INDICATIONS OF CAESAREAN SECTION IN PRIMIGRAVIDAS WITH INDUCED LABOUR

Abstract

Background: Induction of labour is a common obstetric practice, especially in post-term pregnancies. Primigravidas undergoing induction are at increased risk of operative delivery due to unfavourable cervical conditions and variable labour responses. Understanding the specific indications leading to Caesarean section in this population is crucial for improving obstetric decision-making and maternal–fetal outcomes.

Objective: To determine the frequency of Caesarean section among primigravidas undergoing induction of labour and to identify the major indications associated with operative delivery.

Methods: This descriptive case series was conducted over three months in the Department of Obstetrics and Gynaecology at a tertiary-care hospital. A total of 150 primigravida women aged 21–38 years, with gestational age between 40 and 40+6 weeks, were enrolled through consecutive sampling. Induction was performed using standard pharmacological and mechanical methods. Baseline demographics, Bishop scores, labour progression, mode of delivery, and primary indications for Caesarean section were recorded. Data were analyzed using SPSS version 21 and presented as means, frequencies, and percentages.

Results: Of the 150 induced primigravidas, 96 (64%) delivered vaginally and 54 (36%) underwent Caesarean section. The most common indications for Caesarean delivery were fetal distress (37%), cephalopelvic disproportion (26%), failure to progress (22%), failed induction (11%), and maternal request (4%). Vaginal deliveries were associated with earlier cervical ripening, whereas Caesarean cases showed slower progression and greater need for augmentation. Maternal and neonatal outcomes were largely favourable.

Conclusion: Caesarean section is relatively frequent among induced primigravidas, predominantly due to fetal distress, cephalopelvic disproportion, and labour arrest disorders. Optimizing cervical assessment and enhancing intrapartum monitoring may help reduce avoidable operative deliveries.