Predictors of Cesarean Section in Term Nulliparous Women Presented in Labour at Tertiary Hospital: A Cohort Study

Objective: To identify predictors of cesarean section in a term nulliparous women presented in labour. So that we can avoid unnecessary primary cesarean section and in the same time avoid, as much as we can, obstructed labour. Methods: This was a cohort study of 216 nulliparous patients presenting in labour at term with singleton vertex fetuses who were followed till delivery either vaginally (n = 144) or by cesarean section (n = 72). Multiple logistic regression was used to identify independent demographic and clinical predictors for cesarean delivery. Results: Increased maternal weight, advanced gestational age, change in cervical dilatation & cervical effacement after two hours of admission and finally change in fetal head station after two hours of admission remained independently significant in a multiple logistic regression model for cesarean delivery. Conclusions: The use of demographic and clinical criteria early during labour in nulliparous women with vertex presentation may reduce the potential morbidity associated with prolonged labour or second stage cesarean delivery.