Caesarean section at full dilatation: What are the risks to fear for the mother and child?

Objectives.- Caesarean section is associated with increased maternal morbidity compared to a vaginal delivery, especially if it occurs during labour. Little data on caesarean section performed at full dilatation is available. Methods.- This was a retrospective study done in University Hospital of type 3 over a period of ten years, including future primiparous patients who had a caesarean section performed at full dilatation, compared to a control group of patients whose caesarean section was conducted in first part of the labour. We collected different maternal data per-and postoperative and neonatal. Results.- In total, 824 patients were enrolled including 412 in each group. For caesarean section at full dilatation, foetal extraction required more manoeuvres (RR = 3.05; 95% CI: 2.1; 4.39; P < 0.001); wenoted more extension of hysterotomy (RR =1.79; 95% CI: 1.30; 2.46; P < 0.001). Postoperative and neonatal maternal morbidity was not different, except more frequent neonatal trauma for caesarean section at full dilatation. Conclusion.- A caesarean section at full dilatation has an excess intraoperative risk and requires great caution. Nevertheless, no significant increase of postoperative and neonatal complications can be pioved. (C) 2017 Elsevier Masson SAS. All rights reserved.