Respiratory distress associated with elective repeat cesarean section. A two-year experience in one medical community

One hundred and forty-five elective repeat cesarean sections performed in one large medical community during a two-year period were studied. Ninety-nine of the patients had no prenatal test for determination of pulmonary or fetal maturity; 18 patients had an amniocentesis for L/S ratio. Only two infants were thought to be delivered prematurely, at 37 weeks gestational age. One of these infants had no respiratory distress. The other infant was delivered before the EDC by menstrual dates because a single ultrasound measurement performed one week before delivery suggested a "term fetus", and this infant had severe hyaline membrane disease. Six other infants had mild respiratory distress compatible with transient tachypnea or aspiration. In this medical community, one must question whether the risk of routine amniocentesis for L/S ratio before every elective repeat cesarean section might outweigh the potential benefits of the procedure.