Maternal outcomes following second stage caesarean section in a tertiary hospital in Malaysia: A 6-year retrospective review
Nurul Nafizah Mohd Rashid 1, 2  
,   Nik Mohamed Zaki Nik Mahmood 1, 3  
,   Mohd Pazudin Ismail 1, 3  
,   Adibah Ibrahim 1, 3  
,   W Fadhlina W Adnan 1, 3  
,   Erinna Mohamad Zon 1, 3  
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Department of Obstetrics and Gynaecology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
Department of Obstetrics and Gynaecology Hospital Raja Perempuan Zainab, Kota Bharu Kelantan, Malaysia
Department of Obstetrics and Gynaecology, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
Erinna Mohamad Zon   

Department of Obstetrics & Gynaecology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan
Submission date: 2020-09-04
Final revision date: 2021-02-25
Acceptance date: 2021-02-25
Online publication date: 2021-06-30
The trend for second stage caesarean section (SSCS) has been rising, and it carries a high rate of maternal and neonatal morbidity.

To determine the prevalence of caesarean section (CS) performed during the second stage of labour and identify maternal outcomes and associated risk factors in these women.

Material and methods:
This retrospective study was performed in the Hospital University Sains Malaysia (HUSM). Medical records of 207 women with singleton cephalic pregnancies at term who underwent a SSCS between January 1, 2010 and December 31, 2015 were reviewed, and demographic and outcome data were collected.

Results and discussion:
During the study period, 8,197 (19.3%) out of 42,546 babies were delivered by CS, including 257 (4.1%) SSCSs. Nearly half (49.3%) the women were nulliparous, 182 (87.9%) experienced spontaneous labour and 123 (59.4%) received oxytocin augmentation. Furthermore, 26 (12.6%) of women had post-partum haemorrhage (≥1000 mL), of whom 22 (10.6%) required blood transfusion. Only 1 (0.5%) woman was admitted to the intensive care unit postoperatively, but 163 (78.7%) had an overall hospital stay length of 3 days. Furthermore, 38 (18.4%) and 33 (15.9%) of women experienced extended uterine tear and uterine atony, respectively. Parity (P < 0.001), attempted instrumentation (P < 0.001) and baby’s weight (P < 0.004) were statistically significantly associated with total blood loss. Parity (P < 0.012) and attempted instrumentation (P < 0.001) were risk factors for extended uterine tear.

The overall outcomes from SSCS were better compared with studies performed in other centres. Current practices must be maintained or improved to provide the best patient caree.

This research was mot supported by any funding agency orgrant.
Authors declare no conflict of interest.
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