Abstract :
Introduction: This study was done to determine the factors influencing mode of delivery in primigravida.
Materials and Methods: A retrospective study was done involving 586 women who delivered at SAH
& RC from 1st March 2018 to 31st August 2018. The data collected was categorised based on maternal
age, mode of onset of labour, expected foetal weight, colour of liquor, presence of FHR abnormalities and
indications for caesarean delivery. Additionally, effect on neonatal outcome was also studied.
Results: Of the 586 pregnancies, 60.75% had vaginal delivery. The significant facilitating factors
for vaginal delivery were found to be maternal age of 20-25 years(34.81%), spontaneous onset
of labour(44.36%), expected foetal weight of 2.5-3.5kg(54.95%), clear liquor(93.00%) and no FHR
abnormality. The caesarean section rate was 39.25%, most common indications being failure to progress
(34.78%), MSAF(17.83%), FHR abnormalities(10.87%), CPD(10%), maternal request (7.8%), second
stage arrest of labour (6.9%) and severe preeclampsia (3.48%). Of the 588 babies delivered, 6 neonatal
deaths occurred(1.02%), of which 5 delivered vaginally(83.33%). 4 were due to birth asphyxia and 1
due to severe preeclampsia. 1 was delivered by caesarean section done for MSAF. 2 babies delivered via
caesarean section (for second stage arrest) were diagnosed as hypoxic ischemic encephalopathy at the time
of discharge. Comparing the outcomes of vaginal delivery and caesarean section, p value of 0.91(significant
value p
of delivery.
Conclusion: The prediction for a woman to undergo vaginal delivery or caesarean section in primigravida
depends on various factors other than obstetric factors such as counselling the woman and her family during
labour and socioeconomic status.
Keyword :
Foetal heart rate, Meconium stained amniotic fluid, Cephalo-pelvic disproportion.