MATERNAL MORBIDITY ASSOCIATED WITH EMERGENCY VERSUS ELECTIVE CAESAREAN SECTION

Objective: To compare maternal morbidity in elective versus emergency caesarean section in a tertiary care teaching hospital. Methodology: This comparative study was conducted at Department of Gynecology Obstetrics, Lady Reading Hospital Peshawar, Pakistan, from July 2006 to June 2007. A total of 100 patients, 50 in emergency and 50 in elective caesarean section group through convenient sampling were included in the study. The sample size was calculated as 100 by keeping 8% prevalence of caesarean section in Pakistan and using WHO software for sample size estimation. The complications were compared in both groups using a semi structured proforma. The comparison was done by using Chi-square test and p-value 0.05 was considered statistically significant. Results: The mean age was 31.54+4.64 and 30.83+5.08 in emergency and elective caesarean section group respectively. Anesthesia related complications were only observed in 11 cases of emergency caesarean section group [Delayed recovery with 8 Cases occurred most] and none in the elective group. Tears in cervix and uterus were noted in 8 cases of emergency caesarean section group only. Hemorrhage was noted in 58% and 4% patients in emergency and elective caesarean section groups respectively. Postoperative complications were found higher in emergency caesarean section as compare to elective caesarean section groups like anemia (70%vs.40%), post partum hemorrhage(40%vs.6%), fever (30%vs.8%) and abdominal distention(30%vs.8%) with p-values of 0.004, 0.007, 0.01, 0.01 respectively. Conclusions: The maternal morbidity including anesthesia related complications, Intra-operative, and post operative complications were more in the emergency caesarean section as compared to elective caesarean section group