Abstract
Introduction: Second stage caesarean section is usually associated with the deeply engaged head, less liquor, and thinned out the lower uterine segment. This can lead to a high risk of maternal morbidities like an extension of the lower uterine segment incision, uterine atony, and injury to urinary bladder as well as neonatal morbidities such as birth asphyxia, NICU admission, and meconium aspiration syndrome. This study aims to observe the maternal and neonatal outcomes of caesarean delivery performed in the second stage of labor.
 Materials and Methods: This was a retrospective study of the fetomaternal outcome of all women with singleton, a cephalic fetus at term delivered by caesarean section in the second stage of labor over one year at Tribhuwan University Teaching Hospital.
 Results: During this study period, there were 4653 deliveries. A total of 2274(48.88%) were born by caesarean section, out of which 1739 (76.5%) were elective and 535(23.5%) were emergency. Among emergency LSCS 36(6.72%) were performed in the second stage of labor. Most of the indications were nondescent of head 34(93.5%) followed by intraoperative maternal complications (hematuria; n=14; 38.88%). Postoperative maternal who had complications were prolong catheterization: 14(38.88%), postoperative fever : 10 (27.77%), prolong hospitalization: 5(13.88%). In perinatal complications meconium stain liquor : 10(27.77%), NNU admissions : 5(13.88%), Apgar score <5 at 5 min : 5 (13.55%), NICU admission : 2(5.54%), fresh stillbirth : 1(2.77%) were observed.
 Conclusions: Caesarean sections done in the second stage of labor are associated with severe maternal and neonatal complications.
Highlights
Second stage caesarean section is usually associated with the deeply engaged head, less liquor, and thinned out the lower uterine segment
Most of the indications were nondescent of head 34(93.5%) followed by intraoperative maternal complications
Caesarean sections done in the second stage of labor are associated with severe maternal and neonatal complications
Summary
Second stage caesarean section is usually associated with the deeply engaged head, less liquor, and thinned out the lower uterine segment This can lead to a high risk of maternal morbidities like an extension of the lower uterine segment incision, uterine atony, and injury to urinary bladder as well as neonatal morbidities such as birth asphyxia, NICU admission, and meconium aspiration syndrome. Second stage caesarean section is a difficult procedure as it is associated with the deeply engaged fetal head, less amount of liquor and thinned out the lower uterine segment, it can lead to high risk of maternal morbidities, such as tearing of the lower uterine segment, extension of the uterine incision, injury to the urinary bladder, postpartum pyrexia, prolonged catheterization, and hospitalization.[4,5,6,7] Neonatal morbidities associated with the second stage CS are birth asphyxia, neonatal intensive care unit (NICU) admission, fetal birth injuries, hypoxic-ischemic encephalopathy, and even neonatal death.[8,9] this study is NEPALESE MEDICAL JOURNAL issue 5 | vol 3 | 2020 being done to observe maternal and fetal complications among women undergoing caesarean section during the second stage of labor
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