Lubna Ali, Subhana Tayyab, Fauzia Perveen.
Cesarean section rate: current trends.
J Surg Pak Jan ;12(2):64-6.

Objective: To determine the rate and analyze indications of caesarean section Study Design : Observational study Place & Duration of study: The study was conducted in Obstetrics & Gynaecology Unit IV, Sindh Govt Lyari General Hospital attached to Dow University of Health Sciences from April 2005 till March 2006. Patients & Methods: All pregnant women booked in antenatal clinic and unbooked patients admitted in early labour on whom caesarean section (CS) was performed, were included in the study. The medical records of all patients were examined to study the socio-demographic variables, nature of procedure and the indication of abdominal delivery. Results: The total number of births during study period were 930 of which 186 patients underwent caesarean section which makes 20% caesarean section rate (CSR) in our unit. Out of 186 CS done, 144 were performed in emergency and 42 as elective cases. The mean age was 30 years and the mean parity was 1.9. Primigravidas were 71(39%), multigravidas 75(40%) and grandmultiparas 40(21%). Commonest indication for caesarean section was repeat caesarean section. Failed progress of labour was the 2nd commonest indication among the 15% of cases. Obstructed labour and fetal distress were indications in 9.6% of cases. Other indications include breech presentation, ante partum hemorrhage, hypertensive disorders, twin pregnancies and transverse lie. Conclusions: The most effective mean to control increasing CSR is the prevention of first caesarean section which could be achieved by adopting the policy of trial of vaginal birth after previous C-section, selective vaginal breech delivery and regular audit of C-section in the department.

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