Prevalence of Caesarean Section in Matri Shishu Miteri Hospital of Gandaki Province

Abstract

Background: Caesarean section (CS) is one of the commonest obstetrics procedure to reduce the risks for mother and fetus when vaginal delivery is not anticipated. The objective of the study was to determine the rate and clinical indication of Caesarean section. 
 Materials and Methods: This was a hospital based descriptive retrospective study done within a time frame of a year (from Shrawan 2075 BS to Ashad 2076 BS; 17 July 2018 to July 16 2019) in Matri Shishu Miteri Hospital, Pokhara, Nepal. The total number of deliveries, their modes of delivery, indication for the Cesarean section, age group, number of parity, period of gestation and type of Caesarean section either elective or emergency were descriptively analyzed. 
 Results: A total of five hundred and eighty eight cases underwent delivery during the study period. Of them 128 (21.76%) cases were delivered by Caesarean section. Analysis revealed that the common age group for the CS patients was between 20-30 years (64.8%) of them 66 (51.6%) cases were primi gravida. Emergency Caesarean section was done for 75(58.6%) cases and elective Caesarean section for 53(41.4%) cases. The most common indication for Caesarean section was found to be previous caesarean section 21% (n=27), cephalopelvic disproportion (CPD) 18% (n=23), fetal distress 18% (n=23), failed induction 14.1% (n=18), breech presentation 10.2 %( n=13), non progress of labor (NPOL) 9.4 %( n=12) and oligohydramnios 7.8% (n=10). 
 Conclusion: Our study revealed that the rate of Caesarean section is higher than that recommended by World Health Organization (WHO), which needed to be 10-15% of the total deliveries. The common indications for Caesarean sections were pervious Caesarean section, fetal distress, CPD, failed induction, breech presentation, non progress of labour (NPOL) and oligohydramnios among others.

Factors contributing to rising cesarean section rates in South Asian countries: A systematic review

“…Unfortunately, these criteria for VBAC are often scarce in most places in low-resource countries. 104 As reported by several previous studies, our review documents many other common key indications for CS: APH/placenta previa/abruption, 22,96,101,103 CPD, 22,95,96,100,103 HDP, 22,95,96,103 failed induction, 22,96,100,103 NPOL, 95,96,[100][101][102][103] oligohydramnios, 95,100,103 multiple pregnancy, 22,95,101,103 malpresentation, 95,96 breech presentation, 22,100,103 and IUGR, 95,101 Similarly, CPD is found to be a key indicator for elective CS. 95,97,98 emergency CS, 95,96,98 primary CS, 99 repeat CS 99 and CS in primigravida.…”

“…99 Recent studies have reported that previous CS is the key leading indication of CS. 22,[100][101][102][103] The growing number of primary CS may influence the decisionmaking around mode of birth. The majority of pregnant women who have a history of previous CS would decline vaginal birth after CS (VBAC).…”