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DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20161668
Research Article
Page 1814
INTRODUCTION
Primary Cesarean Section is defined as the cesarean
section done for the first time in a patient who has
delivered vaginally previously or not.1 Cesarean delivery
is one of the most commonly performed operations today.
The indications for cesarean sections have been
undergoing a gradual change over the last few decades.
Besides the obstetric causes, several other medical,
social, ethical, economic and medicolegal factors play a
role in this rising trend of cesarean section. Initially it
was performed mainly for maternal interest but recently
the health of the fetus has played a significant role in
making the decision for a cesarean birth. The 2012 US
Cesarean delivery rate was 32.8%. The cesarean rate rose
nearly to 60% from 1996 (20.7%) to 2009 and has been
stable since then.2
Exclusion criteria
Consent
1.
2.
3.
METHODS
It is a cross sectional study. This study is carried out in
the Department of Obstetrics and Gynecology, PDU
Medical College and Hospital, Rajkot during one year
period from April 1, 2014 to March 31, 2015.
During this study, patients (booked or unbooked)
attending the labor room, undergoing primary cesarean
section in the department will be selected according to
the inclusion criteria. Patients will be examined for their
age, parity, general and obstetric examinations. Their
intra-operative and post-operative complications will be
noted so also maternal & fetal morbidities if any.
During the study period 685 primary cesarean section
data were collected. On a pre-decided proforma the age,
socio economic demographic data, booking status etc.
1349 (18.5%)
5946 (82.1%)
7295 (100%)
PCS
CS other than PCS
Total no. of CS
No. of cases
(n=685)
124
372
147
32
10
685
Percentage
(%)
18.1
54.3
21.4
4.7
1.5
100
Percentage (%)
79.3
20.7
100
No. of cases
(n=685)
496
118
54
14
3
685
Percentage
(%)
72.4
17.2
7.9
2.0
0.5
100
Antenatal
complications
Parity
Primipara
Multipara
Anaemia
348
(68.2%)
162
(31.8%)
APH
10(26.3%)
28(73.7%)
Eclampsia and
preeclampsia
70(82.4%)
15(17.6%)
Malpresentation
238(98.8%)
3(1.2%)
Oligohydramnios
45(83.3%)
9(16.7%)
P value
2 = 7.85,
p = 0.00
(Significant)
2 = 42.78,
p = 0.00
(Significant)
2 = 4.83,
p = 0.02
(Significant)
2 = 129.18,
p = 0.00
(Significant)
2 = 26.42,
p = 0.00
(Significant)
No. of cases
(n=685)
Percentage
(%)
Malpresentation
235
34.3
Parity
Primipara
Multipara
Malpresentation
159(67.7%)
76(32.3%)
APH
10(26.3%)
28(73.7%)
Non-reassuring
foetal status
41(73.2%)
15(26.8%)
MSL in first
stage of labour
116(76.8%)
35(23.2%)
Failure of
induction
72(82.8%)
15(17.2%)
P value
2 = 4.03, p
= 0.04
(Significant)
2 = 42.78,
p = 0.00
(Significant)
2 = 0.02, p
= 0.88
(Not
significant)
2 = 1.88, p
= 0.16
(Not
significant)
2 = 5.43, p
= 0.01
(Significant)
No. of cases
(n=297)
Percentage (%)
182
61.3
32
10.8
17
5.7
12
4.0
16
5.4
12
4.0
32
Type of C.S
Parity
Elective
Emergency
16(5.4%)
281(96.1%)
297
126(32.5%)
262(67.5%)
388
142
543
685
Type of CS
Elective
Emergency
Abdominal
distension
5(13.2%)
33(86.8%)
10.8
Wound gap
7(21.2%)
26(78.8%)
4
6
3
1.4
2.0
1.0
Fever
2(7.4%)
25(92.6%)
1.0
0.7
UTI
4(21%)
15(79%)
P value
2 = 1.40,
p =0.23
(Not
significant)
2 = 0.00,
p = 0.94
(Not
significant)
2 = 3.03,
p = 0.08
(Not
significant)
2 = 0.00,
p = 0.97
(Not
significant)
32(9.7%)
19(67.9%)
CONCLUSION
15(4.5%)
10(3.0%)
7(2.1%)
7(25%)
6(21.4%)
4(14.3%)
1(3.6%)
Referred
(%)
Direct (%)
Admitted
(%)
Total
Maternal
morbidity
70(55.6%)
42(33.3%)
14
(11.1%)
126
Maternal
mortality
Perinatal
morbidity
164(49.7%)
139(42.1%)
27(8.2%)
330
Perinatal
mortality
32(71.1%)
10(22.2%)
3(6.7%)
45
2.
3.
4.
5.
6.
7.