Indications of primary caesarean section in multiparous women in patients of rural area of Western Maharashtra, India

Background: Caesarean section is commonly performed operation in women in last few decades and can be life saving for the child, the mother or both in certain cases. Primary caesarean section in the multipara means first caesarean section done in the patients who had previously delivered vaginally once or more. Aims and objectives of this study were to know the incidence and various indications of primary caesarean section in multipara.Methods: This was a prospective study of primary caesarean section in multipara women admitted at tertiary care hospital in western rural Maharashtra during the period of 6 months from January 2018 to June 2018. Multipara with pregnancy of >28 weeks gestation (gravida 2 and above), each of whom has had a previous vaginal delivery of >20 weeks gestation were included. Women with previous abortions and previous section were excluded.Results: Total no. of deliveries during this period were 4648.Total 1705 sections were performed during the same period. Thus, the incidence caesarean sections are 36.68%. Out of these sections 194 sections were performed in multipara for the first time, thus giving the incidence of 0.42% of total deliveries and 11.38% of total caesarean sections. Most common indication for caesarean section in multipara was malpresentation (19.6%) followed by foetal distress (16.49%) and severe pre-eclampsia (13.4%).Conclusions: Present study concludes that proper antenatal care should always be given to multipara even though there was history of previous vaginal deliveries.

Estimation of various associated factors in multiparous females undergoing primary caesarean sections at a tertiary care health centre in rural Western Maharashtra, India

Background: Caesarean section is one of the commonly performed operation in women due to safety reason and modern techniques. Primary caesarean section in the multipara means first caesarean section done in the patients who had previously delivered vaginally once or more. Aims and objectives of this study were to know association of various parameters like Age, Parity, Haemoglobin, Blood Pressure, Baby weight, Perinatal and Maternal Mortality with primary caesarean section among multipara.Methods: This was a prospective study of primary caesarean section in multipara women admitted at tertiary care hospital in western rural Maharashtra during the period of 6 months from January 2018 to June 2018. Multipara with pregnancy of >28 weeks gestation (gravida 2 and above), each of whom has had a previous vaginal delivery of >20 weeks gestation were included. Women with previous abortions and previous section were excluded.Results: Total 1705 sections were performed during the same period out of total 4648 deliveries. Out of these sections 194 sections were performed in multipara for the first time. Maximum numbers of patients (58%) were in the age group of 15-24 years and Parity 2 (68%). Almost 70% women among multipara have Hb <11 Mgm/dl. Most of the patients (84.53%) have normal Blood pressure readings. Most of the babies’ i.e.70 (36.08%) have birth weight in the range of 2.5-3 kg. Out of 194 deliveries, there were only 3 neonatal deaths (1.54%) and 1 maternal death (0.51%).Conclusions: Proper antenatal and intrapartum care and early referral can reduce the maternal and perinatal morbidity and mortality in multipara.

Correlation Between Age, Ipss, Prostate Size With Histopathological Findings And Management Of Patients Of Prostatism

Introduction:Benign prostatic obstruction/enlargement (BPO/BPE) is one of the important aetiology for Bladder outlet obstruction (BOO) in men. Study has been planned to measure various parameters of bladder dysfunction by using Cystometry in patients of Prostatism and to find out correlation between various parameters like age, prostate size, IPSS, management of patients with Prostatism, choice of operative procedure performed and various histopatho-logical findings. Methods: This was observational study. Total 75 patients with age> 50 year and IPSS > 19 having symptoms of Prostatism were included in the study. Patient detailed history was taken and demographic parameters with IPSS, histopathological findings, management plan, Ultrasonography findings were recorded in structured profor-ma. Results: It is seen that the maximum i.e. 39 (52%) cases of prostatism are observed in the age group of 60 to 70 years. The average age was 67.29 years. Maximum i.e. 31 (41.33%) cases of prostatism had prostate size in 50-70 gms.36 patients were managed by catheterisation while surgery was performed in remaining 39 patients. Transurethral resection of prostate (TURP) was performed in 36 of 39 patients. IPSS was decreased significantly from average of 26 to average of 22 after 2 weeks of operation/catheterisation. Conclusion: Prevalence of BPE increases with age as there found to be positive correlation between age and Prostate size. TURP was preferred procedure in our tertiary centre for the treatment of BPE. Significant decrease in IPPS suggests improvement in symptoms of BPE after operation/catheterisation.