Background & Objectives: It is a study of the analysis of primary caesarean section done in women who had previous vaginal delivery of a viable neonate. The various indications for caesarean section, incidence according to age, gravidity and maternal and fetal outcome were studied.

Aim Of Study

1.      To know the indications of primary caesarean section in multigravida.

2.      To study incidence according to age and gravida.

3.      To study maternal and fetal outcome.

Methods

Study Design: Prospective observational study

Study Settings: Department of Obstetrics and Gynaecology, Government Medical College, Kottayam, Kerala, India.

Study Duration: April 2013 – September 2014

Result: Maximum numbers of patients were in the age group of 25-29 years and majority were second gravida. Majority had emergency caesarean section and main indications were pathological CTG and malpresentations .most common intraoperative complication was atonic PPH and most common postoperative morbidity were Wound infection and respiratory tract infection. There were no maternal deaths in the present study. Perinatal morbidity was seen in 27 cases and there were 4 cases of perinatal mortality.

Conclusion & Interpretation: Even with regular antenatal care, primary caesarean section may be unavoidable in parous women with previous vaginal delivery. Even though caesarean section is relatively safer than before, with emergency sections inherent complications do exist, but with good antenatal care, early recognition and timely intervention we can improve the maternal and fetal outcome.

Keywords: Caesarean section; Multipara, Abdominal Delivery, Postcaesarean Section