Factors affecting the rate and the indications of primary caesarean section

الملخص EN

Objective : To describe the clinical indications of primary caesarean sections and to evaluate the factors affecting the obstetric outcome.

Methods : We reviewed caesarean deliveries at the King Fahd Hospital of the University performed between 1st of January 1994 and 31st December 1998 (n = 690).

The indication for the procedure and obstetrics outcome was obtained from the surgeon’s operative reports and obstetrics files.

Results : The hospital caesarean rate during the study period was 9.8 %.

About 49 % of the caesareans were primary procedures.

There were more caesarean sections in women below the age of 30 years and in parity < 5.

Elective primary caesarean delivery was performed in 26.9% cases while emergency caesarean section was performed in 73.1% of cases.

The leading cause of primary caesarean sections was cephalopelvic disproportion followed by breech presentation and fetal distress.

Emergency caesarean sections were performed more frequently in patients who had no or irregular antenatal care.

Babies born by emergency caesarean section had lower 5 minutes Apgar score and more post operative complications.

Larger babies ≥3.5kg were delivered by caesarean section mainly due to failure to progress and breech presentation.

Conclusion: Primary caesarean section rates contribute to nearly 49 % of the total caesarean section rate and it is on the increase.

Many obstetric factors responsible for the increase should be evaluated.