title: Fetal outcome in emergency versus elective cesarean sections at Souissi Maternity Hospital, Rabat, Morocco.
abstract: BACKGROUND
  Perinatal mortality rates have come down in cesarean sections, but fetal morbidity is still high in comparison to vaginal delivery and the complications are more commonly seen in emergency than in elective cesarean sections. The objective of the study was to compare the fetal outcome and the indications in elective versus emergency cesarean section performed in a tertiary maternity hospital.
  
  
  METHODS
  This comparative cross-sectional prospective study of all the cases undergoing elective and emergency cesarean section for any indication at Souissi maternity hospital of Rabat, Morocco, was carried from January 1, to February 28, 2014. Data were analyzed with emphasis on fetal outcome and cesarean sections indications. Mothers who had definite antenatal complications that would adversely affect fetal outcome were excluded from the study.
  
  
  RESULTS
  There was 588 (17.83%) cesarean sections among 3297 births of which emergency cesarean section accounted for 446 (75.85%) and elective cesarean section for 142 cases (24.15%). Of the various factors analyzed in relation to the two types of cesarean sections, statistically significant associations were found between emergency cesarean section and younger mothers (P < 0.001), maternal illiteracy (P = 0.049), primiparity (P = 0.005), insufficient prenatal care (P < 0.001), referral from other institution for pregnancy complications or delivery (P < 0.001), cesarean section performed under general anesthesia (P < 0.001), lower birth weight (P < 0.016), neonatal morbidity and early mortality (P < 0.001), and admission in neonatal intensive care unit (P = 0.024). The commonest indication of emergency cesarean section was fetal distress (30.49%), while the most frequent indication in elective cesarean section was previous cesarean delivery (47.18%).
  
  
  CONCLUSIONS
  The overall fetal complications rate was higher in emergency cesarean section than in elective cesarean section. Early recognition and referral of mothers who are likely to undergo cesarean section may reduce the incidence of emergency cesarean sections and thus decrease fetal complications.
authors.affiliation: National Reference Center in Neonatology and Nutrition, Children's Hospital, University Hospital, Rabat, Morocco; Research Team on Health and Nutrition of Mother and Child, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University of Rabat, Morocco.
authors.forename: Soukayna
authors.initials: S
authors.lastname: Benzouina
authors.affiliation: National Reference Center in Neonatology and Nutrition, Children's Hospital, University Hospital, Rabat, Morocco; Research Team on Health and Nutrition of Mother and Child, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University of Rabat, Morocco.
authors.forename: Mohamed El-Mahdi
authors.initials: Mel-M
authors.lastname: Boubkraoui
authors.affiliation: Research Team on Health and Nutrition of Mother and Child, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University of Rabat, Morocco; Departement of Public Health, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University of Rabat, Morocco.
authors.forename: Mustapha
authors.initials: M
authors.lastname: Mrabet
authors.affiliation: Research Team on Health and Nutrition of Mother and Child, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University of Rabat, Morocco; Souissi Maternity Hospital, Rabat, University Hospital, Morocco.
authors.forename: Naima
authors.initials: N
authors.lastname: Chahid
authors.affiliation: Research Team on Health and Nutrition of Mother and Child, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University of Rabat, Morocco; Souissi Maternity Hospital, Rabat, University Hospital, Morocco.
authors.forename: Aicha
authors.initials: A
authors.lastname: Kharbach
authors.affiliation: Cheikh Zaid Hospital, Abulcasis International University of Health Sciences, Rabat, Morocco.
authors.forename: Amine
authors.initials: A
authors.lastname: El-Hassani
authors.affiliation: National Reference Center in Neonatology and Nutrition, Children's Hospital, University Hospital, Rabat, Morocco; Research Team on Health and Nutrition of Mother and Child, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University of Rabat, Morocco.
authors.forename: Amina
authors.initials: A
authors.lastname: Barkat
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000379:methods*; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000379:methods; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D005315:Fetal Diseases / Q000453:epidemiology; D046689:Fetal Mortality; D006771:Hospitals, Maternity; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D009018:Morocco / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D055815:Young Adult
keywords: Elective cesarean section; emergency cesarean section; fetal outcome