Abstract
Background: Knowledge of the patterns of normal and abnormal labour, and of women’s behavior, is fundamental to the formulation of mode of delivery. It is observed that women admitted to hospital early have a higher frequency of obstetric interventions in labour than those admitted later.
 Objective: To study the outcome of spontaneous onset of labour in nulliparous and multiparous patients.
 Materials and method: During the study period of 1st July 2008 to 31st Dec 2008, 568 pregnant women admitted in Kumudini Women’s Medical College were included in this study. Mothers were observed since admission with spontaneous onset of labour and followed up till they were released from the hospital. Labour outcome was measured and mode of delivery was compared among nulliparous and multiparous women.
 Results: Among the nulliparous women, normal vaginal delivery occurred in 71 (23%) patients presented with early cervical dilatation (0-3 cm) and in 142 (46%) patients presented with late cervical dilatation (>4 cm). In nulliparous women caesarean section were needed in 60 (45.8%) patients in early cervical dilatation group and in 35 (19.8%) patients in late cervical dilatation group. In multiparous women, normal vaginal delivery occurred in 66 (25%) patients presented with early cervical dilatation and in 133 (51%) patients presented with late cervical dilatation whereas cesarean section were done in 35 (34.7%) patients and in 25 (15.8%) patients in the two groups respectively. Duration of labour between nulliparous and multiparous was significantly different (8 hours vs. 6 hours). Indication of caesarean section were, 61 (40%) patients due to prolong labour, 48 (34%) due to foetal distress and 44 (26%) due to cephalopelvic disproportion.
 Conclusion: Normal vaginal delivery occurred more and duration of labour was shorter in patients admitted with advanced labour (cervical dilatation >4cm).
 Delta Med Col J. Jan 2019 7(1): 16-20
Highlights
Rates of caesarean section have been a major public health concern in Bangladesh in recent years
Normal vaginal delivery occurred in 72 (23%) patients presented with early cervical dilatation and in 142 (46%) patients presented with late cervical dilatation
Normal vaginal delivery occurred in 66 (25%) patients presented with early cervical dilatation whereas in 133 (51%) patients presented with late cervical dilatation
Summary
Rates of caesarean section have been a major public health concern in Bangladesh in recent years. Of Obstetrics & Gynaecology, Ibn Sina Medical College, Dhaka, Bangladesh. Of Obstetrics & Gynaecology, Delta Medical College, Dhaka, Bangladesh. Nulliparous women in particular have no experience of labour and so may find the timing of presentation to hospital difficult to judge. A previous study has shown that women admitted to hospital early (contractions of four hours or less) have a higher frequency of obstetric interventions in labour than those admitted later.[3]. The objective of this study was to determine how the caesarean section rate changes with the cervical dilatation at which women present in labour. In addition the effect of deferring admission, in women presenting in early labour, was examined
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