Comparing Maternal and Fetal Outcomes of Emergency Cesarean Deliveries: Booked vs. Unbooked Cases (Code-T0023)

Introduction: Cesarean deliveries are increasingly common, with significant risks in emergency settings, particularly among unbooked rural referrals. Unbooked cases often result in poorer maternal and fetal outcomes due to inadequate prenatal care and delayed interventions.

Aim and Objectives

Aim

• To study the maternal and fetal outcome of emergency caesarean delivery between unbooked rural referrals and booked cases at kamineni institute of medical sciences Narketpally.

Objectives

• To study the maternal and fetal outcome of unbooked rural referrals who undergo emergency caesarean delivery at KIMS , Narketpally, Nalgonda.
• To study the obstetric outcome of booked cases of KIMS, Narketpally,who undergo emergency caesarean delivery.
• To compare the obstetric outcome of unbooked rural referrals and booked cases of KIMS Narketpally, who undergo emergency caesarean delivery at KIMS Narketpally, Nalgonda.
• To study, evaluate and compare the risks and complications associated with emergency caesarean delivery in both booked and unbooked cases.
• To study and compare the demographic characters of both groups.

Methods: This comparative cross-sectional study included 570 unbooked rural referral cases and 430 booked cases undergoing emergency cesarean delivery. Data on demographic characteristics, indications for surgery, and outcomes were collected. Statistical analysis was performed using Pearson's Chi-square test, with a significance threshold of p<0.05.

Results: Emergency cesarean rates were higher among unbooked cases (58.14%). Unbooked cases exhibited significantly higher rates of maternal complications, including postpartum hemorrhage (24.1% vs. 9.5%), wound infections (12.8% vs. 5.9%), and maternal near-miss events (18 vs. 4 cases). Fetal outcomes were poorer in unbooked cases, with higher perinatal mortality (p<0.05), low birth weight (40.2% vs. 11%), and NICU admissions (65.5% vs. 35.1%). Factors such as lower socioeconomic status, illiteracy, and inadequate transport contributed to poor outcomes.

Conclusion: The study highlights significant disparities in maternal and fetal outcomes between booked and unbooked emergency cesarean cases, underscoring the need for improved antenatal care access, health education, and timely referrals in rural areas.

Keywords: Emergency cesarean, maternal outcomes, fetal outcomes, unbooked cases, antenatal care, rural referrals