Am J Perinatol 2010; 27(6): 507-512
DOI: 10.1055/s-0030-1248936
© Thieme Medical Publishers

Outcome in Second- versus First-Stage Cesarean Delivery in a Teaching Institution in Eastern India

Subrata Lall Seal1 , Gourisankar Kamilya1 , Joydev Mukherji1 , Subir Kr Bhattacharyya1 , Alok De1 , Avijit Hazra2
  • 1Department of Obstetrics and Gynecology, R. G. Kar Medical College, Kolkata, West Bengal, India
  • 2Department of Pharmacology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, West Bengal, India
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Publication History

Publication Date:
19 February 2010 (online)


We evaluated the maternal and perinatal complications of cesarean delivery performed in the second stage compared with the first stage of labor in nulliparous women. We performed a hospital-based cohort study in a teaching institution in Kolkata, West Bengal, India. The primary maternal outcomes measured included intraoperative surgical complications, duration of surgery, need for blood transfusion, wound infection, transfer to intensive care unit, and length of hospital stay. The neonatal outcomes included 5-minute Apgar score 3 or less, need for endotracheal intubation, admission to neonatal intensive care unit, fetal injury, septicemia, neonatal seizures, and neonatal death. There were 1702 cesarean deliveries performed in the first stage and 124 cases in the second stage. Cesarean deliveries performed in the second stage were associated with longer operation time and increased need for blood transfusion, rates of wound infection, intraoperative complications, and need for transfer to intensive care unit. Neonatal complications included significantly low Apgar score at 5 minutes, increased neonatal death, admission to neonatal intensive care unit, increased need for intubation, septicemia, neonatal seizures, and fetal injury (all having p < 0.05). Cesarean deliveries performed in the second stage of labor were associated with higher rates of maternal and neonatal complications.


Dr. Subrata Lall Seal

AE-684, Salt Lake City, Sector-1

Kolkata-700 064, West Bengal, India