Indication and complication of caesarean section at tertiary care hospital: a retrospective study

Abstract

Background: The incidence of cesarean section is steadily rising. Cesarean delivery has played a major role in lowering both maternal and perinatal morbidity and mortality rates. There are various factors involved in the rise of rate of cesarean section like rising incidence of primary cesarean delivery, identification of high-risk pregnancy, wider use of repeat cesarean section, rising rates of induction of labor and failure of induction, no reassuring fetal status etc.Methods: A retrospective cross-sectional study was conducted. Data was collected from patient records of the hospital during 1st January 2018 to 30th June 2018. All patients (N= 602) who had delivered their baby by caesarean section were included in the study. Data were analyzed by help of SPSS version 21 after proper compilation.Results: Among all women who underwent cesarean section, majority were age group between 21 and 30 years (67.1%). Repeat cesarean section (48.5%), followed by fetal distress (18.9%), oligohydramnias (6.6%) and cephalopelvic disproportion (6.5%) were most common among all major indication of cesarean section. Intrapartum complication (2.0%) includes postpartum hemorrhage (1.2%), CS hysterectomy (0.5%), bladder injury (0.3%) and postpartum complication (2.3%) including UTI (0.8), wound infection (0.5%), sepsis (0.5%), lactation failure (0.5%) were major maternal complication of cesarean section.Conclusions: Reduction of number of primary cesarean section, successful VBAC, individualization of the indication and careful evaluation, following standardized guidelines can help to keep rate of cesarean section to the possible minimum level.

Perinatal outcomes of multiple cesarean sections

“…These results are similar to those of a recent study, in which 63.6% of cases were emergency CSs and only 36.4% of cases were planned CSs [10].…”

“…The proportion of women aged 21-30 years was similar in both study groups (48.0% and 58.3%, respectively; p > 0.05). Rehman et al, in a recent study, confirmed that most women who underwent CS were aged 21-30 years (67.1%) [10].…”

“…A previous CS is the most common indication for the next CS. A cross-sectional retrospective study performed on a group of 602 women with CD found that repeat CS (48.5%), followed by fetal distress (18.9%), oligohydramnios (6.6%), cephalopelvic disproportion (6.5%), failure of labor (5.6%) and malpresentation (3.8%) were the most common major indications for CS [10].…”

“…(3) pregnant women over 40 years of age; (4) pregnancy with a gestational age less than 35 weeks; (5) anterior "T" or "J"-shaped hysterotomy; (6) transverse fetal position; (7) multiple pregnancies; (8) patients with severe extragenital diseases (autoimmune diseases, diabetes, cardiovascular diseases, deficiency of coagulation factors); ( 9) patients with uterine rupture, bleeding tendency, and infections; (10) patients with incomplete data who did not undergo all the investigations according to the study protocol.…”