Vol. 6 No. 01 (2022)
Original Article

Indications of Primary Caesarean Section in Multipara Patient

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Zakia Begum
Assistant professor, Department of Obstetrics & Gynecology BSMMCH, Faridpur
Mahbuba Haque
Assistant Professor, Department of Obstetrics & Gynecology National Institute of cancer research & hospital
Umme Kulsum
Medical officer, Department of Fetomaternal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka
Md. Shafiq Ullah
Assistant Professor, Department of Pediatrics, Sheikh Sayera khatun Medical College, Gopalgonj
Mst. Zinat Rehena
Assistant Professor, Department of Gynecology, Institute of Child & Mother Health (ICMH), Matuaile, Dhaka

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Abstract

Background: It's believed that if a mother's first kid is born vaginally, subsequent births will be the same. As a result, multiparous moms typically ignore standard prenatal checkups and intranatal care, which can cause poor birth outcomes. Analysis of the Caesarean section (CS) in women with previous vaginal birth. Objective: To analyze the indications of primary caesarean section in
multi para women. Methods: The present cross-sectional study was conducted in the Department of Obstetrics & Gynaecology, Chittagong Medical College & Hospital, Chittagong between July 2016 to June 2017. During this period 150 multipara women were selected as study population from total admitted patients. Results: The individuals' ages ranged from 19 to 45 years (mean: 28.7
+_5.6). 86% of patients were Muslim, 14% were other ethnicities. Nearly 25% of women were upper-class, 54% middle-class, and 21.3% lower-class. 35% of moms had regular ANC, 48% irregular, and 17.3% none. The patients were 80% multipara and 20% grandmultipara. 78% were hospitalized at term, 16.7% at preterm, and 5.3% postterm. Out of 150 patients, 18 (12%) had APH, 11.3% had preeclampsia (PE), 6.7% oligohydramnion, 5.3% polyhydramnion, 4.7% IUGR, 5.3% postterm pregnancy, and 1.3% HELLP syndrome. 35.3% of patients had anemia, 4.7% diabetes, 6% UTI, 3.3% chronic hypertension, and 0.7% asthma. Over 25.3% of pregnant women were blood group A, 27.4% B, 11.3% AB, and 36.3% O. 93.3% were Rh-positive. Foetal distress (24.7%) and prolonged 1st stage of labour (25%) were the main indications for caesarean section, followed by placenta praevia (16%),
obstructed labour (14%), pre-eclampsia (13.3%), BOH (10.7%), malpresentation (9.3%), transverse lie (6%), eclampsia (2%) and previous VVF repair (0.7%)and others (3.3 percent). 4.7 hours passed between caesarean decision and delivery. 126 (84%) moms had emergency surgery; 24 (16%) had elective surgery. 15% of women experienced significant bleeding and 2% anesthetic complications. Postoperative wound infection was 14%, followed by failure of lactation (11.3%), post spinal headache (7.3%), PPH (6%), UTI (4.7%), urine retention (4%), and postpartum eclampsia (0.7%). 12 births (8%) had perinatal death among them 8(66.7%) had stillbirths and 3(33.3%) neonatal deaths. 34.7% of newborns required resuscitation. About 20% of newborns were low-birth-weight, 75.3% were normal, and 5.1% were overweight. 42% of newborns had APGAR <7. Congenital abnormalities were present
in 0.7%. Birth asphyxia in 19.6%, 6.5% prematurity, 4.3% IUGR, 8.6% jaundice, and 4.3% septicemia. Conclusion: Primary caesarean section in multipara women may be indicated for a variety of reasons like foetal distress, prolonged 1st stage of labour, placenta previa, obstructed labour, pre-eclampsia etc. Whatever be the reason be, screening of high-risk mothers during antenatal and intranatal period could improve the foetal outcome.

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Published 15-08-2022

Keywords

  • Multipara patients,
  • Caesarean section,
  • Indications of CS,
  • Outcome

How to Cite

1.
Begum Z, Haque M, Kulsum U, Ullah MS, Rehena MZ. Indications of Primary Caesarean Section in Multipara Patient. Planet (Barisal) [Internet]. 2022 Aug. 15 [cited 2023 Feb. 4];6(01):44-53. Available from: https://bdjournals.org/index.php/planet/article/view/169