الفهرس 
? Changes in incidence of cesarean section4Only 14 pages are availabe for public view
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Abstract
This study was conducted at Ain Shams University maternity hospital throughout the period between 7-2018 and 1-2019 to find out the maternal and fetal morbidity in vaginal deliveries and cesarean sections either emergency or elective and to compare these results among a sample of women attending Ain Shams University Maternity Hospital in a period of 6 months.
Of all 1064 births during the study period, 43.8% were normal vaginal deliveries, 0.8% were operative vaginal deliveries, 26.5% as elective cesarean sections and 28.9% as emergent ones.
The incidence of total cesarean sections was 55.4%. The commonest indication for C-delivery was repeated cesarean section (48%) followed by failure of progress of labor (16.5%).
The total maternal morbidity due to causes attributed to mode of delivery in the current study was 1.3% in vaginal deliveries (non-instrumental vaginal deliveries and instrumental vaginal deliveries), while the total maternal morbidity in cesarean sections (elective cesarean section, emergency cesarean section) was 13.4% .
The most detected maternal morbidity among study group was maternal need to blood transfusion by 4.3% followed by maternal need for advanced surgeries by 3.3%, then febrile morbidity development, postpartum hemorrhage and wound infection by 2.5%, 2.2% &1.2% respectively while maternal ICU admission came at last by 1.1%.
The cesarean sections (elective & emergent) had higher risk of maternal need to blood transfusion, febrile morbidity development, postpartum hemorrhage comparing to instrumental and non instrumental vaginal delivery. While, instrumental vaginal delivery was associated with the highest statistically significant risk of maternal need for advanced surgery, low APGAR score, NICU admission and, need for assisted ventilation in comparison to cesarean section and non instrumental vaginal delivery.
In comparison between instrumental vaginal delivery and emergent cesarean section, the current study concluded that emergent cesarean section was more associated with maternal morbidities than instrumental vaginal delivery but, this difference was not statistically significant. On the other hand the instrumental vaginal delivery was more associated with neonatal ICU admission, low APGAR score, and need for assisted ventilation and this difference was statistically significant. This leads us to conclude that emergent cesarean can decrease incidence of NICU admission, low apgar score and need for assisted ventilation, but maternal morbidities remain higher compared to instrumental vaginal delivery.