Factors Associated with Repeat Caesarean Sections in Tertiary Care Hospital

Anila Mahmood; Rizwana Lakho; Nusrat Lakho; Shoaibunisa; Priya Kumari

Anila Mahmood Assistant Professor, Dept. of Obs & Gynae, LUMHS Jamshoro/ Hyderabad
Rizwana Lakho Consultant Gynecologist, (WMO) Shaikh Zaid Women Hospital, SMBBMU Larkana
Nusrat Lakho Associate Professor, Dept. of Obs & Gynae, Isra University Karachi Campus
Shoaibunisa Associate Professor gynae and OBS, GMMCH Sukkur
Priya Kumari FCPS Part -1 CPSP Karachi

Keywords: Caesarean Section, Repeat Caesarean Sections

Abstract

Objective: To evaluate the causative factors responsible for repeat caesarean sections among patients presented at Zaid Women Hospital, CMCH Larkana.

Methodology: The descriptive cross-sectional study was conducted in department of Obstetrics and Gynecology, Shaikh Zaid Women Hospital, CMCH Larkana from March 2018 to August 2018. Women with a prior caesarean section's history and undergoing repeat C-sections, aged >18 years old, gestation age > 28 weeks and of either parity were included. A complete clinical examination and routine required laboratory investigations were done. Repeat C-sections were performed by experienced and skilled gynecologists with at least five years of experience. All the women were assessed for the causative factor of repeated c-sections. A structured study form was used to record all demographic information, including causal factors. The SPSS version was used for the analysis of the data.

Results: A total of 114 women who underwent repeated caesarean sections were studied, their average age was 27.11±5.66 years and their mean gestational age was 36.43+2.49 weeks. Cephalopelvic disproportion, short Interval, mal presentation, bad obstetrical history, lower segment fibroids, congenital uterine anomalies, septate uterus, bicornuate uterus and didelphys uterus were significant factors of repeated caesarean section. The approximated causative factors were statistically insignificant according to residence and booking status (p->0.05).

Conclusion: As per study conclusion the cephalopelvic disproportion, short Interval, mal presentation, bad obstetrical history, lower segment fibroids, congenital uterine anomalies, septate uterus, bicornuate uterus and didelphys uterus were observed to the factors responsible for repeated cesarean sections. Maternal health care providers should be trained to provide respectful and individualized care to the mother and the neonate, thus ensuring the safety of both during birth.