Objective: To evaluate neonatal outcome between general elective repeat cesarean section (ERCS) at gestational age at birth <39 or ≥39 weeks, and to assess the neonatal adverse outcome of delivering by emergency cesarean section (CS).

Materials and Methods: Retrospective cohort study of 1,461 singleton pregnant women scheduled for repeated CS at term from the Department of Obstetrics and Gynecology, Prapokklao Hospital from January 2013 to December 2015. The women were divided into two groups for CS at 37 - 38⁺⁶ weeks or at 39 - 42 weeks. Primary objective was the adverse outcome of neonatal including pulmonary complication, hyperbilirubinemia, APGAR score at 5 min <7 and admission at neonatal intensive care unit (NICU). Independent t-test was used to compare maternal age and birth weight. Fisher exact test and Pearson’s chi-squared were used to compare nominal data between the two groups.

Results: CS of 1,048 (71.7%) cases was performed before 39 completed weeks of gestation while 413 (28.3%) cases were operated at ≥39 weeks of gestation. Neonatal outcome between the 2 groups were not statistically different. Patients of parity >2 signified more risk for emergency CS than those of parity ≤2 (2.16% versus 0.84%). Premature rupture of membrane (PROM), which is one of the causes of unplanned CS was found 3.82% in gestational age <39 weeks group, compared to 1.69% in gestational age ≥39 weeks group (p-value 0.047). In emergency CS, the neonates were prone to NICU admission 3% (p-value 0.042).

Conclusion: There is no significant adverse neonatal outcome of ERCS at gestational age <39 or ≥39 weeks. The adverse neonatal outcome from emergency CS was NICU admission.

Keywords: Previous cesarean section, Emergency cesarean section, Elective caesarean section, repeated cesarean delivery