13. AN AUDIT OF RATE AND INDICATION OF CESAREAN SECTIONS IN A PRIVATE TEACHING HOSPITAL

Shahnaz Parveen1, Mohammad Naeem2, Rubeena Gul2

1Department of Obstetrics & Gynaecology, Mercy Teaching Hospital, Peshawar - Pakistan
2Department of Community Medicine, Khyber Medical College, Peshawar - Pakistan

Abstract

Objective: To determine the rate and analyse the clinical indications of caesarean section in a private teaching hospital
of Peshawar.
Materials and Methods: Retrospective record base study conducted in Mercy teaching Hospital, Peshawar. Records of
caesarean section conducted from January 2011 to December 2013 were looked into and those patients who needed
hysterectomy were excluded. Data was collected from admission/discharge records and analyzed in Microsoft Excel.
Results: A total of 5230 deliveries were conducted in three years. The overall rate of caesarean was 4.36% (228) were
caesarean births, of which elective caesarean were 71 (31.14%) and emergency caesarean were 157( 68.86%). Out of
228 patients primigravida were 26(26.32%) , multigravida were 122(53.51%), grand multigravida 42(18.42%) and great
grand multigravida 4(1.75%). 35(15.3%) patients were booked, 36 (15.7%) were admitted through OPD one day before
C-section. Majority of caesarean sections were done in multigravidas. The major indication for emergency C-section
was obstructed labour in 48 (30.57%) followed by fetus distress in 30(19.11%). common indication for elective C-section
was previous 2 or more C-sections in 28 multigravidas(39.45%) followed by malpresentation in 14(19.72%).
Conclusion: The emergency C-section rate was high and most common indication was obstructed labour with its
associated maternal and fetal complications. Selective and comprehensive emergency obstretical care (EmOC) should
be implemented at the all health care facilities in order to further reduce the indications for ceasearen sections.

Keywords: Elective, caesarean section, emergency, Fetal distress.

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