Feto-Maternal Outcomes of Second Stage Caesarean Section at Pravara Rural Hospital, Loni

Introduction: A Caesarean section performed during the second stage of labour carries significant consequences for both maternal and neonatal health as well as potential complications in subsequent pregnancies. Incidence of second stage caesarean section has increased from 0.9 to 2.2%.3 The Royal college of obstetricians and gynaecologists (RCOG) reports that approximately 6% of caesarean section for singleton pregnancies occur at full dilatation.4 Material and methods: This retrospective descriptive study, conducted at Pravara Rural Hospital at Loni, Maharashtra, aimed to analyze the feto - maternal outcomes of caesarean sections performed during the second stage of labor at term (37 weeks) in singleton pregnancies with cephalic presentation. The study included women who underwent caesarean delivery in the second stage of labor at term, while excluding those with multiple pregnancies, malpresentation, or preterm deliveries. The study was conducted over four months, from August to November 2024, involving patients admitted to the antenatal ward of the obstetrics and gynecology department. Total number of deliveries during this period were 3439 deliveries among which 1530 were caesarean deliveries. Results: As per the study, out of all women in whom cesarean section was performed in the second stage of labour (91) which is 5.94 % of the total caesarean deliveries (1530) performed during the study period, majority of women were in the age group of 20 - 25 years (54.9%), among which 78% of them were primiparous. Majority of the cases were labor induced (54.9%).76.9% of second stage caesarean sections performed were due to non descent of fetal head. Majority (57.1%) of the babies were delivered by vertex method. Most common intraoperative complication and postoperative complication was hematuria (40.7%).16.5 % of neonates experienced birth asphyxia. Most babies weighed in the range of 2.5 - 3.5 kg (90.1%). Conclusion: The study concluded to analyze the rate, risks of second - stage caesarean sections and their impact on pregnancy outcomes. Key precautions include proper surgical techniques, monitoring labor progression, and ensuring regular audits, training, and use of prophylactic measures to improve outcomes.