Comparison of maternal and fetal outcomes of elective and emergency caesarean deliveries

Abstract

Background: Caesarean delivery (CD) is a procedure which poses a major public health concern to Obstetricians. The outcome of emergency and elective caesarean delivery largely depend on the maternal and or fetal conditions. The study compared maternal and fetal outcomes in both elective and emergency caesarean delivery at the University College Hospital, Ibadan, Nigeria.

Methods: This was a six-year retrospective study of pregnant women who underwent caesarean delivery at the University College Hospital. Information was extracted from their medical records using a proforma. Comparison of maternal and fetal outcomes of elective and emergency caesarean deliveries was done. Data were analyzed using SPSS version 20.

Results: A total of 6,854 women had caesarean delivery (CD), mean age was 28.85 ± 5.62 years and ranged from 15-48 years. A higher proportion (85.5%) had emergency CD in which majority were unbooked (80.4%) with the commonest indication as prolong obstructed labour while repeat caesarean delivery (57.6%) was the commonest indication for elective CD. Haemorrhage, puerperal sepsis, wound infection, anaemia, blood transfusion, urinary tract infection, and admission into intensive care unit were more among those with emergency CD and all were statistically significant (p<0.05). Low birth weight stillbirths and admission into special care baby unit were also higher among the fetus of those who had emergency CD, and these were statistically significant (p< 0.05). Women with postdated pregnancy had twice the chance of having emergency CD (OR= 2.15, 95% CI= 1.71-2.72).

Conclusion: Maternal and fetal complications were more among women with emergency caesarean delivery and prolong obstructed labour was the main indication thus it is expedient to educate pregnant women and the community on complications of pregnancy and labour to prevent or  promptly intervene when necessary to reduce adverse maternal and fetal outcomes.