RESUMEN
Background: This study aims to observe the maternal and neonatal outcomes of caesarean delivery performed in the second stage of labor.Methods: This was retrospective observational study conducted at Cheluvamba hospital, Mysore medical college, Mysore, in the department of Obstetrics and Gynaecology. All second stage caesarean sections performed between January 2023 to June 2023 were analyzed in terms of incidence, indications of caesarean-section, intra-operative and postoperative complications, maternal and fetal outcome.Results: During the study period there were total 4194 deliveries. Out of this 1771 deliveries were done by caesarean section. Out of them 48 were 2nd stage caesarean sections contributing to 2.71% of total sections. Patwardhan method was used in 41.6% cases for delivery of deeply engaged head. Intra-operative complications were higher in terms of atonic pph (25%), hematuria (16.66 %). 14% cases had postoperative fever and 41.6% cases need prolonged catheterization. 20.83% babies required NICU admissions and neonatal death was 4.16%.Conclusions: Caesarean section in the 2nd stage of labour is associated with increased maternal and neonatal morbidity. A proper judgement is required by a skilled obstetrician to take a decision for caesarean section at full cervical dilatation.
RESUMEN
Background: Placental abruption is responsible for increased risk of maternal and fetal morbidity and mortality worldwide. Studies specific to placental abruption in pregnancy-induced hypertension (PIH) are still lacking. This study is designed to focus on collecting data on placental abruption and to objectively determine its impact on the outcome of pregnancy complicated with PIH in terms of improving fetal and maternal morbidity and mortality.Methods: This was retrospective observational study conducted at Cheluvamba Hospital, Mysore Medical College and Research Institute (MMCRI), Mysore, in the department of obstetrics and gynaecology. All pregnant women with diagnosis of abruptio placenta over 28 weeks and with PIH between January 2022 to August 2023 were included. Data was collected from medical records department and results were analysed.Results: During the study period there were total of 14027 deliveries. Of this 63 (0.44%) occurred in patients with placental abruption with PIH. Mean age group was 24.57 years; majority were multigravida (58.46%) Majority were preterm (77.77%). 61.90% had pre-eclampsia with severe features. Mean systolic blood pressure (SBP) was 151.90 mmHg, diastolic blood pressure (DBP) was 98.73 mmHg. 65.08% delivered by caesarean section. 47.61% was the perinatal mortality, perinatal asphyxia was 45.71%, prematurity was 65.71%, low birth weight was 84.12%. 71.42% was the neonatal intensive care unit (NICU) admission rate. Maternal complications seen was postpartum haemorrhage (PPH) (31.74%), requiring blood and blood products transfusion (63.49%), coagulopathy (14.28%), shock (12.69%). 4 women developed severe features of pre-eclampsia in postpartum period, 2 of them needed MgSO4. 58.73% had requirement of antihypertensives in postpartum period.Conclusions: Abruption is one of the obstetric emergencies. In our study severe adverse maternal and perinatal outcomes were more pronounced in pre-eclampsia with severe features and it needs an individual and intense surveillance and management to have better maternal and perinatal outcome.