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.