Shazia Aft Ab, Samina Ayaz, Erum Khalid, Tahmeena Ali, Fariha Hussain, Komal.
A comparative analysis of indications of primary cesarean section in multigravida and primigravida.
Pak J Surg Jan ;36(3):264-9.

Background: The number of caesarean sections (CS) has been on the rise over the last decade. caesarean section are potentially life-saving, a medically necessary caesarean section can prevent maternal and infant mortality. The adverse maternal and perinatal outcomes when a caesarean section is not medically necessary have become a major public health concern as the associated expenses decrease resources available for other maternal and child health interventions. Aim and objective: The aim of study is to compare the incidence and indications of primary caesarean section in multigravida and primigravida. Material and Methods: This is a prospective comparative study of primary caesarean section in multigravida and primigravida in duration of one year between January 1, 2018 and December 2018 at Jinnah Medical College Hospital, Karachi. All the deliveries were included i.e. vaginal and cessarean sections and were divided into two groups i.e. primigravida and multigravida and patients who had undergone primary cesarean section were taken as cases. Patients who had repeat caesarean section were excluded from the study. Statistical analysis was conducted using SPSS version 23. Results: During the one year study period, total deliveries were (1032) out of which vaginal deliveries were (639) i.e. 61.91% and total cessarean section were (393) with rate of 38.08. Women who had cessarean section for the first time (primary cessarean section) constituted 26.06% of total. From the total primary cessarean sections more than 2/3 were primigravidas i.e. 62.8% and multipara were 37.17%. Conclusion: The study presents the higher incidence of primary caesarean section in primigravidas. Failure to progress of labour and foetal distress were leading causes in both groups, adequate uterine contractions during active phase and intensive foetal monitoring may reduce the caesarean section rate.

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