MATERNAL MORBIDITY IN EMERGENCY VERSUS ELECTIVE CAESAREAN SECTION AT TERTIARY CARE HOSPITAL
Abstract
Background: In the past 30 years the rate of caesarean section (C/S) has steadily increased from 5% tomore than 20% for many avoidable and unavoidable indications. The objective of this study was to
compare maternal morbidity and determine its cause in elective and emergency caesarean section.
Method: It was a cross-sectional comparative study conducted in Civil Hospital Karachi at Obs/Gyn
Unit III. All mothers admitted through OPD or emergency during the study period, of any age or parity
undergoing C/S were recruited in the study. Patients having previous myomectomy, hysterotomy or
classical C/S were excluded from the study. Patients undergoing emergency C/S were placed in group A,
and those delivered by elective C/S were included in group B. Study variables were general and obstetric
parameters and complications observed intra-operatively. Any postoperative complications were
recorded from recovery room till patient was discharged from the ward. Results: There were 50 patients
in each group. In group A, 11 (22%) were booked and 33 (66%) were referred cases. In group B, 48
(96%) were booked. The mean age in both groups was 28 years. In both groups, multigravida compared
to primigravida were 78% vs 22% in group A, and 92% vs 8% in group B. Indication for C/S was
previous C/S in 10 (20%) patients in group A, and 39 (78%) patients in group B, placenta previa,
chorioamionitis, obstructed labour (6, 12% each); pregnancy induced hypertension and eclampsia in 5
(10%) cases in group A only. Intra-operative complications in group A were 48 (96%) vs 15 (30%) in
group B (p=0.000). Postoperative morbidity in group A was 50 (100%) and 26 (52%) in group B
(p=0.000). Intra-operative complication was haemorrhage in 46 (92%) cases in group A and 11 (22%) in
group B. Anaesthetic complications were 40 (80%); prolonged intubation 25 (50%), aspiration of gastric
contents 8 (16%), and difficult intubation 7 (14%) in group A. Ten (20%) cases had anaesthetic
complications in group B. Commonest postoperative complication in both groups was anaemia in 41
(82%) and 11 (22%) cases respectively. Conclusion: Maternal morbidity is significantly higher in
emergency C/S. Haemorrhage is a frequent complication in C/S, emergency or elective.
Keywords: Emergency C/S, Elective C/S, Maternal, Caesarean Section, Morbidity and Mortality
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