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A study of Primary cesarean section in Multiparous women

Dr. Leena Gattam,D. Bindu

Published 2019 in Unknown venue

ABSTRACT

Aim: To study the incidence, indications for primary caesarean section in multiparous women and analysis of various related factors, To study maternal and fetal outcome after primary caesarean section in multiparous women and To investigate the association of high hsCRP (> 3 mg/L) levels with ischemic stroke and its subtypes in Indian patients. Place and duration of study: Gynaec & Obst. Department, Siddhartha Medical College / Government General Hospital, Vijayawada,Krishna District, Andhra Pradesh from Jan’2017 to June’2018. Methodology: 150 patients of primary cesarean sections in multipara done in Govt.General Hospital, Vijayawada attached to Siddhartha Medical College, Vijayawada were studied and analysed. This study includes the multiparous women who had delivered vaginally in previous pregnancies and are undergoing cesarean section for the first time. Results: Majority (67.33%) of patients were from the age group 21-25yrs. 79.33% patients were booked cases and 20.6% were unbooked. Anemia (57%), antepartum hemorrhage (24%), malpresentations and severe preeclampsia (20%) were most frequently encountered antenatal complications in multiparous women. Antepartum hemorrhage (24%) and fetal distress (24%) were the common indications for cesarean section in multiparous women. There were no cases of maternal mortality in our study. Paralytic ileus and puerperal sepsis were more Common post operative morbidity and seen in 3 cases each. 32.66% babies were admitted in NICU. Most common indications for NICU admissions were meconium aspiration syndrome and prematurity. Perinatal mortality in the study was 15.6% and among them Antepartum hemorrhage has the highest perinatal mortality rate of 56.25%. Conclusion: The most common indications for cesarean sections in multipara are antepartum haemorrhage, fetal distress and malpresentations. Cephalopelvic disproportion in multipara can be more significant and dangerous than in primipara because delay in recognition leads to obstructed labour and second stage cesarean sections which carry more maternal and fetal morbidity. Good antenatal and intrapartum care and early referral will reduce the maternal and perinatal morbidity and mortality in multipara. Multipara in labour should be given the same attention as primigravida.

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    2019

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