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Objective: To find out the indications of repeat caesarean sections in women with or without labour.
Material and Methods: This descriptive study was conducted in Gynae A Unit of Khyber Teaching Hospital, Peshawar,
Pakistan from January 2014 to December 2014. All patients with previous 1 caesarean section who underwent repeat
caesarean section in Gynae A Unit were included in the study and their indications were recorded. Other parameters
like parity, period of gestation, elective or emergency and with or without labour were also analyzed. Patients with more
than 1 caesarean section and primigravida were excluded from the study.
Results: A total of 177 patients underwent repeat caesarean section during the specified period of time. The most
common indication of repeat caesarean section was contracted pelvis in 35 (20%) cases followed by suspected scar
dehiscence in 29 (16%), fetal distress in 26 (15%) and PROM in 17 (10%). Breach presentation, non progress in 1st
stage of labour and nuchal cord were in 12 (7%), 12 (7%) and 10 (6%) cases respectively. Post date pregnancy, oligohydamnios,
Bad Obstetrical History (BOH), low biophysical profile, ante partum hemorrhage. Multiple pregnancy,
unstable lie, chorioamnionitis, non progress in 2nd stage of labour, obstructed labour, previous myomectomy and
diabetes accounted for <5%.
Conclusion: Suspected scar dehiscence, fetal distress and PROM are the indications which can be reduced by experienced
obstetricians and close monitoring facilities like continuous electronic fetal monitoring, intrauterine pressure
devices, 1:1 midwifery service, fetal scalp blood PH and delivery in a tertiary care hospital.
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