Prevalence and Indications of Caesarean Section at a Tertiary Level Hospital, Kathmandu

Abstract

Caesarean section (CS) is one of the most common surgeries performed in modern obstetrics.Caesarean  section rates have been increasing worldwide over the past few decades, with most countries and  regions exceeding the World Health Organization recommended rate of 15% of all deliveries. The  objective of the study was to assess the prevalence and indications of caesarean section in a teaching  hospital. This study was conducted in labour room of Tribhuvan University Teaching Hospital  Kathmandu. The respondents in this study of caesarean section were all CS cases documented in  confinement record book from Ist Jaunry to 30 ^th March 2015.  

Out of 1112 delivery cases, 436 caesarean sections were performed. Among them (72.24%) were  emergency CS and elective CS were (27.75%). The most common indication of emergency caesarean  section were meconium stained liquire (23.17%), fetal distress (20.63%), non-progresslabour  (9.84%), oligohydramnios (9.52%), previous CS (6.98%), breech presentation (4.44%), Prelabour  rupture of members 4.12%).The common indications of elective CS were previous CS (40.49%),  breech presentation (14.04%), CPD (5.78%), bad obstetric history (6.61%), pregnancy, induced  hypertensive disorders (4.13%). 

Based on the study finding it is observed that meconium stained liquire, fetal distress, non progresslabor, previous CS are most common indication for emergency Cesarean section..The most  common indications of elective CS were Previous CS followed by breech presentation, cephalopelvic  disproportion, bad obstetric history and pregnancy hypertensive disorders . Future efforts to reduce  the overall caesarean section rate should be focused on reducing the primary caesarean section, and  early detection and management of pregnant women in any medical and obstetric complication.