Publication:

A study on primary caesarean section in multigravida patients at a tertiary care center

Background Historically, most caesarean delivery took place because of or in association with obstetric complications or medical illness. However, rates of elective primary caesarean deliveries with no clear medical or obstetrical indication are rising dramatically. The most common indication for primary c-section include in order of frequency labor dystocia, abnormal or indeterminate fetal heartrate tracing, fetal malpresentation, multiple gestation, fetal macrosomia. Many other factors that have contributed to the increasing rate of caesarean include improved surgical technique and patient demand and pressure on caregivers to practice “defensive medicine”. The increasing rate of caesarean section is a matter of international public health concern as it increases the caesarean related maternal morbidity and fetal complications as well as the cost of health care as compared to normal delivery.

Methods This study was carried out in the Department of Obstetrics and Gynecology at PDU Medical College and Hospital Rajkot, Gujarat from January 2021 to June 2022.

Results The study was conducted on 234 cases, the percentage of primary caesarean section in the study population of PDU Medical College Rajkot was found to be 2.96%. In this study, 38.46% of patients belonged to 26-30 year age group. In this study, 78.63% of multigravida patients were 2nd and 3rd para. There were 41.45% of cases underwent LSCS for foetal distress, 12.39% for antepartum haemorrhage, 12.82% for malpresentation and rest for various other indications. 33.33% of the study population in this study belonged to Robson’s group 3, 26.92% were included in category 4a, 15.81% belonged to category 4b. Among all deliveries 94.87% were live births whereas 5.98% were still births.

Conclusions Many unforeseen complications occur in women who previously had a normal vaginal delivery. It is recommended that all antenatal patients must be booked and receive proper and regular care. Also 100% deliveries in multigravida should be institutional deliveries in order to reduce maternal and perinatal morbidity and mortality.