LABOR AT TERM

COMPARISON OF OBSTETRIC OUTCOME BETWEEN PRIMIGRAVIDA AND MULTIGRAVIDA PRESENTING IN LABOARTERY

Abstract

Objectives: To compare the obstetric outcome between primigravida and
multigravida presenting in labor at term. Study Design: Cross sectional study. Period: Six
months from Jan 2013 to Jun 2013. Setting: Obs/Gynae unit III, Jinnah hospital, Lahore.
Patients and methods: 800 patients were included in the study which comprised 400
of primigravida and 400 of multigravida. Patients having single, alive fetus with cephalic
presentation at 37-41 weeks were included in the study. Those having recurrent miscarriages,
parity >5, antepartum hemorrhage, previous uterine scars and significant medical illness were
excluded from the study. The data was collected on specially designed proforma. Observations
mode of delivery including the indication of cesarean section or instrumental vaginal delivery
if applicable. Maternal complications such as postpartum hemorrhage along with its cause,
retained placenta and uterine inversion were also recorded. Fetal and neonatal observations
included CTG abnormalities, oligohydramnios, low birth weight, macrosomia, Apgar score < 7
at 5minutes, NICU admission, fresh still birth and early neonatal death. Results: Mean age was
25.57+ 3.46 years in primigravida women while it was 25.75 + 3.44 years in multigravida group.
CTG abnormalities (15.5% VS 4.25%), instrumental deliveries (9.75% VS 1%), cesarean section
(15.25% VS 1%) and postpartum hemorrhage (5.7% VS 1.75%) were commoner in primigravida
women. In addition, NICU admissions, low birth weight babies and a low Apgar score at
5-minute were also commoner in primigravida women. Conclusion: Nulliparous women are
at greater risk of labor abnormalities, fetal distress, instrumental deliveries, cesarean section,
postpartum hemorrhage and neonatal morbidity. These adverse factors should therefore be
looked for and treated well in time.