Evaluation of Perinatal outcomes of High Risk Pregnant Mothers who undergo Caesarean Section

Abstract

Background: Rising caesarean rates above the recommended 10% has shown to worsen the perinatal outcome, especially with reference to developing countries. Early detection of perinatal outcomes followed by special intensive care can significantly alter perinatal mortality rates. The study was undertaken with the objective of evaluating the perinatal outcomes of high risk cases undergoing caesarean section.

Objective: To evaluate perinatal outcome in high risk pregnant mother who undergo caesarean section

Methods: This is a prospective cohort study. The sample size was calculated to be 125 each in cohort and control. A total of 357 women from SAT Hospital, Thiruvananthapuram were interviewed which included those posted for elective caesarean and others. They were categorised according to Coopland's scoring system into high risk and low risk groups and 250 women who underwent caesarean section were followed up on the 4th day of their confinement and their perinatal outcomes assessed.

Result: The mean age of women who took part in the study was 26.45 years (SD-4.693) and the mean gestational age was 261 days (SD-14.181). It was found that 39.2% of women had a history of previous caesarean section, 26.8% and 18% of women had gestational diabetes-mellitus and hypertension during their present pregnancy respectively. The relative risk for significant neonatal outcomes in high risk group when compared to low risk group are: respiratory-distress syndrome-11.965(CI 1.51-94.144, P=0.03), neonatal-hyperbilirubinemia -14.393(Cl 1.853 to 111.795, P=0.001), prematurity-2.042 (CI 1.101-3.785, P=0.022), neonatal hypoglycaemia-4.125(CI 1.329-12.805, P=0.009).

Conclusion: Our study found that neonates of high risk women had a greater risk of respiratory-distress syndrome, neonatal-hyperbilirubinemia, prematurity and neonatal-hypoglycaemia. We suggest a timely care and referral of high risk women and a targeted treatment plan for their neonates.