Analysis of caesarean delivery at a tertiary care hospital in Pakistan.

We conducted an analysis of caesarean sections (CS) in a tertiary care hospital in Pakistan to determine the rate of CS, indications and outcome. This information will be useful to formulate strategies to control the rate of CS and its associated complications in our hospital. This was a descriptive study conducted at the Obstetrics and Gynaecology Unit III, Sir Ganga Ram Hospital, Lahore during a period of 6 months, from 1 September 2000 to 28 February 2001. A proforma was constructed to document the details of all caesarean sections during the study period. During the 6-month period, of a total of 1424 deliveries conducted in the unit, 300 women had CS. These caesarean deliveries were analysed for the present study. The rate of caesarean sections in the study group was 21.07%. Of 300 caesarean deliveries, 34 were elective (11.33%) and 266 were emergency caesarean sections (88.67%). The main indications for the emergency caesarean deliveries were dystocia (28.2%), fetal distress (22.18%), CPD (6.77%) and a previous one (5.64%) or two caesarean sections (7.52%), while the main indications in the elective caesarean deliveries were a previous two (50%) or three (2.94%) CS. One hundred and two (34%) women were primigravida, 152 (50.67%) were gravida 2-4 and 45 (15%) women were among gravida 5-9. The mean age of the study group was 29 years. There was one maternal death and overall maternal morbidity was 14%. The majority of women were hospitalised for 2-6 days. In the group of emergency caesarean sections, there were four stillbirths (1.5%) and seven perinatal deaths (2.63%). The overall perinatal mortality rate was 4% in the study group. High-risk pregnancies without antenatal care constitute a major reason for the increased rate of caesarean deliveries and its associated morbidity and mortality.