Analysis of Primary Cesarean Deliveries: An Audit Of 708 Cases

Farah Deeba Nasrullah, Gulfishan Haq, Saima Shaikh, Shagufta Mubeen

Abstract

Objective

To analyze frequency, indications, maternal and fetal outcome of primary cesarean section performed at a public sector tertiary care hospital. 

Study design

Retrospective observational.

Place & Duration of study

Department of Obstetrics & Gynecology Unit 3, Civil Hospital Karachi, from July 2018 to June 2019.

Methodology

Case files of primary cesarean section performed were reviewed. Study variables included age, gestational age, parity, booking status, indication of cesarean section, maternal and fetal outcome including complications. All data were entered and analysed on SPSS version 16.

Results

During the study period 1589 cesarean sections were performed including 708 (44.5% %) primary cesarean deliveries. In the study population, the mean age of the patients was 26 ± 5.6 year and the  mean gestational age 37±2.5 weeks. Majority (n= 424-60%) of the patients were unbooked. In these patients 370 (52.3%) were primigravid, 198 (28%) multipara  and  140 (18.2%) grand multipara. The most common indication was fetal compromise (n=171-24.1%) followed by failure to progress (n=151-21.3%), severe pre eclampsia and eclampsia (n=126-17.7%) mal presentation (n=119-16.8%) and APH (n=87-12.4%). Maternal complications included wound infection (n=79-11.1%), sepsis (n=17-2.4%), PPH (n=33-4.7%), paralytic ileus (n=3-.42%) and obstetric hysterectomy (n=2-0.2%). Fetal mortality rate was 8.1% (n=57 ) and APGAR score of  less than 7 was observed in (n=229-32.4%) cases.

Conclusion

A high rate of primary cesarean section was observed in this study with significant maternal morbidity.

Key words

Primary cesarean section, Maternal morbidity, Perinatal mortality, Obstetric hysterectomy.