Frequency and Indications of Lower Segment Cesarean Section in Multiparous Women with previous Normal Deliveries

Nazish Mustafa, Jawaria Rasheed, Z. Saqlain, S. Isa, F. Rasheed, K. Siddiq
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Abstract

Background: Cesarean section (CS) has become a frequent practice in the recent years while this increase has been seen in developing as well as developed countries. The aim of current study was to determine the frequency of lower segment cesarean section (LSCS) along with indications of LSCS in multiparous women with previous normal deliveries. Methods: This was a cross sectional study, done at the Department of Gynaecology & Obstetrics, Nishtar Hospital, Multan, from 20th July 2018 to 20th January 2019. A total of 222 pregnant women with live singleton pregnancy at term with gestational age between 37 to 41weeks and multipara with no previous LSCS were included in the study. The decision to undertake LSCS if indicated was made in every case after complete assessment. Data was collected for frequency of LSCS and its indications in shape of fetal distress, antepartum hemorrhage and malpresentation. Results: Mean age was 32.720±1.96 years, mean height 1.551±0.11 meters and mean BMI was 27.855±3.14 Kg/m2. Most women were 31-35 years (90.5%) of age and 2-4 parity (89.2%). Primary caesearen section was seen in 43 patients (19.4%). Indications for primary caesarean section were malpresentation 27.9%, fetal distress 41.9% and antepartum hemorrhage 30.2%. Conclusion: The frequency of LSCS in multiparous women with previous normal deliveries was noted to be 19.4%. Fetal distress turned out to be commonest indication for primary caesarean followed by antepartum hemorrhage and malpresentation.
正常分娩的多胎妇女下段剖宫产的频率和适应症
背景:剖宫产术(CS)近年来已成为一种常见的做法,而这种增长在发展中国家和发达国家都有所增加。本研究的目的是确定下节段剖宫产术(LSCS)的频率以及LSCS的适应症在既往正常分娩的多胎妇女中。方法:这是一项横断面研究,于2018年7月20日至2019年1月20日在木尔坦Nishtar医院妇产科完成。该研究共纳入222名胎龄在37 - 41周的足月单胎妊娠孕妇和既往无LSCS的多胞胎孕妇。如有需要,决定进行LSCS是在完成评估后作出的。收集LSCS的频率及其在胎儿窘迫形状、产前出血和表现不良方面的适应症。结果:平均年龄32.720±1.96岁,平均身高1.551±0.11 m,平均BMI为27.855±3.14 Kg/m2。大多数妇女的年龄为31-35岁(90.5%)和2-4胎位(89.2%)。原发性剖宫产43例(19.4%)。初次剖宫产的指征为产形不良27.9%,胎儿窘迫41.9%,产前出血30.2%。结论:既往正常分娩的多产妇女LSCS发生率为19.4%。胎儿窘迫是初次剖宫产最常见的指征,其次是产前出血和表现不佳。
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