Correlation Between Timing Of Elective Repeat Cesarean Section At Term And Neonatal Outcomes In A Peripheral Tertiary Hospital
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 10
Abstract
Background: Births by elective cesarean section (CS) have risen over the last decade worldwide, particularly before 39 weeks’ gestation in mothers with previous cesarean deliveries, which may be associated with unacceptably high risk of adverse neonatal outcomes. So the optimal timing of these deliveries needs to be determined with recent recommendations to delay births by elective CS until 39 weeks. Aims: To evaluate the association between the gestational age (GA) at birth and neonatal outcomes after elective repeat CS between 37 and 40 completed weeks, so that timing of elective repeat cesarean section can be mapped out without compromising neonatal and maternal outcomes among the low and middle socio-economic mothers in a peripheral tertiary hospital of West Bengal, India whose outcome was not studied extensively. Materials and Methods: This was a prospective observational comparative study of viable singleton neonates delivered by elective repeat CS at Bankura Sammilani Medical College & Hospital, Bankura, West Bengal, India. During the study period from 1st September 2017 to 31st August 2018 a total of 101 mothers delivered by elective repeat cesarean section at term were stratified into two GA groups with early term Group A (between 37weeks,0day and 38weeks,6days) compared with the reference group of full term Group B (between 39weeks,0day and 40weeks,6days). The neonatal outcomes examined were serious respiratory morbidity (respiratory distress syndrome, Transient tachypnea of new born), depression at birth, neonatal sepsis, nursery admission. Results: Out of 101 elective repeat cesarean deliveries at term, 46.53% were performed between 37weeks,0day and 38weeks,6days. 53.46% between 39weeks,0day and 40weeks,6days. We found a significant risk in the early term Group A in comparison to the reference group of full term Group B for development of neonatal respiratory complications i.e. respiratory distress syndrome(RDS) (P=0.031), transient tachypnea of new born(TTN) (P=0.003); neonatal sepsis (P=0.031), admission in sick newborn care unit (P=0.003). Conclusion:Elective repeat CS performed at 37–38 completed weeks is associated with poorer neonatal outcomes compared to those delivered at 39–40 completed weeks. This study supports recent recommendations to delay delivery by elective repeat CS until 39 weeks if possible.
Authors and Affiliations
Dr. Tamal Kumar Mandal, Dr. Pratima Garain
Keywords
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- EP ID EP401949
- DOI 10.9790/0853-1710072529.
- Views 103
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