Primary Cesarean Section in Multiparous Women at a Tertiary Care Hospital

Abstract

Introduction: Cesarian sections are life-saving procedures for both the mother and fetus subject to obstetric complications. The rapid rise in cesarean delivery rates remains a global problem. Due to multifactorial reasons for primary caesarean section among multiparous cohort, this study aims to find out the prevalence and the underlying indications of primary cesarean section in these women.

Materials and Methods: A descriptive cross-sectional study was conducted at a tertiary care hospital of Madhesh Province from April 2025 to July 2025. Ethical clearance was obtained from the Institutional Review Committee. All multiparous women, fulfilling the inclusion criteria, were enrolled in the study. Data was collected using a specifically designed proforma. Data entry was done in Microsoft EXCEL and simple descriptive analysis was performed.

Results: Out of 518 multiparous women, 99 (19.11%) underwent a primary cesarean section. Majority of women, 45 (45.45%) belong to 26- 30 age-group and predominantly 79 (79.80%) were from rural areas. Most participants, 39 (39.39%) were of first and second parity. Emergency caesarean section was 91 (91.92%) which was much higher than elective ones. The most common indication for primary caesarean section was fetal distress 42 (42.43%), followed by Oligohydramnios 16 (16.16%) and Breech Presentation 8 (8.08%).

Conclusion: Previous vaginal deliveries offer no guarantee of subsequent ones. Multipara with a previous vaginal delivery may still require a caesarean section due to various indications. Most of the primary CS are emergency and fetal distress remains the most common indication.