Caesarean section (C/S) in the second stage of labour is associated with many maternal and neonatal complications, inspite of that little has been paid to its rise in obstetrical practice. This is a hospital- based study conducted at Omdurman maternity hospital (OMH) during the period from January 2012- December 2013 to assess maternal and neonatal complications associated with C/S performed in the second stage of labour. Records of all patients delivered by emergency C/S at full dilatation of cervix over two years were reviewed (10988). Women delivered by emergency C/S during second stage of labour included in this study were 470 out of 10988 (4.3%). All had term singleton pregnancy; of them 256 (54.5%) were primigravida. Labour started spontaneously in 428 (91.1%), 300 (63.8%) were augmented by oxytocin and decision for C/S was made by resident registrars for 427 (90.9%). Failure to progress in second stage of labour was the commonest indication for second stage C/S, in 459 women out 470 (97.7%). Unsuccessful instrumental delivery was 56 (11.9%). Intra-operative complications developed for 240 (51.1%), including; extended uterine tear, intra-operative bleeding, bowel, bladder, ureter and baby injuries. Post-operative complications reported in 142 (30.2%), mainly due to puerperal infection, post partum haemorrhage (PPH), paralytic ilius, wound dehiscence and one maternal death. Twenty three (4.9%) had fresh still birth (FSB) and seven (1.5%) perinatal deaths, 138 (29.4%) were admitted to neonatal unit. C/S in the second stage of labour carries a high maternal and neonatal mortality and morbidity, which necessitates involvement of senior obstetrician in decision – making and delivery.
 

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