Evaluation of Criteria for Primary Caesarean Sections in Multiparous Women with Prior Vaginal Deliveries at a Tertiary Care Facility

Primary Caesarean Sections in Multiparous Women

Abstract

Objective: To evaluate the criteria for primary caesarean sections in multiparous women with prior vaginal deliveries at Sohail Trust Hospital/Jinnah Medical College, Karachi. Study Design: Retrospective observational cross-sectional study. Settings: Sohail Trust Hospital/Jinnah Medical College, Karachi Pakistan. Duration: January 1, 2023, and December 31, 2024. Methods: The study sample comprised 5,280 women who delivered within the department and 476 multiparous women with primary caesarean delivery. Maternal demographic, maternal complications, mode of birth, and infant outcomes were obtained. The statistical analysis involved an SPSS version 23, where the continuous variables were analyzed in terms of mean and standard deviation, and categorical variables were analyzed with the Chi-square test. Results: The incidence of primary caesarean sections in multiparous women was 39.47%. Emergency caesarean was 85 percent of the total, with foetal distress (26.47) and malpresentation (21.43) the most common manifestations. Some of the maternal complications were transfusion reactions (12.18%), urinary tract infection (8.19%), and postpartum hemorrhage (4.20). Neonatal complications included respiratory distress syndrome (6.93%). Conclusion: Pure caesarean delivery of multiparous women who gave birth to previous babies through vaginal delivery is related with high rates of maternal and infant mortality. Early recognition and optimal antenatal care of high-risk women would decrease the rate of emergency section and lead to better results.