A One Year Cross Sectional Study Of Primary Cesarean Section At Kle Dr Prabhakar Kore Charitable Hospital

Abstract

BACKGROUD AND OBJECTIVES Cesarean section initially introduced as a life savior for both mother and the baby has now become the most commonly performed surgery in obstetrics. The recent trend of rising cesarean sections across the globe has become an issue of international public health concern. It is important to reduce the rate of primary Cesarean section, in order to curb the commonest indication for LSCS today which is previous LSCS as today’s decision depends on yesterday’s choice, just as today’s choice will determine tomorrow’s decision. METHODOLOGY This one year prospective cohort study was conducted in labour room at KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum during the period of January 2017 to December 2017. A total of 1516 cases who had primary caesarean section,were recruited for the study and data was obtained and subjected to analysis using inferential statistics. RESULT Total number of deliveries conducted between January to December 2017 were 5756. The rate of cesarean section was 48.5% (2792), Out of which primary cesarean sections were 1516 (54.5%) The frequency of primary cesarean section was higher in primipara than multipara. Fetal distress(30.3%) was the commonest indication followed by malpresentation, non progress of labor, severe pre- eclampsia and eclampsia. PPH was the most common intraoperative complication leading to extended operative interventions like compression sutures, and step wise uterine DE vascularization and peripartum hysterectomy. The most commonly observed post operative complications in the present study were abdominal distension, wound gape and fever. 2 maternal deaths were reported in the present study. There were 1539 live births, 12 fresh still births and 7 macerated still births. Majority of the babies had a birth weight between 2.5 to 3 kg with an average APGAR score of 7. There were 22 perinatal deaths with prematurity contributing the major part. CONCLUSION Since ours is referral hospital the rate is higher. The need of the hour is to limit its rate and develop a consensus on safe prevention of primary cesarean delivery. The most effective approach to reducing overall morbidities related to cesarean delivery is to avoid the first caesarean.This mandates the need of target driven restrictions on the primary cesarean deliveries