Comparison of Neonatal Outcomes at Different Timing of Repeat Elective Cesarean Delivery
Objective: To compare neonatal outcomes in women undergoing elective cesarean section at 37 weeks verses 40 weeks of gestation.
Methodology: The randomized clinical trial study was conducted at Jinnah post graduate Medical centre, from Jan 2017-Dec 2019. A randomized was performed in to two groups by using lottery methods; group A and B. Patients were selected through non probability consecutive Technique. Patients in Group A underwent elective C section at 37 weeks of gestation and in Group B underwent C section at 40 weeks of gestations. Baby was examined and advised for admission to NICU when it was necessary. The outcome variables meconium stained liquor and admission to NICU were noted along with age, parity, educational status and family monthly income.
Results: Mean age of the patients was 31.2 ±4.86 years. Out of 310 patients most of the patients I84 (59.4%) were multipara( P1-4). Most of the patients were found to have education up to Matric 90(29%).Majority of patients193 (62.3%) belong to the monthly income group of middle class (monthly income 25,000-50,000 RS). The comparison of mean birth weight of the baby in grams was 3376±450 vs. 3560±467. 116(74.8%) baby had belong to category <2500 g in 40 weeks of gestation group while 95(30.6%) in 37weeks of gestation respectively. Admission to the NICU was found in 26(16.7%) and 11(7.09%) in women underwent C section at 37 and 40 completed weeks of gestation respectively. Meconium staining was found in 6(1.9%) in A group while 16(5.2%) women underwent C section in B group.
Conclusion: Elective Cesarean section performed earlier than 38 weeks of gestation should be avoided to minimize neonatal risks and complications. This approach will also reduce the medical expenses associated with NICU admissions and avoid separating mothers from their newborns.
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