Complications associated with cesarean section in the second stage of labor

Objective: To determine maternal and neonatal complications associated with cesarean section done in the second stage of labor. Method: Cohort study comparing cesarean sections done in the second stage of labor (cases) with those done for poor progress in the first stage (controls). Only singleton cephalic live pregnancies at 36 weeks or more, without previous cesarean section, were included. Result: There were 39 cases and 39 controls. Cesarean section in the second stage of labor took significantly longer (median 45 vs. 30 min; P < 0.001), and was associated with more frequent postoperative pyrexia (10 vs. 2; P = 0.012). There were more neonatal admissions in the case group (17 vs. 3; P < 0.001). Hypoxic ischemic encephalopathy was more frequent in infants following second-stage cesarean section (8 vs. 1; P = 0.013), as was subaponeurotic hemorrhage (6 vs. 0; P = 0.012). Conclusion: Cesarean section in the second stage of labor is associated with significant intraoperative and neonatal morbidity.