Caesarean sections at full cervical dilation: a case series on outcomes and proactive measures in an Indian teaching hospital

This case series examines 20 cesarean sections performed at full cervical dilation at Khaja Banda Nawaz Teaching and General Hospital, India, from January to December 2024. Among 852 deliveries, 548 were cesarean sections, with 20 (3.65%) occurring at full dilation. Maternal complications included postpartum hemorrhage in 35% of cases, sepsis in 12%, blood transfusion in 15%, and one peripartum hysterectomy. Neonatal outcomes showed 10% NICU admissions, primarily for respiratory distress and sepsis. Deep transverse arrest was the leading indication in 66.15% of cases. The findings highlight the high morbidity associated with second-stage cesarean sections and propose proactive measures such as team training, standardized protocols, and enhanced monitoring to improve outcomes. These results emphasize the need for specialized care and further research in resource-constrained settings.