DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20203496

Outcome of pregnancy in previous caesarean section: an observational study

Vidya A. Thobbi, Syeda Zeba

Abstract


Background: Presently, good obstetrics means an uncomplicated antenatal period, labour and puerperium for the mother and birth of a healthy body. Post caesarean section pregnancy has now become one of the most common high-risk cases tackled at any hospital. In this paper an attempt has been made to assess the outcomes of pregnancy in previous caesarean section.

Methods: This study was conducted among patients in the department of gynecology and obstetrics at Al-Ameen Hospital from June 2016 to December 2018. For that purpose, a sample size of 100 was considered. Data were analyzed using SPSS software v. 23.0. and Microsoft office 2007.

Results: The incidence of caesarean section was 10.25%. Anaemia, pregnancy-induced hypertension and diabetes mellitus found in this study is more coincidental. Placenta previa cases were also present. Cephalopelvic disproportion was the commonest indication of the previous section in this study. 20% of the cases have had their previous section due to cephalopelvic disproportion. 18% of the cases had delivered vaginally, 15 cases were delivered by forceps (72.2%) and 3 cases were delivered normally (27.8%). Maternal morbidity was found to be low and there was no maternal death.

Conclusions: The patient whose primary section was done due to cephalopelvic disproportion should be assessed thoroughly in her current pregnancy before placing her to elective repeat section. As there is always the possibility of scar rupture in a case of post caesarean section pregnancy one must think twice before doing the primary section. More research is required to evaluate optimum time of management.


Keywords


Anaemia, Cephalopelvic disproportion, Pregnancy, Previous caesarean section, Primary section, Post caesarean section

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References


Robson MS. Classification of caesarean sections. Foetal Matern Med Rev. 2001;12:23-39.

Anderson GM, Lomas J. Determinants of the increasing Caesarean birth rate. N Eng J Med. 1984;311:887-92.

Steer P. Caesarean section: an evolving procedure? Br J Obstet Gynaecol. 1998;105:1052-5.

Sultan AH, Kamm MA, Hudson CN, Thomas JM, Bartram CI. Anal sphincter disruption during vaginal delivery. N Eng J Med. 1993;329:1906-11.

Viktrup L, Lose G, Rolff M, Barfoed K. The symptoms of stress incontinence caused by pregnancy or delivery in primiparas. Obstet Gynecol. 1992;79:945-9.

Glazener C. Sexual function after childbirth: women's experiences, persistent morbidity and lack of professional recognition. Br J Obstet Gynecol. 1997;104:330-5.

Paterson-Brown S. Should doctors perform an elective caesarean section on request? Yes, as long as the woman is fully informed. BMJ. 1998;317:462-3.

Sultan AH, Stanton SL Preserving the pelvic floor and perineum during childbirth-elective caesarean section? Br J Obstet Gynaecol. 1996;103:731-4.

Feldman GB, Freiman JA. Prophylactic caesarean section at term? N Eng J Med. 1985;312:1264-7.

Robson MS, Scudamore JW, Walsh SM. Using the medical audit cycle to reduce caesarean section rates. Am J Obstet Gynaecol. 1996;174:199-205.

Notzon FC, Cnattinguis S, Bergsjo P. Caesarean section delivery in the 1980s: International comparison by indication. Am J Obstet Gynaecol. 1994;170:495-504.

Cleary R, Beard RW, Chappie J, Coles J, Griffin M, Joffe M, et al. The standard primipara as a basis for inter-unit comparisons of maternity care. Br J Obstet Gynaecol. 1996;103:223-9.

Robson MS. Labour ward audit. In: Creasy R. (ed) management of labour and delivery. Oxford: Blackwell; 1997:559-570.

Mould TAJ, Chong S, Spencer JAD, Gallivan S, Women's involvement with the decision preceding their caesarean section and their degree of satisfaction. Br J Obstet Gynaecol. 1996;103:1074-7.

Graham WJ, Hundley V, McCheyne AL, Hall MH, Gurney E, Milne J. An investigation of women's involvement in the decision to deliver by caesarean section. Br J Obstet Gynaecol. 1999;106:213-20.

Wackerhausen S. What is natural? Deciding what to do and not to do in medicine and health care. Br J Obstet Gynaecol. 1999;106:1109-12.

Ong C, Banks B, Smith C, Crowther C, Beilby J, Smith CA, et al. Department of Health Changing Childbirth, Report of the Expert Maternity Group. London: HMSO, 1993. Dr Foster Good Birth Guide, Vermilion, 2002. Families online-complementary therapies in pregnancy-SW London Babies. Perspect Complement Alternat Med. 2003;9:387.

Parazzini F, Pirotta NLa Vechia C, Fedele L Determinants of caesarean section rates in Italy. Br J Obstet Gynaecol. 1992;99:203-6.

Amu O, Rajendra S,Bolaji I. Should doctors perform an elective caesarean section on request? Maternal choice alone should not determine method of delivery. BMJ. 1998;317:463-65.

Showalter E, Griffin A. Commentary: all women should have a choice. BMJ. 1999;319:1401.

Anon. Is there a legal right to choose a Caesarean section? Br J Midwifery. 1999;7:515-8.

Goldbeck-Wood S. Women's autonomy in childbirth. BMJ. 1997;314:1143-4.