Caesarean sections in the second stage of labour – a risk evaluation

Objective: To retrospectively analyse the relative rate of complications caesarean sections performed in second stage, comparison to those done first stage labour, singleton uncomplicated pregnancies. A secondary objective was see whether a conscious attempt had been made for an instrumental delivery where it seemed feasible avert labour. Method: retrospective cohort study 2440 out total 5349 procedures 2019 and 2020, at ward 10, shocking reaching 49% 60% (university, health ministry units) Teaching Hospital, Peradeniya. The mere 1.63% 2020. There were only 1220 caesareans Hence, similar number (1220) cases selected from purpose complications. Results: Requirement blood transfusions; intraoperative or within 24 hours 6 against 36 instances respectively. 16 recorded extensions angles tears, 3 broad ligament haematomas procedures. one instance even vaginal tear dislodging jammed fetal head following failed forceps. Only records angle when attempting deliver high floating heads during stage. Uterine scar dehiscence found 12 but this not result procedure longer duration labour former situation. two bladder injury 7 second. mean hospital stay markedly different 2.2 4.6 days. 17 patients ended dependency unit ICU due procedure-related no mortalities. operating times sample drawn theatre (300 each stage) 28.6 min 46.5 min. Failed forceps ventouse 2 instances. Conclusions: Second more technically difficult as judged by time taken likely be complicated higher risk admission Intensive care. We cannot conclude that they any safer than AVD, with AVD audited study. Better training may improve unacceptable situation half women (49%) deliveries 2019. trial resultant should automatic reprimand operator leads performing defensive medicine. Senior-most obstetricians on site must called morbidity. This is so has failed.