Frequency and Factors Associated with Cesarean Section in a Tertiary Care Hospital of Southern Punjab, Pakistan

Abstract

Background: There is a large variation in the frequency of cesarean section in different countries and in different regions of the same country. To reduce the country-wide disparity in this mode of delivery, WHO has set in an optimal range of 10–15%. In Pakistan, the rate of cesarean sections has increased over time. Rising rate of cesarean section may be associated with maternal age, antenatal care, parity, fetal lie and presentation, comorbidities, previous cesarean section, maternal choice, and clinical management policies. Objective: To determine the frequency and factors related to the cesarean section in females in a Tertiary Care Hospital in Southern Punjab of Pakistan. Methodology: It was a descriptive cross-sectional study, conducted from 1st March 2020 to 31st December 2020. Two hundred and five females fulfilling the inclusion criteria were enrolled applying the statistical formula. A predesigned questionnaire was applied to collect data at a Tertiary Care Hospital, Bahawalpur. The data were analyzed by using SPSS version 24. Results: The mean age of the respondents was 25.3±4.4 years; 45.4% of females belonged to the upper-middle class and 95.6% were housewives. The mean number of antenatal visits was 3.4±1. Overall, 72.7% of females had cesarean section deliveries. The risk factors associated with cesarean section were: previous cesarean section 34.6%, fetal distress 13.7%, cephalo-pelvic disproportion 12.7%, oligo-hydramnios 10.7%, low lying placenta 8.3%, abnormal lie presentation 6.8%, and failure to progress in labor 5.9%. Conclusion: The frequency of cesarean section was high. Major factors associated with cesarean section were previous cesarean section, education level, fetal distress, cephalo-pelvic disproportion, and oligo-hydramnios.