were booked and 11.25% were unbooked, 42.5% belonged to lower middle class and 31.25% belonged to upper middle class. 47% women had height of <150 cm and 70% had a BMI between (25-29.9) kg/m. 43% women had gestational age between 39-40 weeks.Conclusions: Second stage caesarean section was more common in young age group and primigravidae. Higher BMI was not only operative but obstetrical risk as well.
ABSTRACT
Background: Incidence of caesarean section is rapidly rising over last two decades and one fourth is contributed by caesarean section in second stage. The objective of this study was to study of fetomaternal outcome in second stage caesarean section.Methods: Prospective observational study was done in 80 women undergoing second stage caesarean section from December 2015 to March 2017 at Lady Hardinge Medical Collage Delhi. These women observed from labour to caesarean section in second stage of labour till post-operative period for any complication. Intraoperative and postoperative complications were observed in these women.Results: Caesarean section rate was 22% in which 3.9% were done in second stage of labour. Most common gestational age being 39-40 weeks (47%). Most common indication being deep transverse arrest (41.25%). Intraoperative complication as bladder injury (5%), extension of uterine incision (23%), PPH (33%) and need for blood transfusion (31%) and post-operative complication as wound sepsis in 58% and 20% requiring resuturing, post-operative fever, prolong hospital stay, prolonged catheterization etc. neonatal complications as severe birth asphyxia (2.5%), respiratory distress (55%), need for mechanical ventilation.Conclusions: Thus, caesarean section done in second stage of labour is associated with increased maternal and neonatal morbidity.
ABSTRACT
A rare case of sirenomelia in a LBW, IUGR & second of a dizygotic twin having multiple congenital anomalies is being reported. Apart from the features of sirenomelia, the newborn had a single umbilical artery, radial hypoplasia, total anorectal & urogenital agenesis and undetermined sex. The single umbilical artery had a normal origin from the iliac artery. There was no Vitelline arterial steal phenomenon. Theories put forward regarding etiopathogenesis are discussed. We conclude that the anomalies in the present case are difficult to be explained with earlier proposed theories. This puts an emphasis on reconsideration of old theory of genetic injury to the embryo by unknown factors.