Objective. We performed a prospective observational audit study to compare neonatal and maternal outcomes of the primary cesarean sections performed in first stage versus second stage of labour. Methods. One thousand three hundred and eighty-nine nullipara women who had undergone cesarean section in a tertiary teaching hospital between February 1, 2009 and January 31, 2010 were included in the study. Primary maternal outcomes of interest were uterine atonia, transfusion requirement, urinary system injury, requirement for hysterectomy, and duration of hospital stay. Results. A total of 1389 women underwent cesarean section at this 12 month time period. Of these 1389 cesarean sections, 1271 were in the first stage of the labour and 171 were in the second stage of the labour. Urinary injuries, transfusion requirement, and uterine atonia hysterectomy were significantly more frequent in women who underwent cesarean section in the second stage of the labour compared to women undergoing cesarean section in the first stage of the labour. Conclusion. Cesarean section in the second stage of the labour is associated with increased maternal and neonatal morbidities. Special attention is required to the patients undergoing cesarean section in the second stage of the labour. 1. Introduction Cesarean section (CS) is the most commonly performed abdominal operation in women all over the world. Variable rates of CS are reported between and within countries [1–3]. One-fourth of the primary CSs are reported to be performed in the second stage of the labour [4, 5] and are more complicated compared to the ones performed in the first stage. The second stage of the labour can be defined as the time elapsed from full dilatation of the cervix to expulsion of the fetus. The extraction of the impacted head of the fetus from the maternal pelvis constitutes the main difficulty of the CS in the second stage of labour and is associated with increased risks such as hemorrhage, prolonged operation time, and other intraoperative complications [6]. Neonatal mortality and morbidity due to hypoxia and fetal trauma remains to be one of the major issues regarding the CSs performed in the second stages of labour [5, 7]. We present here the comparative prospective data of the maternal and neonatal morbidities in nulliparas undergoing CS in the first and second stage of labour. 2. Materials and Methods One thousand three hundred and eighty-nine nullipara women undergoing CS between February 1, 2009 and January 31, 2010 at Zekai Tahir Burak Maternity Hospital Ankara, were included in the study.
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