Publication:

Study of primary caesarean section among multiparous women in tertiary care centre of Bastar region: a prospective study

Background In this study was to know the incidence of primary Caesarean section in multigravidas, its indications among these patients.

Methods Prospective observational study. All deliveries at Late Baliram Kashyap Memorial Hospital and Govt Medical college Jagdalpur, Bastar, Chhattisgarh, India. 8729 deliveries during the period of 2 year from January 2022 to December 2023. Multigravida women admitted to hospital with pregnancy of >28 weeks gestation (gravida 2 and above), each of whom has had a previous vaginal delivery of >28 weeks gestation were included. Women with previous abortions and previous section were excluded. Indication of caesarean section, obstetric history, antenatal history.

Results A total of 8729 deliveries were conducted in the institute Lt shri BRKM Govt Medical College Jagdalpur Chhattisgarh among which 2709 (31%) were caesarean sections and 6015 (68.9%) were conducted vaginally. Total number of primary CS in multiparous women were 642 about 23.6% of the total CS rate. The mean age is 26±4 years ranged from 18 – 40 years. Most of the patients were in the age group of 26-30 years (45.01%) followed by 21-25 years (26.01%) Out of 642 primary cs in multipara, 316 (50.6%) cases underwent emergency CS whereas rest 326 went elective CS. Maternal and fetal indications contributed 21% and 79%.

Conclusions Many unforeseen complications occur in women who previously had a normal vaginal delivery. With this study we came to the conclusion that fetal distress is the major contributor of primary CS in multigravida. Thus, preventive measures should be taken to decrease the fetal distress and non-progress of labour.