Natural delivery in 1500 Afghan primegravidae

摘要

Objective: To assess the advantages and disadvantages of natural labour with minimal intervention in 1500 primigravidae. Methodology: It was an open observational study conducted at department of Obstetrics and Gynecology, Mercy Hospital, Peshawar, Pakistan from May 31, 2000 to June 07, 2002. One thousand five hundred Afghan primigravidae at or above 36 weeks of gestation went through natural labour. Components of "active labour" management were avoided as far as possible. Results: The group had a low induction and augmentation rate. Breech, forceps and vacuum extraction accounted for 114 cases. The remaining 1340 women had vertex delivery with the following outcome: No episiotomy and no tear in 60.3%, minor lacertion in 5.4%, first degree tear in 18.2%, second degree tear in 5.8% and third degree tear in one patient only. Cervical tears occurred in 0.44% cases. Artificial rupture of membranes was only performed for medical or obstetrical indications. The average duration of third stage was 8 minutes and PPH rate 1.2% inspite of Non-use of oxytocics. Low Caesarean Section rate (4.7%) low perinatal mortality and "zero" maternal mortality speak in favour of "masterly inactivity". Conclusion: Natural labour with minimal intervention appears to be safe, gratifying and economical.