AN ATTEMPT AT NATURAL DELIVERY IN 1500 AFGHAN PRIMIGRAVIDAE

Abstract

Introduction: The objective of this study was to assess the advantages and disadvantages of natural labor with minimum intervention as a choice in preference to active labor in Primigravidae.

Materials & Methods: The descriptive study took place in Mercy Hospital, Peshawar, Khyber Pakhtunkhwa, Pakistan, between January 2003 and July 2006 on 1500 Afghan Primigravidae. Only patients at or above 37 weeks of gestation and singleton cephalic pregnancies were included in the study. Induction was employed only when medically indicated. The membranes were kept intact as long as possible. Episiotomy during second stage and use of oxytocics during third stage of labor were generally avoided. Analgesia was used only for repair of episiotomy or lacerations.

Results: Episiotomy was performed only in 258 (16.83%) patients, that included 114 (9.6%) patients of operative vaginal delivery and 144 (9.6%) of normal vaginal delivery. Patients who had neither episiotomy nor tear totaled 1242 (82.72%). There were 12 perinatal deaths (0.8%), but no maternal mortality in the entire series.

Conclusions: Natural vaginal delivery remains a safe and tolerable procedure for most uncomplicated primigravidae and should be practiced as a routine choice for maternal delivery unless otherwise indicated.