A Prospective Analysis of Lower Segment Cesarean Deliveries Conducted Before 34 Weeks of Gestation

Abstract Background: Preterm lower segment cesarean section (LSCS) before 34 weeks of gestation is often performed due to maternal or fetal indications such as preeclampsia, fetal distress, or preterm premature rupture of membranes (PPROM). Understanding the feto-maternal outcomes associated with this intervention is crucial for improving perinatal care. Objective: This prospective study aims to evaluate the feto-maternal outcomes of LSCS performed before 34 weeks of gestation, analyzing maternal complications, neonatal morbidity, and mortality rates. Duration of Study-2.5 Years (January 2023 To May 2025) Methods: A prospective analysis of medical records of pregnant women who underwent LSCS before 34 weeks was conducted. Data regarding maternal demographics, indications for LSCS, intraoperative and postoperative complications, neonatal birth weight, Apgar scores, need for neonatal intensive care unit (NICU) admission, and perinatal mortality were collected and analyzed. Results: The study observed that the most common indications for preterm LSCS were deranged doppler (43.5%), Severe preeclampsia (24.35%), and PPROM (21.7%). A total of 78 LSCS cases before 34 weeks of gestation were analyzed, yielding 79 neonates (including one twin pregnancy). The most common indication was deranged Doppler (44.1%), followed by severe preeclampsia (24.3%) and PPROM (23%). Of the 79 neonates, 37 (46.8%) weighed less than 1.5 kg and 42 (53.2%) weighed more than 1.5 kg. Overall, 57 babies (72.2%) survived, while 22 (27.8%) demised. The most frequent causes of neonatal demise were respiratory distress syndrome (40.9%), sepsis (22.7%), intraventricular hemorrhage (13.6%), necrotizing enterocolitis (13.6%), and extreme prematurity with low birth weight (9.1%). Conclusion: Preterm LSCS before 34 weeks of gestation is associated with significant maternal and neonatal complications. Identifying high-risk cases and optimizing perinatal care can improve outcomes. Further prospective studies are recommended to refine management strategies and minimize morbidity.