Title: Institutional Study of Primary Cesarean Section among Multigravida
Authors: Dr Sherin Sams, Dr Cicily T J, Dr Anjana Balachandran
DOI: https://dx.doi.org/10.18535/jmscr/v5i4.158
Abstract
Background & Objectives: It is a study of the analysis of primary caesarean section done in women who had previous vaginal delivery of a viable neonate. The various indications for caesarean section, incidence according to age, gravidity and maternal and fetal outcome were studied.
Aim Of Study
1. To know the indications of primary caesarean section in multigravida.
2. To study incidence according to age and gravida.
3. To study maternal and fetal outcome.
Methods
Study Design: Prospective observational study
Study Settings: Department of Obstetrics and Gynaecology, Government Medical College, Kottayam, Kerala, India.
Study Duration: April 2013 – September 2014
Result: Maximum numbers of patients were in the age group of 25-29 years and majority were second gravida. Majority had emergency caesarean section and main indications were pathological CTG and malpresentations .most common intraoperative complication was atonic PPH and most common postoperative morbidity were Wound infection and respiratory tract infection. There were no maternal deaths in the present study. Perinatal morbidity was seen in 27 cases and there were 4 cases of perinatal mortality.
Conclusion & Interpretation: Even with regular antenatal care, primary caesarean section may be unavoidable in parous women with previous vaginal delivery. Even though caesarean section is relatively safer than before, with emergency sections inherent complications do exist, but with good antenatal care, early recognition and timely intervention we can improve the maternal and fetal outcome.
Keywords: Caesarean section; Multipara, Abdominal Delivery, Postcaesarean Section
References
1. Gary F Cunningham, Kenneth J Leveno, Steven L Bloom, John C Hauth, Lassy C Gilstrap III, Katharine D Wenstrom. Cesarean delivery and peripartum hysterectomy. In Williams Obstetrics, 23rd Ed. United States of America; Appleton & Lange, 2010: p. 544-563.
2. Hickl EJ. The safety of caesarean section. In: Popkin DR and Peddle LJ, Eds. Women’s Health Today. London: Parthenon Publishers, 1994. P. 65-70.
3. Mala Vijaykrishnan, BhaskarRao K. Cesarean deliveries – Changing Trends. In: Arulkumaran S, Ratnam SS, Bhasker Rao K Editors. The Management of Labour, 2nd Ed., Hyderabad, Orient Longman, 2005: p. 351-63.
4. Basak S, Lahiri D. Dystocia in Eutocicmultigravidae. J. Obstet&Gynec 1975; 25: 502-7.
5. John F Sullivan. Hazards associated with multiparity. J. Obstet&Gynec. Brit. C Wlth 1963; 70: 158-64.
6. Sarah Jacob, Hitesh Bhargava. Primary caesarean section in multipara. J Obstet&Gynec India 1972; 22(6): 642-50.
7. Kala Vashishta, RekhaLogawney, Gupta AM. Primary caesarean section in grand multipara. J Obstet&GynecInd 1974; 26: 386-90.
8. Robinson AL. British Medical Journal 1930; 2: 47.
9. Diana B Petitti. Maternal mortality and morbidity in caesarean section. Clinical Obstetrics &Gynecology 1985 Dec; 28(4): 763-68.
10. Samir Prasad Sen. Primary caesarean section in multipara. J. Obstet&Gynec India 1967 June; 17: 522-29
11. RakshaArora, AshaOumachigui. A study of patterns and maternal morbidity in caesarean section. Journal of Obstetrics &Gynecology 1991 April; 192-97.
12. Pal SK. Stillbirths in caesarean section – A critical review. J. Obstet&Gynec. Ind 1992; 10: 616-19.