Primiparity as an intrapartum obstetric risk factor

To ascertain whether primiparity is an intrapartum obstetric risk factor for maternal and perinatal outcome.

The comparative case-controlled study was conducted at the Department of Obstetrics and Gynaecology of Sir Syed Hospital, a tertiary care facility in Karachi, from January 2008 to June 2009. A self-developed structured proforma was used to obtain relevant information about 400 women who were recruited part of the study: 200 primigravida and 200 multigravida. The proforma covered detailed record of labour management. Inclusion criteria was singleton pregnancy with cephalic presentation at term. Exclusion criteria was significant medical illness, recurrent miscarriages, bad obstetrical history, intrauterine death, congenital anomalies, previous uterine scar, multiple pregnancy, malpresentation, significant antepartum haemorrhage and Rhesus (Rh) incompatibility.

Primigravidas were at significantly higher risk for prolonged first and prolonged second stage of labour, increased chances of foetal distress during labour and need for intensive monitoring as compared to the multigravidas. Primigravidas were also at significantly increased risk for operative vaginal delivery and emergency caesarean section. The chances of primary postpartum haemorrhage in primigravidas were found to be more, and perinatal morbidity was also increased in the group.

Results highlighted primiparity as a risk factor for maternal and perintal outcome in comparison with multigravida.