A study of the effect of antenatal and intrapartum risk factors for cesarean delivery in a primigravida-a retrospective analysis release_5huiapx2bza6dldmpqmnrbe6ou

Abstract

Introduction: In recent times, the caesarean section rate has increased globally. Caesarean section in a primigravida most commonly due to fetal distress may be preceded by certain risk factors present in the antenatal period; or may arise denovo at the time of labour. Hence a study of these antenatal and intrapartum factors that influence the mode of delivery in a primigravida is essential. Objective: To evaluate the antenatal and intrapartum risk factors that effect mode of delivery in a primigravida. Materials and Method: A retrospective analysis of 200 case records of primigravida at Department of Obstetrics and Gynecology, Apollo Institute of Medical Sciences, Hyderabad, was done. 100 who underwent primary caesarean section were taken as cases whereas 100 who underwent normal deliveries were taken as controls. Results: The mode of delivery in primigravida with age <25 years is normal delivery (58%). In primigravida of height <150cms, caesarean section rate of 62%. Among the caesarean section group, 55% had some antepartum risk factor. 72% of the normal delivery group, had spontaneous onset of labour. In the cases who underwent caesarean section, 51% had induction of labour as compared to 26% in the normal delivery group. 92% of primigravida who had normal delivery had clear liquor. Meconium stained liquor was found in 36% of primigravida undergoing caesarean section. Conclusions: Mode of delivery in a primigravida is influenced by various antenatal and intrapartum factors. Identification of antenatal risk factors and careful use of induction of labour can significantly reduce the primary caesarean section rate.
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