Primary cesearean section in multigravidas

Sonia Arogya Prakash, Archana Vikram, Raja Gopal K., Poluri Seeta Lavanya


Background: Cesarean section is one of the widely performed surgical procedures across the world. Cesarean section is associated with increased risk of maternal morbidity and mortality, despite remarkable improvements in the safety. The objective of the present study is to study the cesearean section in the context of various indications, parity, intraoperative complications, post-operative morbidity, and perinatal morbidity among multigravidae undergoing cesarean section for first time.

Methods: The present study was carried out at Yenepoya medical college hospital. All multigravidas who had delivered vaginally once or more and who underwent primary caesarean sections for the first time during time period of August 2015-May 2016 were included in study and various factors are analyzed.

Results: In our study most of primary cesearean sections were in second paras who constituted 50%, followed by 4/> paras constituting 29.54%, and it was observed that incidence in third paras was 20.45%. 75% of the patients underwent emergency cesearean section and 25% had elective ceserean section. The most common indication for cesearean in our study was observed to be fetal distress accounting for 25% of the cases, 2nd most common being malpresentations (19.31%), non-progress of labor constituting 11.36% of cases. Intra operative complications were noted in 6.81% of cases, most common complication being extension of uterine incision extension of uterine incision.

Conclusions: Complications may occur in women who previously had a normal vaginal delivery requiring interventions in the form of caesarean section and is not uncommon. Though to a small extent, they are contributing to rise is total caesarean section rates seen. There are many cases where a caesarean becomes mandatory for her. The fact that a multipara who 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. A parous woman needs good obstetric care to improve maternal and neonatal outcome and still keeping caesarean section to a lower rate.


Caesarean section, Multiparous, Parous women

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Khan R, Blum LS, Sultana M, Bilkis S, Koblinsky M. An examination of women experiencing obstetric complications requiring emergency care: perceptions and sociocultural consequences of caesarean sections in Bangladesh. J Health Popul Nutr. 2012;30(2):159-71.

Lumbiganon P, Laopaiboon M, Gulmezoglu AM, Souza JP, Taneepanichskul S, Ruyem P, et al. Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08. Lancet. 2010;375(9713):490-9.

World Health Organization. Indicators to monitor maternal health goals: report of a technical working group, Geneva, 8-12 November 1993. Geneva. WHO. 1944. pp. 44.

Singh G, Gupta ED. Rising Incidence of Caesarean Section in Rural Area In Haryana India: A Retrospective Analysis. The Internet Journal of Gynecology and Obstetrics. 2013;17(2).

Gregory KD, Jackson S, Korst L, Fridman M. Cesarean versus vaginal delivery: whose risks? Whose benefits? Am J Perinatol. 2012;29:7-18.

Hickl EJ. The safety of cesarean section. In: Popkin DR and Peddle LJ, Eds. Women's Health Today. London: Parthenon Publishers. 1994. pp. 65-70.

Mala V, Bhaskar Rao K. Cesarean deliveries - Changing Trends. In: Arulkumaran S, Ratnam SS, Bhasker Rao K (Editors). The Management of Labour, 2nd Ed., Hyderabad, Orient Longman. 2005. pp. 351-63.

Basak S, Lahiri D. Dystocia in Eutocic multigravidae. J Obstet Gynec. 1975;25:502-7.

Desai E, Leuva H, Leuva B, Kanani M. A study of primary caesarean section in multipara. Int J Reprod Contracept Obstet Gynecol. 2013;2:320-4.

Al Rowaily. Cesarean section in a high-parity community in Saudi Arabia: clinical indications and obstetric outcomes. BMC Pregnancy and Childbirth. 2014;14:92.

Rao JH, Rampure N. Study of Primary Caesarean Section in Multiparous Women. Journal of Evolution of Medical and Dental Sciences. 2013;2(24):4414-8.

Sethi P, Vijaylaxmi S, Shailaja G, Bodhare T, Devi S. A study of primary cesarean section in multigravidae. Perspectives in medical research 2014;2(2).