Post-operative morbidity in elective versus emergency caesarean section: a prospective cohort study.
Context: Caesarean delivery is associated with the risks of post-operative morbidities.
Objective: To assess post-operative morbidity in clective versus emergcncy caesarean section
Design: Prospective cohort study
Setting: Department of Obstetrics and Gynaecology University of Abuja Teaching Hospital, Abuja in Nigeria
Population : Women who underwent either elective or emergency caesarean sections at the hospital during the designated study period
Main Outcome measures: Wound infection. long duration of hospital stay, Postoperative fever. Urinary tract infection and blood transfusion.
Results: There were significantly higher morbidities: wound infection (OR 3.4: 95% CI 1.7-7.3: P<0.0001 ) post-operative fever(OR 6.7; 95% 03.6-13.2. P<0.0001 ).longer duration of hospital stay (OR 6.2; 95% CI 3.3-12.6; p<0.0001) and blood transfusion (OR 5.4; 95% Cl 2.7-11.8; P<0.0001) in women who had emergency caesarean delivery compared with elective caesarean delivery. There was no significantb
difference in the frequency of urinary tract infection (OR 3.0; 95% CI 0.8-12.2; P -0.12) in both arns of study. Following logistic regression. only unhooked status retained significant association with wound infection (OR 4.3; 95% CI 2,4-7.9). post-operative fever (OR 3,6; 95% CI 2.3-5.7); longer duration of hospital stay (OR 5,7; 95% CI 3.4- 9.4) and blood transfusion (OR 7.6; 95% CI 4,2- 14.0)
Conclusion : This study identified significantly higher post-operative morbidities in emergency than elective caesarean delivery. The most important predictor of post-operativc morbidity was lack of antenatal care.
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