Comparison of neonatal outcome between cesarean section and vaginal delivery at a secondary level hospital of Eastern Rajasthan
Abstract
There is controversy regarding betterment of cesarean section or vaginal delivery as per neonatal outcomes. So this study was conducted on 100 cesarean section and 100 vaginal delivery to compare the neonatal outcomes in cesarean section or vaginal delivery. Chi-square test and unpaired 't' tests were used to find out difference in proportion and means respectively. The present study revealed that there was no significant difference in neonatal outcomes in CS group and VD group in outcome of delivery, baby weight, and Apgar score after five minutes of delivery. Proportion of cases with reparatory distress were also without significant difference (p>0.05). Only significant (p<0.05) difference was observed in Apgar score at birth, where it was significantly more in CS group than VD group.
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Introduction
India has the highest number of neonatal mortalities in the world. As of 2015, 20% (1,201,000) of global under-five deaths occurred in India, meaning that one in every five global child deaths occurred in India.1 Over 50% of under-five deaths and 70% of infant deaths occur during the first 4 weeks of life.2
A survey was conducted in 596 Indian districts to compare the neonatal mortality3 and reported that NMR ranged from 4.3 (Kannur, Kerala) to 65.1 (Datia, Madhya Pradesh), with the mean NMR being 29.8. Almost two-thirds of the districts (n = 380, 63.7%) had NMRs between 20 and 40. The top third of neonatal deaths could be accounted for by just 71 districts of a total of 596.3
Reducing the maternal and neonatal mortality is one of top of health and development agendas. 4 The proportion of births by cesarean section (CS) has been chosen as the indicator of provision of lifesaving services for both mothers and newborns.5
Some studies favor elective cesarean delivery, and other surveys benefit vaginal delivery. Some studies recommend elective cesarean delivery to prevent urinary and fecal incontinence after vaginal delivery and adverse neonatal outcome.6–8 Other studies prefer vaginal delivery because cesarean delivery has a higher risk of maternal death,9 a longer recovery time and operative complications,10 a higher risk of unexplained stillbirths in subsequent pregnancies, 6 and respiratory problems of the newborn infant.11–13 Others,5,12,14 reported that good-quality care during labor, birth, and in the immediate postpartum period than the route of delivery plays a key role to prevent the onset of complications and enable their early detection and prompt management.
So this present study was designed to compare the neonatal outcomes of cesarean section and vaginal delivery in Eastern Rajasthan.
Conclusion
This present study concludes that there was no significant difference in neonatal outcomes in CS group and VD group in outcome of delivery, baby weight, and APGAR score after five minutes of delivery. Proportion of cases with reparatory distress were also without significant difference (p>0.05). Only significant (p<0.05) difference was observed in APGAR score at birth, where it was significantly more in CS group than VD group.
As there was not much difference in neonatal outcomes of cesarean section and vaginal delivery, so it is suggested that decision of type of delivery may be taken as per the indication.