Primary Caesarean section in Tabuk community in Saudi Arabia – rate and clinical indications

Abstract

Introduction: Studying the rate and indications for Caesarean section (CS) provide helpful guidance for health care givers and researchers who are trying to reduce the rate of CS and its complications. Objectives: To identify the rate and the indications for primary CS and develop strategies to decrease the overall CS rate and its complications, especially in our community where large families are the norm. Materials and methods: A retrospective cohort study of 987 women who gave birth by CS at King Khalid Hospital, Tabuk, Saudi Arabia, during the period from January 2013 to December 2013 was performed. All patient medical records were reviewed to obtain the rate of primary CS and characterize its indications. Results: Of a total of 2720 deliveries during the study period, 987 deliveries were CS deliveries (36%). More than half of CS deliveries (55.5%) were primary CSs. The most frequent indications for primary CS were non-reassuring fetal status (23%), breech presentation (20%) and failure to progress (18.8%). All patients with intermediate category of fetal heart tracing (72%) did not have fetal scalp pH testing (not available in the labour ward). Conclusions: Primary CS is high in King Khalid Hospital compared with the national and international institutions, which offer external cephalic version and fetal scalp pH testing. These are important strategies that should be implemented to reduce the primary CS delivery rate and hence the overall rate of CS in the Tabuk community. Acknowledgements: Dr Amani Al-Shaman and Dr Rania Kamel for supervision of this project.