Elective Caesarean Deliveries at Term and Evaluation of the Neonatal Outcomes
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- Category: Vol. 81, June 2013
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Elective Caesarean Deliveries at Term and Evaluation of the Neonatal Outcomes,EMAN A. HUSSEIN ALY
Abstract
Background: Timing of elective caesarean delivery is very important, as elective caesarean deliveries before 39 weeks are associated with adverse neonatal outcomes as increased rates of respiratory complications and neonatal intensive care admission.
Aim of the Study: To evaluate neonatal outcomes of elective repeated cesarean deliveries at term (37, 38 and 39 weeks of gestation) and assess adverse neonatal outcomes in elective deliveries before 39 weeks.
Methods: This study included 162 low risk pregnant patients who were delivered by elective cesarean section at term from February 2012 to January 2013 at the Department of Obstetrics and Gynecology, Kasr El Aini Hospital, Cairo University Hospitals. Adverse neonatal outcome included neonatal death, respiratory complications, hypoglycemia, newborn sepsis, and admission to the neonatal intensive care unit (NICU).
Results: Elective deliveries were 69.7% before 39 weeks, 13.58% at 37 weeks and 56.1% at 38 weeks. At 39 weeks 30.2% of the cases underwent caesarian section. One neonatal death occurred. As compared with deliveries at 39 weeks, deliveries at 37 weeks and at 38 weeks were associated with an increased rate of adverse respiratory outcomes, admission to the neonatal ICU, mechanical ventilation, and hospitalization for days.
Conclusions: Timing of elective Caesarean delivery at term is associated with neonatal outcome. Elective cesarean delivery is discouraged before 39 weeks of gestation in the absence of medical or obstetric indication unless there is evidence of fetal lung maturity.