MATERNAL MORBIDITY ASSOCIATED WITH EMERGENCY VERSUS ELECTIVE CAESAREAN SECTION

Abstract

Objective: To compare maternal morbidity in elective versus emergency caesarean section in a tertiarycare teaching hospital.

Methodology: This comparative study was conducted at Department of Gynecology & Obstetrics, LadyReading Hospital Peshawar, Pakistan, from July 2006 to June 2007. A total of 100 patients, 50 inemergency and 50 in elective caesarean section group through convenient sampling were included in thestudy. The sample size was calculated as 100 by keeping 8% prevalence of caesarean section in Pakistanand using WHO software for sample size estimation. The complications were compared in both groupsusing a semi structured proforma. The comparison was done by using Chi-square test and p-value< 0.05was considered statistically significant.

Results: The mean age was 31.54+4.64 and 30.83+5.08 in emergency and elective caesarean section grouprespectively. Anesthesia related complications were only observed in 11 cases of emergency caesareansection group [Delayed recovery with 8 Cases occurred most] and none in the elective group. Tears incervix and uterus were noted in 8 cases of emergency caesarean section group only. Hemorrhage wasnoted in 58% and 4% patients in emergency and elective caesarean section groups respectively.Postoperative complications were found higher in emergency caesarean section as compare to electivecaesarean section groups like anemia (70%vs.40%), post partum hemorrhage(40%vs.6%), fever(30%vs.8%)and abdominal distention(30%vs.8%) with p-values of 0.004, 0.007, 0.01, 0.01 respectively.

Conclusions: The maternal morbidity including anesthesia related complications, Intra-operative, and postoperative complications were more in the emergency caesarean section as compared to elective caesareansection group.