To evaluate the feto-maternal indications for primary cesarean section in a tertiary care hospital

Abstract

Objective:  To evaluate the feto-maternal indications of the primary cesarean section. Materials and methods:  The present descriptive cross-sectional study was conducted in the Dept. of Obstetrics and Gynecology, Narayan Medical College and Hospital, Sasaram, Bihar, India. The study includes 160 subjects planned for primary cesarean section for various reasons. Results: Incidence of primary caesarean section calculated was 24.8%. Majority of the subjects belonged to 20-25 year age (51.3%) followed by 26-30 year age (26.9%). Mean age was 25.12±3.31. 81.3% were gravida 1 and 24.4% were gravida 2. Mean gestational age was 37.09±2.14 weeks. Fetal indication of caesarean section in our study was Non-reassuring or Abnormal CTG (28.1%), Malpresentation (11.3%), Abnormal umbilical artery colour Doppler (8.1%), Macrosomia (3.3%) and Congenital anomaly (0.6%). Under maternal indications CDMR (9.1%), Abnormal placentation (5.8%), Under maternal indications CDMR (9.4%), Abnormal placentation (5.6%), Maternal cardiac disease (1.9%), Genital tract obstructive mass (1.3%), Pelvic deformity (1.3%), Failed operative vaginal delivery (1.3%) and 0.6% had previous vesicovaginal fistula (VVF) repair. Conclusion: Fear of litigation and violence against doctors has increased obstetricians stress.Appropriate guidelines should be followed to reduce primary cesarean and subsequently repeat cesarean section rate.

Keywords: audit, primary cesarean section, maternal indications, fetal indications.