An audit of cesarean sections in Military Hospital Rawalpindi

Objective: To analyze the rate, the frequency of different indications and the most common indication of cesareansections in Military Hospital Rawalpindi.Study Design: Cross sectional studyPlace and Duration: Obstetrics and Gynecology Department of Military Hospital Rawalpindi from September 2011to February 2012.Methodology: A total of 3555 pregnant females delivered during study period were enrolled in the study. Healthvolunteers and the cases of uterine rupture, pregnancy with fetal anomaly, or termination of pregnancy were excludedfrom the study. All patients were admitted in labor room. Detailed obstetric and gynecological history was taken. Detailedgeneral physical examination and obstetric examination was done. Baseline investigations were checked. Fetal anomalieswere ruled out by anomaly scan. Strict fetomaternal monitoring was done during labor. Cervical foley catheter andprostaglandin E2 (Prostin®) tablets were used for induction according to Bishop score. Clinical record of all patients,including mode of delivery and indication, was analyzed in terms of percentage and frequency and documented in aspecial performa after written informed consent. Filled performas were attached with patient’s case notes.Results: Patients enrolled in the study over six months were 3555, out of which 1620 (45.5%) were delivered by cesareansection, 1901 (53.4%) were spontaneous vaginal deliveries and 34 (0.9%) were delivered by vaginal birth after cesarean(VBAC). The rate of cesarean section in our study was 45.5% and the most common factor was repeat cesarean section(44.4%), followed by failed trial of labor (27.1%) and fetal distress seen in 165 (10.1%) cases.Conclusion: The rate of cesarean section in our study was 45.5% and the most common factor was repeat cesareansection 44.4%.