Indication For Caesarean Section Research Articles

Avaliação das informações sobre indicações absolutas e relativas de cesarianas disponíveis em sites populares

Abstract Objectives: to evaluate the reliability of information available on popular websites, in other words, websites aimed lay pregnant women, about absolute and relative indications for cesarean sections. Methods: this was a descriptive/comparative study based on the popular websites most likely to be visited by lay pregnant women and that contained information about indications for absolute and relative cesarean sections. Cohen’s Kappa index of agreement was used to analyze the reliability degree on the indications for cesarean sections presented on the websites and the scientific evidence. Results: there was a higher prevalence (62.63%) of information on the indications for cesarean sections that did not mention whether the indication was absolute or relative, and of these indications, 40.74% were not indications for cesarean sections. Low agreement was also observed among websites and the scientific evidence when the website mentioned the indication for cesarean section was absolute or relative. Conclusion: this study showed that the reliability of the information on absolute and relative indications for cesarean sections available in popular websites is questionable.

What are the implications of using Robson’s classification system in a Moroccan case study?

Today, cesarean section rates are increasing worldwide for varied and complex reasons. To examine this more closely, several countries have adopted the 10-group classification of cesarean sections, also known as the Robson classification. This classification aims to monitor and compare cesarean section rates in a standard, reliable, and indication-based way. In the vision of improving the quality of care and especially rationalizing cesarean section rates, this descriptive and retrospective study, which lasted ten months, considered a population of parturients who had given birth by cesarean section at the maternity ward of the Cheikh Khalifa Hospital in Casablanca. Using Robson’s classification system, data on deliveries can be compared between different regions of Morocco or between different time periods. This allows assessment of trends, geographic outcomes, and temporal variations in environment-related obstetric outcomes, which can help identify specific maternal health issues and develop targeted policies. We first listed all cesarean deliveries and then classified them into ten groups (Robson’s classification) to highlight the contribution of each group to the overall cesarean rate and to explain the discrepancies for which we proposed recommendations. This study considered 890 cases, of which 541 required a cesarean section, a 61% rate higher than that recommended by the WHO (15%) and the national rate (21%). Robson’s classification identified group 10 as contributing most to the overall cesarean rate (43.4%). Namely, this group included singleton pregnancies with a cephalic presentation, gestational age < 37 weeks, and a scarred uterus. This group’s relative size and cesarean section rate were 68% and 63%, respectively. Cesarean section should be considered a surgical procedure, considering the potential maternal and neonatal risks involved and ensuring that the indication for cesarean section is tangible, based on the Robson classification, among other things.

Роды с рубцом на матке через естественные родовые пути: клинический опыт

The article presents the clinical experience of conservative delivery of 1124 women with a scar on the uterus at Republican Clinical Perinatal Center in Ufa. It was established that a woman’s age less than 40 years, certain indications for the previous caesarean section and the absence of indications for the previous cesarean section at this gestation, the history of vaginal delivery, the development of spontaneous labor should be considered criteria associated with the success of «trial» births. Pregnant women who meet these criteria can be delivered through the natural birth canal. Such a tactic allows avoiding unnecessary caesarean sections and improving maternal morbidity and mortality.

Prediction of Success Rates of Vaginal Birth after Cesarean Delivery According to the Previous Indication for Cesarean Delivery

Background: Trial of labor after cesarean delivery (TOLAC) has long been accepted as a safe option for women with previous cesarean delivery. Previous efforts have been exerted in trials to predict the success rates of TOLAC according to specific parameters related to previous cesarean section and before TOLAC. We aimed to investigate the different indications of previous cesarean delivery as independent predictors for successful vaginal birth. Methods: A retrospective study was conducted in Armed Forces Hospitals of the Southern Region between December 15, 2019, and July 1, 2020. The included 566 patients with previous cesarean section who were willing to undergo a trial of labor were divided into two groups according to the success of vaginal birth (VBAC). Results: The nonrecurring indications for previous cesarean delivery were higher in the successful group (fetal distress 54.7% vs 41.1%, malpresentation 26% vs 21.4%, multifetal pregnancy 3.8% vs 2.7%). Additionally, the successful VBAC group had a significantly higher percentage of previous successful VBAC (47.7% vs 21.9%) and prior vaginal deliveries (58.5% vs 44.2%) and less coincidence of medical disorders and meconium-stained liquor (18.1% vs 26.3% and 3.2% vs 8.2%, respectively) than the unsuccessful group. Conclusion: During counseling regarding trial of labor after cesarean section, indications for previous cesarean section not related to arrest of labor can predict higher success of VBAC. Moreover, previous successful vaginal delivery or VBAC improves the success rates.

Evaluation and Relevance of Indications for Primary Caesarean Section: A Five-Year Experience Report from Nevers Hospital Center

Evaluation and Relevance of Indications for Primary Caesarean Section: A Five-Year Experience Report from Nevers Hospital Center

Vaginal Birth after a Cesarean Section at Good Shepherd Mission Hospital at Tshikaji in Democratic Republic of the Congo (DRC)

Background: The success rate of vaginal birth after cesarean section with a single cesarean scar is greater than 50%, the lack of the information about the safety of vaginal birth after cesarean delivery pushes most of obstetricians to increase the num ber of cesarean sections following a previous cesarean section. Guidelines for Vaginal birth after cesarean (VBAC) indicate that TOLAC offers women with no contraindications and one previous transverse low-segment cesarean. The objective of the current study was to study the outcome of trial of labour after caesarean section (TOLAC), the indications for emergency repeat cesarean section and to determine the maternal and fetal prognosis in vaginal birth after caesarian section (VBAC) at Tshikaji Mission Hospital. Patients, Material and Methods: This is a retrospective study of the records of 126 women were selected to undergo the TOLAC in the department of gynecology and obstetrics at the Tshikaji Mission Hospital over the period from January 1st to December 31st, 2021. The data on demography, antenatal care, labour and delivery and outcomes were collected from the maternity unit of this hospital. The data were analyzed using SPSS version 2.0. Results: The TOLAC in 126 studied women. The course of work allowed vaginal delivery 107 parturient women, a success rate of successful VBAC of 85% after the TOLAC. The repeat emergency cesarean section was necessary for delivery in 15% of cases for failed TOLAC. There was no maternal mortality, but we recorded one fetal death or 0.8% of perinatal mortality, 2 cases of cicatricial dehiscence, the incidence of 1.6%. Maternal morbidity after delivery on cicatricial uterus was dominated by postpartum hemorrhages, with 19 cases or 15.1% of cases. Cervical dilatation of more than 3 cm at the time of admission, the parity more than 3 and were the significant factors in favor of a successful VBAC. Birth weight of more than 3500 g, fetal distress and malpresentation were associated with a lower success rate of VBAC. The TOLAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas. Conclusion: Pregnancy on a cicatricial uterus represents a high-risk pregnancy. Trial of VBAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas. There is a significantly high vaginal birth after caesarian section (VBAC) success rate among selected women undergoing trial of scar in Tshikaji Hospital. TOLAC remains the option for childbirth in low resource settings as Kasai region in DRC. Adequate patient education and counselling in addition to appropriate patient selection for TOLAC remain the cornerstone to achieving high VBAC success rate.

Vaginal Birth after Cesarean Score for the Prediction of Successful Vaginal Birth after Cesarean Section – A Prospective Observational Study

Aim: The aim of this study was to evaluate the demographic and obstetrical factors affecting the chances of vaginal birth after cesarean (VBAC) delivery and to develop a scoring system for the prediction of same. Materials and Methods: It was a prospective observational study done over a period of 1 year. A total of 100 term pregnant women with previous one lower-segment cesarean section (LSCS) fulfilling the criteria for a trial of labor were recruited for the study. As 23 patients refused to undergo trial of labor after cesarean (TOLAC) in early labor, 77 women formed the study group. Parameters assessed to predict successful TOLAC were maternal age, body mass index (BMI), history of prior vaginal delivery, interdelivery interval, indication of previous cesarean section, gestational age, type of labor, Bishop's score, and expected baby weight. Scores 0–2 were given, and the mean score obtained was correlated with the outcome of TOLAC. Results: Successful vaginal delivery occurred in 57.14% (44/77) of women. BMI ≤30 kg/m2 (P = 0.004), parity ≤ 3 (P = 0.005), Bishop's score >4 (P = 0.000), spontaneous onset of labor at the time of admission (P = 0.001), and nonrecurrent indication of previous LSCS (P = 0.029) were found to be significantly associated with the VBAC. The probability of having a successful VBAC was 83.3% and 100%, with the VBAC score value of more than 18 and 20, respectively. Conclusion: The mean VBAC score of 18–20 by the current scoring system is beneficial in predicting the outcome. This can help in counseling the patient, relatives as well as health professionals to undergo labor trial to decrease the cesarean section rate in the current era.

МЕТОДЫ ИНДУКЦИИ РОДОВ ЖЕНЩИН С ТЯЖЁЛОЙ ПРЕЭКЛАМПСИЕЙ

Objective: The article presents a literature review on the current possibilities of induction of labor (IOL) in severe preeclampsia (SPE). Delivery is the only treatment for preeclampsia (PE), a serious pregnancy complication. In women with SPE, better maternal and perinatal outcomes are associated with vaginal delivery. The exceptions are cases where there are obstetric indications for cesarean section (CS) or the need for urgent delivery due to complications of PE. The optimal IOL methods for women with SPE, especially when early delivery is necessary, are still not established. In this regard, studies on the most appropriate IOL methods for women with PE are crucial. A literature data search was conducted through Elibrary, Cyberleninka, and PubMed to obtain relevant information from the abovementioned databases. Keywords: Pregnancy, severe preeclampsia, labor induction, methods of labor induction.

A Review of Caesarean Delivery at the Kogi State Specialist Hospital, Lokoja, Nigeria

Background: Caesarean delivery rate is increasing globally including in Nigeria. Caesarean delivery is a life-saving surgery for both mother and child. Objective: The aim of the study was to assess the caesarean delivery rate at the Kogi State Specialist Hospital, Lokoja, Nigeria over a one-year period. Methods: This was a prospective assessment of the demographic characteristics of patients, indications, types, rates and outcomes of Caesarean delivery in Kogi State Specialist Hospital, Lokoja, Nigeria from December 15, 2020 to December 14, 2021. Data collected were analyzed using SPSS version 20.0 statistical package (IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp). The categorical data were displayed using tables and charts. Results: There was a total of 491 deliveries, out of which were 113 Caesarean deliveries and 378 spontaneous vaginal deliveries making the Caesarean delivery rate in Kogi State Specialist Hospital, Lokoja, Nigeria 23.0%. There were no instrumental deliveries during the study period. The commonest indication for Caesarean section was obstructed labour in 31% of cases. There was no maternal mortality. There were three early neonatal deaths due to severe birth asphyxia. Conclusion: The rate of Caesarean delivery in this study was 23.0% and obstructed labour was the leading indication in 31% of cases. The rate of Caesarean delivery in this study is high, albeit the overall outcome was good for both mother and child. Caesarean delivery, therefore, remains one of the means for reducing maternal and perinatal morbidity and mortality in Nigeria.

Analysis of cesarean section using Robson’s criteria in tertiary care center

Introduction: This study aims to analyze all the women delivering in our institute according to the Robson’s classification. Robson’s ten group classification system (TGCS) endorsed by WHO, is a global standard tool for assessing, monitoring and comparing cesarean section rates at all levels.
 Method: This cross sectional study was conducted in the department of obstetrics and gynecology, Patan hospital, Patan academy of health sciences (PAHS), Lalitpur, Nepal over 12 months’ period. All women who delivered during this period were classified according to the Robson’s classification (TGCS) into a specific group. Relative size and overall cesarean section rate of each group were calculated.
 Result: A total of 4,985 cases were analyzed. The cesarean section rate was 57.7%. Group 1+2 represented nearly half (49%) of the obstetric population served during the study period. Group 2A was found to be the highest contributor (27.4%) followed by Group 5 (22.8%) and Group 1 (13.0%). In terms of indication for cesarean section -Fetal distress and previous cesarean section were found to be the most common indications. Similarly, nulliparous women were three to four times more likely to be delivered by cesarean section when labor was induced.
 Conclusion: From this study, we can conclude that for an effective reduction in the overall high cesarean section rate in our Institution, we need to focus on a more stringent protocol for inducing labor especially among nulliparous women and to practice evidence based guidelines. Redefining failed induction needs to be considered critically as well.

Assessment of compliance with a color code protocol for non-elective cesarean section and its impact on time to delivery interval and neonatal outcomes

IntroductionWe set out to assess the compliance with a cesarean section color code protocol and its impact on maternal and neonatal outcomes since its implementation in our maternity ward. MethodsThis was a retrospective study including a sample of 200 patients per year who underwent a non-elective cesarean section delivery in Rennes University Hospital from January 1, 2015 to December 31, 2018. Patients were grouped by year and by color code (red, orange or green). The main outcome was compliance with the protocol (color code in accordance with indication for cesarean section) and compliance with the corresponding decision-delivery interval. Secondary outcomes were maternal and neonatal outcomes. ResultsEight hundred patients were included during the study period. There was no significant difference in patient characteristics over the years. There was a significant improvement in protocol compliance: full compliance increased from 22.4% in 2015 to 76.5% in 2018 (p < 0.0001). The respect of the 15 min decision-delivery interval in red code protocol increased between 2015 and 2018 (p = 0.0020). ConclusionWe observed a significant improvement in compliance with the color code protocol between 2015 and 2018 and in the 15 min decision-delivery deadline for the red code.

Indication &amp; Outcome of Second Stage Caesarean Section; A Longitudinal Study

Background: Caesarean section is one of the common surgical interventions to save lives of the mothers and/or the newborns. However there is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. Within this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. Due to a limited literature regarding this topic in the Indian scenario, the present study was done to assess the predisposing factors, indications of second stage caesarean section and its fetomaternal outcome. Material and Methods: In Present descriptive longitudinal study 211 patient’s undergone caesarean sections at full cervical dilatation were included as per inclusion and exclusion criteria. A pilot study was done for validation, practicality and applicability of questionnaire. Results: In present study most cases were in the age group of 26 to 30 years (38.38%). The most common indication for emergency second stage caesarean section was non-progression of labour followed by obstructed labour. Atopic PPH, hematuria was the commonest intraoperative complications while pyrexia, prolong catheterization was the predominant post-operative complications NICU admission needed for 16.11% babies due to birth asphyxia and respiratory distress. Conclusions: Caesarean section in the 2nd stage of labor is associated with maternal and neonatal morbidity and mortality. These factors needs to be anticipated to reduce mortality and morbidity associated with it. A proper judgment is required by a skilled obstetrician to take a decision for caesarean section at full cervical dilatation.

Primary cesarean section rate among full-term pregnant women with non-previous uterine scar in a hospital of Vietnam

AimThis article aims to determine the contributing indications for primary cesarean sections among full-term pregnant women with non-previous uterine scars and suggests several potential solutions to reduce the cesarean section rate. MethodsThis is a descriptive study with data being retrospectively collected from electronic medical records (EMRs) at Hanoi Obstetrics & Gynecology Hospital, Vietnam, in 2020. We studied 23,631 women at ≥37 weeks of gestation with non-previous uterine scars. Main ICD-10 categories of diagnosis on the EMRs were used to classify the indications. The proportions of indications for primary cesarean sections were calculated, thereby offering potential solutions to reduce the cesarean section rate. ResultsThe proportion of cesarean sections among full-term pregnancies with non-previous uterine scars was 40.7%. The most common indications for primary cesarean sections were non-reassuring fetal heart rate tracing (40%), labor arrest (31%), and maternal request (11%). Among the low-risk pregnant women, the cesarean section rate was 35.9%, of which the percentages of labor arrest and non-reassuring fetal heart rate tracings and maternal request were 13.6%, 17.7%, and 4.6%, respectively. ConclusionsThe proportion of primary cesarean sections among full-term pregnancies with non-previous uterine scars is high; non-reassuring fetal heart rate tracings, labor arrest, and maternal request were three main indications. It is necessary to build the strategies of health organizations regarding the management of clinical practices and the programs improving the knowledge, attitudes, practices of pregnant women and obstetricians regarding cesarean sections.

The relationship between the first trimester maternal serum PAPP-A and β-hCG values and newborn intensive care needs in low-risk pregnancies.

The purpose of the study was to look at the connection between newborn intensive care requirements in low-risk pregnancies and maternal blood pregnancy-associated plasma protein (PAPP-A) and free human chorionic gonadotropin (hCG) levels, which are elements of screening tests within the first trimester. In the delivery unit of our hospital, pregnant women between the years of 18 and 35 had singleton pregnancies who delivered between 37 and 41 weeks of pregnancy between July 2021 and January 2022 were split into 2 groups. One hundred eighty two pregnant women with infants who required neonatal intensive care (NICU) were enrolled in the first group, whereas 890 pregnant women with infants who did not require NICU were enrolled in the second. These two groups' maternal blood PAPP-A and free hCG levels, which are among the first trimester screening procedures, were examined. Additionally, subgroup analysis were performed in terms of cesarean section indications and NICU admission indications. Logistic regression analysis and ROC analysis were performed with related variables for estimating NICU need. The mean serum PAPP-A value was found to be 0.91±0.34 multiples of the median (MoM) in the blood taken from the infant mothers who needed NICU, while the mean serum PAPP-A value in the blood taken from infant mothers who did not need NICU was 1.12±0.59 MoM (p<0.000). The PAPP-A MoM mean of the group with Apgar 5th minute score ≥8 (1.09±0.57) was higher than the PAPP-A mean (0.84±0.27) of the Apgar 5th minute score <7 group (p=0.013). According to the results of our study, in groups with a PAPP-A value below 0.95, the possibility of increased NICU need of newborns is higher. The low serum PAPP-A level, which is used as a screening test among pregnant women, demonstrates that it is successful in predicting perinatal outcomes in the low-risk pregnancy group.

STUDY OF THE PROPORTION AND VARIOUS INDICATIONS ASSOCIATED WITH PRIMARY CESAREAN SECTION IN MULTIPAROUS WOMEN IN TERITARY CARE HOSPITAL IN WESTERN MAHARASTRA

Background : World wide raise in cesarean section rate in the last three decades has been the cause of alarm and need for study in depth .cesarean section has been one of the most commonly performed surgical procedures . Primary caesarean section in the multipara means first caesarean section done in the patients who had previously delivered vaginally once or more(1). Aims and objectives of this study were to know the proportion and various indications of primary caesarean section in multipara. Methods : This was a prospective observational study of primary caesarean section in multipara women admitted at tertiary care hospital in western rural Maharashtra during the period of 1year from june2021 to june2022. Multipara with pregnancy of &gt;28 weeks gestation (gravida 2 and above), each of whom has had a previous vaginal delivery of &gt;20 weeks gestation were included(2). Women with previous abortions and previous section were excluded. Results:During the study period of one year, total 8124 deliveries occurred, out of which 3000 (37.39%) underwent caesarean section and 386 (12.61%) were primary caesarean section in multigravida. Out of these multigravida patients who underwent primary caesarean section- most of the patients were unbooked (77.72%). Majority of the cases were direct admission in the hospital (61.13%). Maximum number of the patients were in the age group of 22- 30 years (55.95%). Two third of the patients were literate (69.44%) Maximum number of patients were Gravida 2 (48.72%). Almost all of them (94.85%) underwent emergency caesarean section. The most common indication for primary LSCS in multigravida patients was fetal distress 120 (30.79%) followed by malpresentation in 76 (19.39%) patients, severe pre ecclamsia and ecclamsia in 82 (19.39%), Obstructed labour in 36 (9.55%), and antepartum hemorrage in 43 (12.1%), Twin pregnancy in 29 (6.44%). Most common maternal complication was pyrexia 40 (10.36%) Most common indication for caesarean section in multipara was fetal distress followed by mal-presentation and severe pre-ecclampsia Conclusion and interpretation:From the above study it is very clear that, many unforeseen complications occur in woman who previously had a normal vaginal delivery, Present studyalso concludes that Fetal distress is a major contributor to primary CS in multigravida. Proper antenatal evaluation with early detection and management of high risk cases can reduce the likelyhood of intrapartum fetal distress.

Ultrasound Assessment of Cesarean Section Scar and its Correlation to Intraoperative Scar Status

Background and Aim: In the past decades the rate of cesarean sections has increased enormously, there are many indications for cesarean section like placenta previa, labor dystocia, presumed fetal distress, fetal malpresentation, multiple gestation, and suspected fetal macrosomia, but the commonest reason for performing a cesarean is a previous cesarean birth .The present study aimed to compare the sonographically measured lower uterine scar with actual status of scar at the time of operation. Methodology: The descriptive cross-sectional study was conducted on 150 female patients who presented to Obstetrics department of Creek general hospital, affiliated with UMDC from August 2021 to January 2022. The Inclusion Criteria was: females with singleton pregnancy with history of previous single caesarian section, vertex presentation and gestational age 36-40 weeks. While women with multiple gestations, placenta previa, polyhydramnios or any uterine abnormality were excluded. Results: The overall mean of age, gestational age, parity and fetal weight were 28.22±4.59 years, 37.60±0.78 weeks, 1.73±0.94 and 2.75± 0.47 kg respectively. Significant association was observed between lower uterine segment measurements by Sonographic scar thickness during pregnancy and intra-operative scar findings at the time of delivery (p-value&lt; 0.05). Conclusion: The present study found that sonographically measured lower uterine scar thickness is a solid predictor for scar defect in women with previous cesarean section. As a result, we can conclude that sonographic measurement of lower uterine segment thickness is a reliable tool for assessing scar status and deciding which women should be given a vaginal delivery trial. Keywords: Previous Caesarean Section, Lower uterine scar, Sonography

Robson Ten Group Classification System and Fetal Distress as the Indication for Caesarean Section

Background: The marked increase in the rates of CS has not only raises the challenges for the medical professional but also became a debatable issues for many gynecologists. In order to explain the increasing rates of CS it is necessary to identify which group of women is more frequently undergoing CS. Objective: The study aimed to evaluate the role the fetal distress and Robson ten group classification play for the indication of caesarean section. Study design: It is a retrospective study conducted at Khawaja Muhammad Safdar Medical College, Allama Iqbal Memorial Teaching Hospital Sialkot, from January 2022 to June 2022. Material and Methods: 5787 women were admitted in tertiary care unit for delivery. Among these 2031 went through caesarean and the remaining delivered normally. Most of the population was included in group 1 and 5, where 501 and 535 individuals were present. Results: The group having the most contribution towards CS was group 5. And the group showing least contribution towards CS was group no.10. Group 5 also showed high contribution towards CS. The evaluation was carried out for 205 patients, the mean age of the patients was 26 years in this study. Most of the patients belonged to gestation week greater than 36 weeks. Conclusion: The group that has low risk had more chances to contribute to the CS rate. The indication for CS was most of the time fetal distress which was seen at the time patients were admitted in hospital. Keywords: Caesarean section and fetal distress.

Effect of the mode of delivery on the risk of endometriosis recurrence: a retrospective cohort study

To evaluate the risk of endometriosis recurrence according to the mode of delivery (cesarean section vs. vaginal birth) in patients who had become pregnant with a live birth after surgery for endometriosis. A retrospective cohort study. A Cox proportional-hazards regression was performed to evaluate the risk factors for endometriosis recurrence at 36 months of follow-up after the last pregnancy. Academic hospital. Patients who have had ≥1 pregnancy with a live birth following conservative surgery for ovarian endometriosis performed from January 2009 to December 2016 at our institution. Patients who underwent ≥1 cesarean section after surgery for endometriosis. The recurrence rate of endometriosis after live-birth pregnancies obtained after the first surgery for endometriosis. Patients with a history of ≥1 cesarean section after surgery for endometriosis have a higher risk of endometriosis recurrence than the patients who have had a vaginal birth, with an adjusted hazard ratio of 2.25 (95% confidence interval, 1.27-3.96). A cesarean section after surgery for endometriosis is associated with a twofold high risk of endometriosis recurrence with respect to vaginal birth. A different follow-up approach may be needed in those patients, and avoiding inappropriate indications for cesarean sections in pregnant patients with a history of surgery for endometriosis is necessary.

Primary Caesarean Section among Multiparous Pregnant Women Visiting a Tertiary Care Centre: A Descriptive Cross-sectional Study

Caesarean section is one of the most common obstetric operations performed. Primary caesarean section in multiparous women means the first caesarean section done in the multiparity who had previously delivered vaginally. This study aimed to find out the prevalence of primary caesarean section among multiparous pregnant women visiting a tertiary care centre. A descriptive cross-sectional study was conducted among multiparous women in a tertiary care centre from 15 June 2020 to 14 June 2021. Ethical approval was obtained from the Institutional Review Committee (Registration number: F-NMC/420/075/076). Demographic data were collected using predesigned proforma in parous women who had a previous vaginal delivery. A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Among 1158 multiparity, primary caesarean section was found in 155 (13.39%) (11.43-15.35, 95% Confidence Interval). Most women 62 (40%) belong to 21-25 years and the majority were second gravida 51 (32.90%). The emergency caesarean section was done in 149 (96.12%). Indications for primary caesarean section were fetal distress 63 (40.63%), non-progress of labour and breech 12 (7.74%). Post-operative complications were uneventful in 110 (70.96%) cases. The prevalence of primary caesarean section in multiparous women was found to be higher than the other studies done in similar settings. caesarean section; multiparity; prevalence.

Profile of cesarean sections among primiparous women at a tertiary care hospital

Background: World Health Organization has declared that an acceptable cesarean rate in any region should not be more than 15%. In modern obstetrics, cesarean section is an accepted standard procedure to reduce maternal morbidity and mortality. To reduce perinatal morbidity and mortality, cesarean section definitely helps, but it poses many health risks to the mother. In the present study, we aimed to study the primary cesarean rate, its complications, and the indications for primary cesarean sections in a tertiary care center. Material and Methods: This was an observational study conducted at a tertiary care teaching hospital.All the primiparous women delivering between October 2018 to May 2020 were included, and the cesarean rates, indications and complications were studied. were calculated. The data was taken from labor room register where details about every delivering woman is kept and the women are classified into different mutually exclusive groups based on Robson's Ten Group classification. Results: Among the delivering women enrolled during the study period, 42.55% of women delivered by cesarean section, and 54.97 % delivered vaginally. The primiparous cesarean rate was 40.9%. Conclusion: The study identifies a significant number of primiparous women undergoing cesarean section and suggests the need for appropriate labor care and regular audits.