PRIMARY CAESARIAN SECTION IN MULTIPARA WITH NEONATAL OUTCOME: A CLINICAL STUDY FROM TERTIARY CARE CENTRE AT GOVERNMENT GENERAL HOSPITAL, ANANTHAPURAMU.

Abstract

BACK GROUND: One of the most commonly performed operations in modern obstetrics is caesarean section.  Primary caesarean section in a multipara means first caesarean section done in the patients who had delivered vaginally once or more.  Mainly malpresentations and fetal distress are responsible for caesarean section in multipara.  AIMS AND OBJECTIVES: To study the incidence, indications, maternal and fetal outcome in primary caesarean section in multiparous women.  MATERIAL AND METHODS:  It is a retrospective observational hospital based study of 100 cases of primary caesarean section admitted at Government General Hospital, Ananthapuramu during the period January – December, 2019.   Cases requiring elective and emergency caesarean sections were included in the present study.  Various indications for caesarean section, intraoperative details, maternal and fetal outcome were recorded.  RESULTS: Most of the cases were unregistered and referred as emergency.  Most common age group was 25 – 30 years and majority were 2^nd and 3^rd gravidas.  Malpresentations (24%), fetal distress (20%), antepartum hemorrhage (12%), CPD (9%), and prolonged labour (9%) were the main indications for primary caesarean section.  CONCLUSION: Even though parous women who had previous normal vaginal delivery, there were many complications like increased incidence of malpresentations, CPD, placenta previa and others which may need caesarean section.  The fact that a multipara has had one or more vaginal deliveries should be regarded as an optimistic historical fact, not as diagnostic criteria for spontaneous delivery of the pregnancy at hand.