Second-stage primary Caesarean deliveries: Are maternal complications increased?

Background: Second-stage Caesarean sections (CSs) are known to be associated with increased complications but most reports originate fromtertiary hospitals, which attend to high-risk patients. Complication rates may differ in district hospitals, which attend to low-risk patients.Methods: This was a retrospective study carried out at a district maternity unit in Durban. The hospital records of all CSs over an eight-month periodwere reviewed and obstetric and neonatal complications of second-stage CSs were compared with a group of first-stage CSs performed during thestudy period.Results: There were 4 654 deliveries, including 1 257 CSs, in the study period. The CS rate was 27.2%. Of 617 (8.5%) emergency CSs, 53 wereperformed in the second stage of labour.The maternal and neonatal complication rates were low and no statistical differences were found between the patients who had second-stage orthose who had first-stage CSs, except for increased blood loss, blood-stained urine, prolonged operative times and postoperative fever for secondstageCSs.Conclusions: Second-stage CSs performed in a district hospital are associated with increased maternal complication rates but not with neonatalcomplications