Abstract

COMPARISON OF NEONATAL OUTCOME OF ELECTIVE CESAREAN SECTION DONE AT 37–38 WEEKS OF GESTATION AND AT 39-40 WEEKS OF GESTATION

Musharaf Jahan*, Farrukh Naheed, Nazish Ali, Nikhat Ahsan, Naila Qamar and Farheen Shiekh

ABSTRACT

Objective: The study aimed to compare the CS between 37 and 38 weeks gestational weeks and those performed between 39-40 weeks gestational weeks in order to determine the neonatal outcome and complications. Study design: comparative cross-sectional. Place and Duration of study: The study was conducted on 200 pregnant women in the Department of Obstetrics and Gynecology, Baqai Medical University, Fatima Hospital, Gadap Karachi from January 2021 to December 2022. Methodology: Women with term singleton pregnancies scheduled for elective cesarean section at 37 - 38 weeks and 39-40 weeks of gestation without medical comorbidities were enrolled. All the patients were distributed into two groups: Group-A composed of pregnant women with gestational age 37-38 weeks and Group-B pregnant women with gestational age of 39-40 weeks. Data such as maternal age, gestational age, parity, and neonatal complication neonatal weight were collected. Transient tachypnea of the newborn (TTN), sepsis, NICU admission, respiratory distress syndrome (RDS), and neonatal outcomes noted. Repeat C-Section, malpresentation, Cephalopelvic Disproportionation (CPD), maternal request were different causes for elective cesarean section. Data was collected from these patient who were admitted in ward for elective cesarean section through a pre design proforma. Data analysis was done in SPSS version 27. Results: Of the total 200, pregnant women who delivered 37-38 (Group-A) and 39-40 gestational weeks (Group-B) were 96 (48%) and 104 (52%) respectively. The incidence of various causes or indications of cesarean sections such as repeat C-Section, malpresentation, Cephalopelvic Disproportionation (CPD), maternal request, and others were 45 (46.9%) vs. 38 (36.5%), 13 (13.5%) vs. 16 (15.4%), 15 (15.6%) vs. 7 (6.7%), 12 (12.5%) vs 13 (12.5%), and 5 (5.2%) vs. 0 (0%) respectively. The incidence of perinatal outcomes such as NICU admission, respiratory distress syndrome (RDS), sepsis, and Transient tachypnea of the newborn (TTN) in group-A vs. group-B were 49 (51%) vs. 59 (56.7%), 55 (57.3%) vs. 17 (16.3%), 16 (16.7%) vs. 9 (8.7%), 35 (36.5%) vs. 9 (8.7%), and 16 (16.7%) vs. 1 (0.9%) respectively. The mean age of women who delivered in 37-38 pregnant weeks was 26.82 ± 6.32 years, which was substantially older than women who gave birth at 39-40 gestational weeks (26.3 ±5.83 years) (P = 0.039). Conclusion: The study proved that without any specific indication for elective cesarean section done at 39-40 weeks to improve neonatal outcome rather at 37-38 weeks give rise unexpected NICU admissions

Keywords: Neonatal outcome, transient tachypnea of newborn, Respiratory distress syndrome, repeat C-Section, elective, ceasarean section.