Maternal and Fetal Outcome of Elective Caesarean Section at 37 – 38 Weeks versus 39 Completed Weeks of Gestation in Enugu, Southeast Nigeria

Abstract

A retrospective study comparing maternal and neonatal outcome of singleton fetuses delivered at 37–38 weeks of completed gestation with those delivered at 39 completed weeks of gestation or longer by elective caesarean section at the University of Nigeria Teaching Hospital, Enugu between January 1, 2004 and December 31, 2008. There were 164(21.3%) elective caesarean deliveries during the study period. 117 (71.3%) were performed between 37–38 weeks of completed gestation and 47(28.7%) at 39 completed weeks of gestation. Elective caesarean births at 37-38 weeks were associated with significantly higher rates of admission to the neonatal care unit, neonatal jaundice, and a higher proportion of newborns with Apgar score <6 at 5minutes. As a result of increased morbidity and iatrogenic prematurity in the developing countries due to elective caesarean delivery at 37-38weeks associated with increased cost of admissions in the newborn special care units, elective caesarean delivery should be advised at or after 39 weeks of gestation unless there is evidence of fetal lung maturity. At 39 completed weeks of gestation, elective caesarean delivery is associated with better fetal outcomes than at 37-38 weeks of completed gestation.