Comparison of neonatal outcomes between category-1 and non-category-1 Primary Emergency Cesarean Section: A retrospective record review in a tertiary care hospital

Dur-E-Shahwar; Iffat Ahmed; Azra Amerjee; Zahra Hoodbhoy

doi:10.12669/pjms.344.14496

Comparison of neonatal outcomes between category-1 and non-category-1 Primary Emergency Cesarean Section: A retrospective record review in a tertiary care hospital

Pak J Med Sci. 2018 Jul-Aug;34(4):823-827. doi: 10.12669/pjms.344.14496.

Authors

Dur-E-Shahwar¹, Iffat Ahmed², Azra Amerjee³, Zahra Hoodbhoy⁴

Affiliations

¹ Dr. Dur-e-Shahwar, FCPS. Department of Obstetrics and Gynaecology, The Aga Khan University Hospital, Karachi, Pakistan.
² Dr. Iffat Ahmed, FCPS. Department of Obstetrics and Gynaecology, The Aga Khan University Hospital, Karachi, Pakistan.
³ Dr. Azra Amerjee, FCPS; MCPS HPE; PGD Bioethics. Department of Obstetrics and Gynaecology, The Aga Khan University Hospital, Karachi, Pakistan.
⁴ Zahra Hoodbhoy, Department of Obstetrics and Gynaecology, The Aga Khan University Hospital, Karachi, Pakistan.

Abstract

Objective: To compare neonatal outcomes between Category-1 and Non-Category-1 Primary Emergency Cesarean Section.

Methods: This was a retrospective analysis, conducted at Aga Khan University Hospital Karachi from January 1^st 2016 till December 31^st 2016. Non-probability purposive sampling technique was used. A sample size of 375 patients who had primary Emergency Caesarean Section (Em-CS) was identified by keeping CS rate of 41.5% and 5% bond on error. Data was collected from labor ward, operating theatre and neonatal ward records by using structured questionnaire.

Results: In the current study, out of 375 participants who underwent primary Em-CS; majority (89.3%) were booked cases. Two-hundred-eighty-two (75.2%) were primiparous women. Two hundred and thirty (61.3%) were at term and 145(38.7%) were preterm. The main indication among Category-1 CS was fetal distress (15.7%). For Non-Category-1 CS, non-progress of labour (45.1%) was the leading cause of abdominal delivery. Except for APGAR score at one minute (p value = 0.048), no other variables were statistically significant when neonatal outcomes were compared among Category-1 and Non-Category-1 CS.

Conclusion: In this study, fetal distress and non-progress of labor were the main indications for Category-1 and Non-Category-1 CS respectively. We did not find statistically significant association between indications of Em CS and neonatal outcomes. However further prospective studies are required to confirm this association.

Keywords: Ante-partum hemorrhage and malpresentation; Category-1 caesarean section; Fetal distress; Non-progress of labour; Primary Emergency Caesarean section.