Analytic study of the intraoperative surgicalcomplications of elective & emergency cesarean sections: incidence & risk factors


Background: Cesarean section accounts for a substantial proportion of total deliveries & is associated with higher rates of maternal & neonatal morbidity.Objective: to determine the effect of the risk factors on the incidence of intraoperative surgical complications in elective & emergency cesarean sections. Methods: This study was conducted in AL-Zahra'a Teaching Hospital of Maternity & Pediatrics in Najaf city, from June to December 2011. A total of 600 patients who had lower-segment cesarean section (280 patients with elective cesareans &320 patients with emergency procedures) participated in the study. A comparison was done between major & minor surgical complications&neonatal outcome in both groups with estimation of the effect of maternal age, body mass index, parity, previous C/S & placenta previa on the incidence of intraoperative surgical complications. Results:Intra-operative surgical complications& poor neonatal outcomewere more commonly associated with emergency than with elective procedures (P<0.05).Uterocervical laceration& blood loss requiring blood transfusion were the most frequent complications & they were more commonly associated with increased maternal age, parity, body mass index, placenta previa&abruption, previous cesarean & emergency conditions.Statistical analysis: The data were analyzed using spss version 15 with the chi –squared test to determine the association between the various factors under investigation. Conclusion: every effort should be directed to affect planned cesarean section with evaluation of risk factors during the antenatal period if possible, so as to reduce the various problems associated with emergency cesarean section.Recommendations: owing to the higher incidence of intraoperative complications if C/S is undertaken in the emergency situations, it is recommended to be accomplished as an elective procedure.