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A Clinical Study of Primary Caesarean Sections in Multipara

Kusuma Naik M.V., Assistant Professor, Department of Obstetrics and Gynecology, ESICMC & PGIMSR, Rajajinagar, Bangalore, Karnataka 560010, India. , Vedavathy Nayak1 , Kusuma Naik M.V.2 , Shwetha Sharan3 , Renuka Ramaiah4

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Indian Journal of Obstetrics and Gynecology 6(4):p 400-404, July - August 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.6418.11

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Abstract

Aims and Objectives: The aim of this study was to evaluate the incidence, indications, maternal and foetal outcome in parous women who underwent caesarean section for the first time and who had delivered vaginally previously.

Material and Methods: This is a prospective study of 129 cases of primary caesarean section done between October 2015 to September 2016 in multiparous
women at ESICMC & PGIMSR hospital, Bangalore. Both elective and emergency caesarean sections in multipara were included in the study. Incidence according to age, gestational age, spacing between births, parity, antenatal complications, indication for LSCS, whether labour was spontaneous or induced, intraoperative and post operative complications were recorded. Foetal outcome was also evaluated.

Results: The primary caesarean section rate in multipara was 8.48%. Most were in the 26 – 30 age group and majority were primipara. Foetal distress (34.88%) was the commonest indication for caesarean section followed by abnormal presentations (22.48%) and prolonged labour (9.3%). In our study severe oligoamnios with fetoplacental insufficiency contributed to 8.53% of caesarean sections in multipara. 6.20% of women had caesreans for antepartum haemorrhage.

Conclusion: Though previous vaginal delivery is a factor in favour of vaginal delivery in the next pregnancy in a parous woman, caesarean section is not uncommon and is showing an increasing trend. The causes are complications like foetal distress, malpresentations and the increasing incidence of hypertension, diabetes and oligoamnios. Physician factors like increased intra partum surveillance and use of electronic foetal monitoring due to medicolegal concerns could be a factor for foetal distress being the commonest indication for Caesarean section in multipara.

Keywords: Caesarean Section; Multipara; Primary; Foetal Distress

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DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.6418.11

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