Indications of Primary Cesarean Section In Multipara

Abstract

Objective: To evaluate the indications of primary cesarean section in multipara and to assess the obstetric outcome including
maternal, fetal morbidity and mortality, perinatal outcome.
Study Design and Setting: It was a hospital based study of primary caesarean sections (CS) done on multiparous patients
in duration of two years between January 1, 2016, and December 2017 at Jinnah medical college hospital Karachi.
Methodology: Multiparous patients were those who had delivered through vaginal route one or more times (i.e. 28 weeks
of gestation or above) or had 1–4children and grand-multiparous are those who had 5 or more children. All the cases
included in the study were hospital based and cesarean section was decided by specialist. The procedure was performed
by registrars and specialists. The selected patients were followed up till they were discharge from the ward with minimum
hospital stay of three days. Data was compiled and results were carried out by SPSS version 23.
Results: During the two years of study period, the number of total deliveries were 2064. The primary CS rate in multipara
was 37.17%. These women have more likely to have an emergency cessarean sections compared to elective i.e. 85%
and15%. The mean age of women was 29.5 years, booked cases were 72.5% and unbooked were 27.5%. Regarding
indications for cesarean sections, non-progress of labour ranked first 25.5% followed by fetal distress 20%, pre eclampsia
12 % and ante partum hemorrhage 10.5% etc. Increase incidence of morbidity and mortality was seen in patients undergoing
cesarean section due to different reasons.
Conclusion: Primary caesarean sections in multipara comprise only a small percentage (37.17%) of total deliveries but
were related to high maternal and fetal morbidity.