الفهرس | Only 14 pages are availabe for public view |
Abstract Summary and Conclusion Caesarean section represents the most significant operative intervention in all of obstetrics. Its development and application has saved the lives of countless mothers and infants. On the other hand, its inappropriate use can be a direct avoidable cause of maternal mortality and morbidity. For these reasons, caesarean section probably represents the largest source of controversy and debate in modern obstetrics. The frequency with which it is carried out continues to rise. This study was conducted to evaluate maternal and neonatal morbidities associated with both elective and emergency caesarean sections. Our study is a prospective study that was conducted at Ain Shams Maternity Hospital. It included 200 patients in which they were divided into two groups: Group 1 :100 patients who had elective CS. Group 2:100 patients who had an emergency CS for maternal or fetal indication. Our results show highly significant difference between the two study groups as regard gestational age of patients as 18% of emergency CS cases were less than 37 weeks gestational age. There was also highly significant difference between the two study groups as regard adequate fasting state and the presence of uncontrolled medical disorder as only 15% of emergency CS were with adequate fasting state and 29% of emergency CS were with presence of un- controlled medical disorders. While 100% of elective group were 100% with adequate fasting state and only 4% of the group were with the presence of uncontrolled medical disorders. In comparison between both groups as regard intraoperative complications. There was a highly significant difference in amount of bleeding between the two groups as 14 cases in the elective group was with mild / moderate bleeding while 19 cases in emergency group was with severe bleeding. There was no significant difference between both groups as regard anesthesia complications and bladder or intestine injury.But there was significant difference between the two groups as regard uterine wound extension. Emergency group show a high incidence of uterine wound extension. In comparison between the two groups as regard blood transfusion and post-operative anemia. There was a highly significant difference between the two groups. in the time that 2 cases had blood transfusion in the elective group there was 12 cases had blood transfusion in the emergency group and when only 13 cases of elective group established post-operative anemia 29 cases of emergency group established post-operative anemia of course emergency CS cases showed higher percentage of cases receiving blood transfusion and developing anemia.In regard to other post-operative complications there was no significant difference between the two study group as regard major wound infection but significant difference between the two study groups as regard minor wound infection as the emergency group shows higher percentage (15% vs7%) in minor wound infection. There was no significant difference between the two study group as regard post-operative urinary or respiratory tract infection. In our study as regard neonatal complications there was no significant difference between the two groups as regard fetal life, neonatal respiratory problems and neonatal intensive care unit admission there was no neonatal injury. In conclusion, the maternal morbidities among emergency caesarean sections was higher than elective caesarean sections and there was no difference in neonatal morbidities. |