Résumé
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.
Résumé
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.
Résumé
Background: Caesarean section is the most commonly performed surgery in obstetrics and there is a rise in caesarean section rates in recent times. This study was undertaken to know the changing trends in caesarean section rate in a rural hospital and to examine the indications contributing to it. The objective of the present study was to know the prevalence and changing trends in caesarean section over the last 6 years (April 2012-March 2018).Methods: Demographic data for all the deliveries, mode of delivery and indications of caesarean sections performed from April 2012 to March 2018 that occurred at MIMS were collected in a retrospective manner.Results: Among a total of 12,522 women delivered during the study period of 6 years, 44.93%, 48.49%, 48.41%, 50.9%, 45.48% and 49.62% were delivered by caesarean section during 2012-2013, 2013-2014, 2014-2015, 2015-2016, 2016-2017 and 2017-2018 respectively. Increase in repeat caesarean section is the primary reason for these increased rates followed by fetal distress. There is a rise in the repeat caesarean section from 44.36% in 2012-2013 to 55.67% in 2016-2017 and 47% in 2017-2018. Whereas primary caesarean section rate reduced from 55.63% in 2012-2013 to 44.32% in 2016-2017 and 53% in 2017-2018.Conclusions: As repeat caesarean section and fetal distress are the most common causes of caesarean section we need to address these to bring down the caesarean section rate.
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Background: Auditing c section rates can be done using Robson’s classification which in turn helps achieve a uniform basis for comparison across centers and across various countries.Methods: A retrospective analysis was done in a tertiary care hospital in north Karnataka KIMS, over a period of 6 months May 2017 to October 2017. All cases of LSCS done during this period were classified according to Robson’s classification and analyzed.Results: Out of 5080 overall deliveries 1876 delivered by cesarean section attributing to 36.76% cesarean section rate. Highest contribution was from group 5 (36%) and group 2 (19.24%).Conclusions: Robson’s classification helps to identify and analyze the group that contribute to the most to overall cesarean section rate and this helps us to modify strategies and interventions to optimize cesarean section rate.
Résumé
Background: This prospective study was carried out to assess, indication, maternal & fetal outcome of primary caesarian in multiparous women. Materials & Methods: 50 women with primary CS (caesarean section) studied in multiparous women studied and analysed. Results: Most of women belonged to >25yrs age group, rural, & low socio-economic group, Malpresentation, Low AFI (amniotic fuid index), Fetal Distress were most common indications. Post operative uneventful in majority of cases. Conclusion: Antenatal care in multigravida, USG (ultra-sonography) Analysis Close monitoring can reduce CS(caesarean section) in multipara.