Shailaja L 1 , Sujatha Thankappan Lakshmi 2 , Nirmala Chellamma 3 , Sreelatha Sumangala
BACKGROUND During the past few decades, the worldwide incidence of Caesarean births has increased markedly. The current range is around 40% of all deliveries. A study of long and short term morbidities following caesarean will create awareness on these adverse outcomes so that efforts can be taken to reduce the high rates of caesarean section. AIM Aim of the study was to assess the short-term and long term morbidities associated with caesarean sections and compare with that of vaginal deliveries. MATERIALS AND METHODS This is a prospective study conducted for 1 year in SATH hospital, Govt. Medical College Trivandrum, a tertiary care center. Women delivered at SATH hospital during this period were included in the study. Sample size calculated as 500 in each group. Of the total 1000 cases studied, 500 cases were caesarean sections, and 500 vaginal deliveries. They were followed up during labour, in the postpartum period, 6 weeks, 6 months and 1 year from the time of delivery and the morbidities were studied. Statistical tests used were mean, percentage, chi square and Fischer’s exact test to assess association of the selected parameters with the type of delivery. RESULTS Majority of caesarean sections (73.4%) were emergency. Previous caesarean section (53.6%) was the leading indication. Intra operative morbidities like excessive blood loss had significant association with caesarean section. 3.2% in the caesarean group required blood transfusion compared to 1% in vaginal delivery group. Intraoperative complications like broad ligament hematoma, adhesions and bladder injury and anaesthesia complications were present in 7% of cases. Short term morbidities like fever, urinary retention, sepsis were significantly more in the caesarean group (9.2%) versus 0.8% in vaginal deliveries. Occurrence of Severe Acute Maternal Morbidity following caesarean section was 0.2-2%. Caesarean section group had longer duration of hospital stay. Long term morbidities like backache and wound related problems were significantly high in caesarean group. CONCLUSION Caesarean section was associated with significantly high incidence of maternal morbidities both intraoperative as well as short and long term morbidities compared to vaginal deliveries.
