الفهرس 
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Abstract
There are two principal types of caesarean section: elective (caesarean section without labour) and emergency (caesarean section performed during labour).Emergency caesarean sections are performed either in the first stage (active labor with aless than full cervical dilatation) or in the second stage (labor with full cervical dilatation) of labour.
The most common cause of caesarean section in the first stage was cervical dystocia . On the other hand caesarean delivery in the second stage of labour accounts for approximately one fourth of all primary caesareans and the principle cause was obstructed labour.
This hospital based cohort study was performed at Ain Shams Maternity hospital where one thousand and two hundred (1200) patients from labour word were included in the study.
This study showed high rates of both maternal and neonatal morbidity associated with primary caesarean section in the second stage of labor. Increased maternal morbidity included longer operation time, uterine incision extension, atonic postpartum hemorrhage, increased hospital stay, hemorrhage,need for blood transfusion .
Caesarean section during the second stage of labor was technically difficult this is often due to deeply impacted fetal head, difficulty in dissecting the bladder, difficulty in identification of limits of lower uterine segment, and decreased amniotic fluid.
The inceased incidence of hemorrhage was due to both intraoperative uterine incision extension and uterine atony.
In this study the neonatal complications were also increased in the seconed group more than first group and this was due to prolonged duration of labor. These complications included increased incidence of neonatal asphyxia and low 5 minutes Apgar score, increased need for intubation, increased incidence of : birth injuries, neonatal seizures, septicemia, systemic infection, and neonatal mortality.
It is to be noted that further larger studies are still needed to confirm these results and to determine the hazards associated with caesarean section in the second stage of labor.