Background: Cesarean section (CS) done before the onset of labor is called an elective
and done during labor is called an emergency CS. During labor, CS may be needed in early(1st) or
late(2nd) stages. Earlier studies have shown more maternal and fetal complications when a cesarean
is done for the first time in the late stages.
Objective: Our objective was to find out whether the maternal and fetal outcomes differ when
primary CS is done in the first stage of labor compared to the second stage of labor for various indications
Methods: This was a retrospective observational study on women who underwent primary CS
during active labor and to link the maternal and fetal outcomes related to the stages of labor. The
study population was patients admitted to the Labor ward of Saqr hospital, Ras Al Khaimah,
UAE, between 1st January 2017 till 31st December 2017, but had to undergo primary CS during
labor for various indications at 1st and 2nd stages of labor. Data was collected from maternal and
neonatal electronic case records.
Results: A total of 135 case records were studied. Most cesarean sections were in the early stage
of labor. The most common indications were fetal distress and prolonged labor. The maternal and
fetal complications were higher in 2nd stage of labor than in 1st stage which includes uterine atonia
(p=.001), postpartum hemorrhage (p=.006), postoperative hematuria(RR=3.46), problems with
breastfeeding (p=0.001) and fetal injuries (p<.001).
Conclusion: Primary CS in late labor is associated with increased maternal and neonatal complications
compared to CS in early labor.