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Abstract

 

Background: Caesarean delivery is defined as the birth of a fetus through incision in the abdominal and uterine wall. Caesarean section can be life saving or can prevent serious morbidity to mother and fetus. Globally rapid increase of this mode of delivery has become the most debated topic in modern obstetric care. The World Health Organization (WHO) recommended that the average C-section birth rate should be 10% to15% while unnecessary C-section may impose detrimental effect on maternal and perinatal outcome.

Aims and objective: To analyze the indications of primary caesarean section along with their obstetric determinants.  To identify the factors needed to be addressed for the development of strategies to reduce primary C-Section rates for improved maternal and child health care.

Materials and Methods: This hospital-based retrospective study was conducted at College of Medicine and JNM Hospital, WBUHS, Kalyani upon all patients undergoing primary caesarean section at the facility from June 2021 to May 2022.

Results: A total of 1716 primary caesarean sections were done in the said period of which 505 cases were elective and 1211 cases were emergency. The percentage of primigravida women was significantly higher in emergency group (82%) than elective ones (64%). The most common indication of all caesarean sections being presumed fetal distress (31.9%) followed by failed induction(22.2%).

Conclusion: Caesarean section is considered as a process indicator in maternal health. Majority of the indication being presumed fetal distress, improved set up to support and revive sick neonates, and lesser fear of litigation may reduce the rate of primary caesarean section. The government should also develop better health-care infrastructure and caesarean audit strategies to decrease the rising trend of caesarean section.

Keywords: Primary caesarean section, indications, elective, emergency.

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