Publication:

Association of early neonatal-maternal outcomes with timing of elective caesarean section at term gestation

Background The decision for optimal time for elective caesarean section (ECS) should be taken considering the minimum risk to the newborn as well as to the mother. This prospective observational study aimed to investigate the effect of gestation of ECS, on neonatal and maternal outcomes.

Methods All the pregnant term mothers admitted to our hospital for ECS and fulfilling the inclusion criteria were enrolled and divided into 2 groups, early term and full term. Patients having high-risk factors like intrauterine growth restriction, amniotic fluid disorders, multiple pregnancies, placenta previa, abruption placenta and medical co-morbidities were excluded. Early neonatal and maternal outcomes were compared between the 2 groups.

Results 244 mothers were eligible for ECS, 183 (75%) women underwent ECS in the early term and 61 (25%) at full term as per the decision of obstetricians of various units. The incidence of neonatal respiratory morbidity (NRM) was 2 percent in our study. Out of 244 newborns, 4 developed NRM in the form of delayed adaption in 3 and respiratory distress in 1. The incidence of respiratory distress was comparable in both groups. The incidence of NNJ, MSL and sepsis was higher in the early term but it was not significant statistically. Maternal outcomes like postpartum haemorrhage, the need for blood transfusion, bladder injury, thin scar, adhesions poorly formed LUS were observed in the early term but the difference was not significant.

Conclusions More research needs to be done for optimization of timing of ECS.