Analysis of Primary Caesarean Section in a District Hospital

Abstract

Background: Caesarean delivery is defined as an operative procedure to deliver the fetus or foetuses after the period of viaility through an incision on the adominal wall and uterine wall in an intact uterus. The World Health Organization (WHO) has identified an ideal caesarean section (CS) rate for a nation of around 10-15%1. The objective of the present study was to find the rate of primary caesarean deliveries in and its contribution to total caesarean rate and to analyze the indications of the caesarean sections.
 Methods: It is a retrospective observational study conducted in the Department of Obstetrics and Gynaecology at Regional hospital,Bilaspur. A total of 90 primary caesarean deliveries were studied.
 
 Results: The total deliveries during the study period were 809 and the total caesarean section rate observed was 14.96%. The caesarean section rate among primigravidae was 74.38%. Out of the total number of primicaesarean deliveries, 92.22% were performed in emergency and 7.78% were performed electively. Among the emergency caesarean sections performed, 60.24% of patients had induced labor and 39.76% had spontaneous labor. The most common indication of caesarean section was fetal distress (43.33%) followed by failed induction(18.89%) and malpresentations (16.67%).
 
 Conclusions: Caesarean audit should be performed routinely and every case should be scrutinised. Reducing the primary caesarean rate not only decreases total caesarean rate but also many long-term complications associated with previous caesarean sections like adherent placenta ,rupture uterus