Background: Repeat caesarean sections are known to be a cause of significant morbidity in both intra and post-operative period. The challenges faced by the surgeon may include adhesions, difficulty in delivery of foetus, visceral injury and bleeding. The post-operative recovery may be marred by problems such as post-partum haemorrhage, febrile morbidity, wound infections and the after effects of intra-operative visceral injury. It is these issues that often make repeat caesarean section a cause for concern and delay the recovery of the mother. Methods: At random, hundred ante-natal patients visiting the obstetric OPD, meeting the inclusion criteria of previous caesarean section and planned for repeat caesarean section were selected and all the data were collected and tabulated. Results: After careful analysis of the data, it is observed that the intra-operative findings of adhesions, placenta praevia and excessive blood loss were encountered in relook caesarean sections. Similarly post operative morbidity in the form of wound infection and fever were observed in the same study population. Conclusions: If we are more vigilant and restrict the number of primary caesarean sections to evidence based appropriate indications, we may be successful in reducing the number of repeat caesarean sections and thereby mitigating the subsequent hardships for the mother.

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Background: Augmentation of labour is a practice that aims to increase the duration, frequency, and intensity of uterine contractions in order to decrease the duration of labour and reduce adverse events of maternal and fetal outcomes associated with prolonged labour. Although oxytocin is the most commonly used drug for the augmentation of labour, there is no universally accepted dosage regimen as various studies have used different regimens of oxytocin as low dose and high dose, leading to clinical heterogeneity. Hence this study was taken up to study the advantages, disadvantages and complications of a widely accepted regime for this study.Methods: 100 patients in active labour, with inadequate uterine contractions were selected. The patients were randomly selected, allotting alternate cases for high dose and low dose oxytocin. The patients were monitored through the course of labour and compared in terms of augmentation-delivery interval, mode of delivery, maternal and fetal outcome. The findings were tabulated and statistically analyzed.Results: Majority of the patients delivered vaginally in both groups (78% of high dose and 90% of low dose group). The mean augmentation-delivery interval was 7.20 and 7.45 hours for high dose and low dose group respectively. 12% patients in high dose group experienced maternal complications, while none were encountered in low doe group. 12% neonates from high dose group and 14% from low dose group required admission to the NICU.Conclusions: It was concluded with moderate certainty that high dose regimen of oxytocin resulted in reduction in the duration of labour, but cesarean rate, maternal and fetal complications were more. It was concluded that neither regimen has got an absolute advantage or disadvantage over the other.