Publication:

Incidence, indication and complications of primary caesarean section in primigravida and multigravida at secondary care centre

Background Caesarean section (CS) is one of the most common obstetric surgeries, with rates rising globally beyond the World Health Organization’s recommended 10–15%. Its overuse increases maternal risks like hemorrhage and abnormal placentation and neonatal issues such as respiratory distress. Understanding the incidence and causes of primary CS, especially in primigravida and multigravida, is essential. This study aimed to compare their incidence, indications and maternal-fetal complications at a secondary care hospital.

Methods This prospective observational included a total of 1200 women were enrolled 600 primigravida (Group A) and 600 multigravidas with previous vaginal deliveries (Group B). Women with prior CS or non-viable pregnancies were excluded. Data on demographics, obstetric history and outcomes were recorded. Mode of delivery, CS indications and complications were analyzed. Statistical analysis was done using SPSS v26; p<0.05 was significant.

Results Of 1200 women, 315 (26.25%) underwent CS, more in primigravida (30.33%) than multigravida (22.17%). Elective CS was higher in Group A (15.0% vs 8.5%), most often for oligohydramnios. Emergency CS was mainly for fetal distress in primigravida (32.61%) and meconium-stained liquor in multigravida (24.39%). PPH was more frequent in multigravida (9.02%). Neonatal outcomes showed no significant differences.

Conclusions Primary CS was more common in primigravida, especially elective cases. Fetal distress and meconium-stained liquor were leading emergency indications. PPH was higher in multigravida, while neonatal outcomes were comparable. Improved antenatal care and counselling may reduce unnecessary CS, with parity-based interventions enhancing outcomes.