Clinical study of primary cesarean section in multiparous women

Abstract

Aims & Objectives: To study the incidence, indications of primary caesarean section in multiparous women. To study the maternal and perinatal outcome after primary caesarean section in multiparous women. Materials and Methods: It is a prospective study of 120 cases of caesarean section done for the first time in multipara for a period of 8months from 1 st January 2019 to 31 st Aug 2019 at government general hospital, Anantapuramu. For all the cases, blood was sent for basic investigations like Haemoglobin, Random blood sugar, Blood grouping and typing, total count, differential count. Special investigations like Liver function tests, Renal function tests done when required and Ultrasonography for placental localization, estimated fetal weight and to rule out abruption. Results: There were 6210 deliveries during this period and 2405 caesarean sections were done, which represented 38.7% of all deliveries. Incidence of primary caesarean sections in parous women is 4.9% of all caesarean sections. Majority (55%) of patients were from the age group 21-25yrs. 32.5%patients were booked cases and 67.5% were unbooked cases. Among the various maternal indications for caesarean section, fetal distress(25%) and malpresentations(23.3%)were common in multipara.There were no cases of maternal mortality in our study. Wound sepsis and pyrexia were more common causes of post operative morbidity. A total of 37 (30.8%) babies were admitted in NICU. Most common indications for NICU admissions were Meconium aspiration syndrome and Prematurity. Conclusion: From the above study it is very clear that, many unforeseen complications can occur in woman who previously had a normal vaginal delivery. Difficult vaginal delivery and obstructed labour carries more morbidity and perinatal mortality when compared to caesarean section. Good antenatal and intrapartum care and early referral will reduce the maternal and perinatal morbidity and mortality in multipara.