Frequency and Indications of Cesarean Section in a Tertiary Care Hospital

Objective: To determine the frequency of cesarean section and to analyze the indications, so as to introduce measures to control the cesarean section rate. Methodology: This descriptive study was conducted in obstetric and gynecology department of Isra university hospital Hyderabad Sindh from 1st Jan 2007 to 31st Dce 2007.In this study clinical record of all the patients who underwent cesarean section was analyzed. It included all the pregnant ladies booked in the antenatal clinic and unbooked patients admitted in early labour for whom cesarean section was indicated later. It also included all those cases coming in emergency at any time for which cesarean section was indicated. Clinically diagnosed cases of ruptured uterus proved on laparotomy were not included in the study. Data was analyzed on SPSS version 11 and frequencies as wall as percentages were calculated. Results: During one year study period, 380 cesarean section were performed. The rate of cesarean section was 64.7%. Emergency cesarean section was performed in 225 (59.2%) patients and elective cesarean section in 155 (40.7%). Among 380 patients, 167 (43.9%) were booked while 213 (56.0%) were unbooked. Repeat cesarean section was the commonest indication seen in 73 (19.2%) patients followed by dystocia in 51 (13.4%) patients, fetal distress in 48 (12.6%) and ante partum hemorrhage in 45 (11.8%) patients. Miscellaneous indications contributed to 16 (4.2%) of the cases. Conclusion: Majority of patients who underwent cesarean section was unbooked and had an emergency cesarean section. The commonest indication was repeat cesarean section.