A TWO YEAR ANALYSIS OF CESAREAN DELIVERY AT CMH HYDERABAD

Analysis of Cesarean Delivery

Abstract

Objective: To determine the frequency and factors leading to cesarean deliveries and its outcome in a Military Hospital of Sindh province.
Study Design: Descriptive study.
Place and Duration of Study: Obstetrics and Gynecology Department of Combined Military Hospital Hyderabad from 1st January 2011 to 31st December 2012.
Material and Methods: All women admitted for delivery were included in the study. However those delivered by spontaneous vaginal and instrumental delivery were excluded from the study. Details of all the cases who underwent cesarean section (CS) were further evaluated. Neonates were also examined at birth and before discharge.
Results: A total of 2874 deliveries were conducted during the 2 years study period. CS was done on 1206 (41.96%) patients while normal vaginal delivery was conducted in 1668 (58.04%) patients. A total of 34.16% patients underwent elective, while in 65.84% patients CS was done in emergency. Majority (60.03%) of patients were un-booked and rest of them (39.97%) were booked. Most common indication was repeat CS, followed by CPD and mal-presentation; other indications were failed trial of labor, fetal distress, and eclampsia /preeclampsia. In our study, maternal morbidity was observed in 12.77% patients and the maternal mortality was 0.33%. A total of 1199 babies were born alive and total perinatal deaths were 73.
Conclusion: Cesarean delivery rate was mainly influenced by previous cesarean. Being a referral hospital for the families of armed forces personnel in this region, is also an important contributing factor to high CS rate. It was concluded that reduction of primary and repeat CS should be the main target of any strategy. Other measures to reduce the CS rate were the early referral and regular antenatal visits.