Maternal and Perinatal Outcomes Among Women Underwent Second-Stage Versus First-Stage Caesarean Delivery at Ibrahim Malik Hospital in Sudan

Background: Second-stage caesarean is more technically difficult due to deep engagement of the fetal head, and this is associated with increased risk of maternal morbidity such as (surgical injuries and intra-operative hemorrhage) as well as fetal morbidity such as (hypoxia and fetal injury).

Objective: To determine maternal and perinatal outcome associated with caesarean sections performed in the second versus first stages of labor.

Methodology: It was observational cross sectional -hospital based study carried out in Ibrahim Malik Hospital in Khartoum State, Sudan, in the period from October 2015 to October 2016. Six hundred women were enrolled in this study. 200 women were undergoing second stage caesarean section for variable indications, while 400 women underwent first stage caesarean section.

Results: We found that women who underwent caesarean delivery in the second stage of labor had greater risk of maternal morbidity than those who underwent caesarean delivery in the first stage of labor. The rate of Bleeding >1000 ml (16.0% vs. 0.7.5%), extension of the uterine incision (20.5% vs. 6.25%), bladder injury (4.0% vs. 1.25%). The rate of fetal injury during delivery (5.5% vs. 2.0%), FSB (4.5% vs. 2.25%), admission to the neonatal intensive care unit (18.0% vs. 12.5%), neonatal sepsis (3.5% vs. 1.5%) and early neo- natal death (2.0% vs. 2.25%).

Conclusion: Intra operative bleeding, adhesion, bladder injury, caesarian hysterectomy, perinatal asphyxia, FSB, birth trauma, NICU admission and low Apgar score were most morbidity related to 2^nd stage cesarean delivery.

Keywords: 2^nd stage C/S, 1^st stage C/S, Maternal, Fetal, Outcome, Comparison