Neonatal Outcome in Preterm Cesarean Section vs Preterm Vaginal Delivery

Abstract

Objective: To compare neonatal outcome in preterm caesarean section vs. preterm vaginal delivery. Design, duration & place of study: Retrospective comparative study from January 2006 to December 2006 at Fatima Memorial Hospital, Lahore Patients and methods: All booked and un-booked patients who delivered from January 2006 to December 2006 were included in the study. The decision of spontaneous vaginal delivery or caesarean section made based on obstetric indications. All the data recorded and subsequently analyzed. Results: Out of 6570 total deliveries during one year, 673 (10.2%) patients delivered pre-term, 265 by C-Sections and 408 by Spontaneous vaginal deliveries. Preterm deliveries done, at 34-37, 32-34, 28-32 gestational weeks were 47.1%, 28.9% and 23.9% respectively. The commonest indications of pre-term Caesarean Sections were fetal distress (6.7%), intra-uterine growth restriction (27.1%) and severe preeclampsia /eclampsia (26.4). Neonatal outcome in terms of baby weight and APGAR scores were not significantly different between the two groups. Neonatal survival was 81.1% who delivered by pre-term Caesarean section compared to 77.9% who delivered by pre-term vaginal deliveries. Sepsis was the main cause of neonatal mortality. Conclusion: This study shows that the neonatal outcome of pre-term infants when delivered by Caesarean section shows no significant difference as compared to the preterm infants delivered by vaginal route. Decision of caesarean sections should be based on obstetric indication only.