Comparative study of maternal morbidity in primary and repeat caesarean section

Abstract

Background: Caesarean section (CS) is the most common obstetric operative procedure worldwide with a continuously increasing incidence for the last couple of decades, giving the women, an obstetric status of "previous caesarean section. Hence here is a study to note the increasing incidence of complications as the number caesarean sections increase. Objectives: To study intra operative and postoperative maternal morbidity up to end of 1 st week in primary and repeat caesarean section in singleton pregnancies. Materials & Methods: This is a hospital based observational prospective clinical study of 100 primary and 100 repeat caesarean sections in term singleton pregnancies. Results: Present study was performed on randomly selected 200 cases of which 100 cases are primary and 100 cases are repeat caesarean. In our study incidence of Caesarean section was 33%, among them Repeat Caesarean accounted for 42.5%. The highest prevalence of caesarean was seen in age group of 23-27yrs (49%) and mean age was 27.5yrs. In our study highest incidence of complications was observed in women who underwent previous two caesarean sections, of which adhesions were observed in 36.5%, in primary-0%, 1 st repeat-38%, 2 nd repeat-72%. mean loss of Hb in primary-1.00, 1 st repeat-1.07, 2 nd repeat-1.47 and P-value-<0.0001(Highly Significant). Conclusion: Maternal morbidity is definitely high as the number of caesarean sections increase. The increasing trend towards caesarean section should be brought down by educating the patients about need for good antenatal care, correction of anemia, need of last few visits to a tertiary level centre in order to decide the mode of delivery. Proper counseling of the women should be done for spacing of pregnancies in previous caesarean cases & there would be better chance for a successful VBAC later.