To study indications for primary caesarean section in primigravida and multigravida

Abstract

Background: Worldwide caesarean section is the most performed surgical procedures in obstetrics. It has been a lifesaving procedure for foetus and mother during the complicated delivery.Aims and objectives: To analyze the incidence and indications for primary C-Section in primigravida and multigravida.Methods: This observational study was conducted over a period of one year in department of obst. & gynaecology, S.P. Medical College, Bikaner. Data was recorded and incidence of primary caesarean section was calculated. Two groups were formed consisting of primigravida and multigravida who underwent primary caesarean section taking 150 patients each and indications of lscs was noted. Women who underwent caesarean section for the first time were included with gestational age (>28 weeks). Exclusion criteria was women with previous caesarean sections, known medical disorders except anemia with gestational age<28 weeks.Results: Out of 6572 primigravidas delivered, 2110 (32.1%) delivered by primary LSCS. Amongst 9814 multigravida patients, 1234(12.6%) were primary LSCS. 10% LSCS were elective in group A as compared to group B where only 7.3% were elective. In group A, most common elective indication was primi breech (40%), while in group B, it was placenta praevia (45.4%). In group A, most common emergency indication was fetal distress (53.3%) followed by primi breech with good size baby (20.7%). In group B, fetal distress was in 30.2% cases but most common indication of LSCS was APH (35.9%). Conclusions: High rate of Caesarean deliveries was observed in primigravidas but not in multigravidas. Though better technology improves outcome but may cause over diagnosis in many cases thereby increasing caesarean section rates.