Is Nulliparity a Risk Factor for Poor Obstetrical and Neonatal Outcomes in Rwandan District Hospital ? A Prospective Observational Study at Muhima District Hospital

ABSTRACT

Introduction: Nulliparity and multiparity are associated with different obstetrical and neonatal outcomes. The latter are well documented in the literature. What is not yet documented is whether such findings apply to Rwandan parturients. Objectives: The aim of this study was to determine whether the established differences in obstetrical and neonatal outcomes between nulliparas and non-nulliparas apply to Rwandan parturients.Methodology: It was a prospective; cross-sectional; analytical and case control study. Data were systematically collected from 608 parturients (300 nulliparas as study group and 308 multiparas as control; gestational age ? 28 weeks) at Muhima district hospital (Kigali City) from April 13th 2009 up to July 13th 2009. X2 test was used to compare observed proportions; and Student's t test to compare means.Results: The rate of spontaneous labour was significantly higher in multiparas than in nulliparas (96;7 vs 91;7; p = 0;008); and nulliparas had a significantly higher rate of induction of labour (8;2 vs 3;2 ; p = 0;008). The rate of cesarean delivery (28 vs 10;7; p 0;001) and the one of assisted vaginal delivery (1;6 versus 0;3 ; p 0;001) were significantly higher in nulliparas than in multiparas. Among indications of cesarean delivery; cephalo-pelvic disproportion (7versus 0;6; p