[Incidence of and factors associated with primary cesarean section in Benin (Africa)].

Among 3225 deliveries in two Cotonou public maternity units, 244 primary cesarean section were observed during July 1988 to December 1989. Primary cesarean section incidence varied according to indications, maternal parity and maternity care units. Foetal distress (65.9%), malpresentation and cephalopelvic disproportion (22.1%) were the dominant organic risk factors for the primary cesarean section. Multivariate stepwise logistic regression technique indicated that the most important indications for the practice in Cotonou were mainly organic risk factors, maternal height and parity as well as repeating stillborn history. Practician experiences (OR = 6.6) and foetal distress (OR = 9.3) in the decision making process were highly associated to cesarean section and differed between maternity units. Authors provided some suggestion for improving the practice of cesarean section in Cotonou and in Bénin.