Respiratory Morbidity in Term Infants delivered by Elective Cesarean Section at a Tertiary Care Hospital in India: A Randomized Controlled Trial

JOURNAL TITLE: Journal of South Asian Federation of Obstetrics and Gynaecology

Author
1. Priyankur Roy
2. Lakshmanan Jeyaseelan
3. Jose Ruby
ISSN
0974-8938
DOI
10.5005/jp-journals-10006-1520
Volume
9
Issue
4
Publishing Year
2017
Pages
6
Author Affiliations
    1. Department of Obstetrics and Gynecology, Jagadguru Sri Shivarathreeshwara Medical College & Hospital, Mysuru, Karnataka India
    1. Department of Biostatistics, Christian Medical College, Vellore Tamil Nadu, India
    1. Department of Obstetrics and Gynecology, Christian Medical College, Vellore, Tamil Nadu, India
  • Article keywords

    Abstract

    Objectives

    (1) To investigate the association between term elective cesarean sections and neonatal respiratory morbidity and the importance of timing of the cesarean. (2) To assess the maternal morbidity when emergency lower segment cesarean section (LSCS) was required.

    Participants

    All women with singleton term (37—41 + 6 weeks) pregnancies and planned for elective cesarean section in Christian Medical College, Vellore, India.

    Outcome measures

    The primary outcome measures were neonatal morbidities such as transient tachypnea of newborn (TTN) and respiratory distress syndrome (RDS). The secondary outcome measures were emergency cesarean section and maternal morbidities such as scar dehiscence, urinary tract infection (UTI), endometritis, peritonitis, and hemoperitoneum in the mother.

    Results

    The percentage of TTN in the infants in group I was 1.3% while there were none in group II. No infants were diagnosed to have RDS. Out of the 150 women who were planned for elective cesarean section, 55 women underwent emergency cesarean section. Among this, 19 (25.3%) of women were from group I as compared with 36 (48.0%) in group II. The difference in proportion between the two groups was –22.7 [95% confidence interval (CI): –37.7, –7.7], which was statistically significant (p < 0.01). The incidence of scar dehiscence, UTI, endometritis, and hemoperitoneum in the mothers of group II was marginally higher than that in the mothers of group I. There was one woman with peritonitis in group I while none was reported in the other group. All the maternal morbidities occurred to women who underwent emergency cesarean section. Out of the 19 women in group I and 36 women in group II who underwent emergency cesarean section, 1 (5.3%) and 6 (16.7%) women had morbidities.

    Conclusion

    Women requiring elective cesarean section can safely be done between 37 and 39 weeks with no further significant increase in the rates of neonatal morbidity such as TTN and RDS.

    How to cite this article

    Roy P, Jeyaseelan L, Ruby J, Garg R. Respiratory Morbidity in Term Infants delivered by Elective Cesarean Section at a Tertiary Care Hospital in India: A Randomized Controlled Trial. J South Asian Feder Obst Gynae 2017;9(4):312-317.

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