ABSTRACT
To analyze different indications and frequency of caesarean section [CS] so as to provide recommendations for reduction of caesarean section rate. Descriptive case series. Obstetrics and Gynaecology Unit III, Civil Hospital and Dow University of Health Sciences Karachi, from January 2009 to December 2009. All patients who underwent CS either booked, unbooked or referred were included in the study. The data was collected and analyzed for socio-demographic parameters and indications of CS. Patients with ruptured uterus on laparotomy were excluded. Data was analyzed on SPSS 11; percentages and mean were calculated. During one year study period 778 CS were performed. The rate of CS was 27.94%. Emergency CS was performed on 85.86% and elective caesarean section on 14.14% patients. Among them 71.34% were non-booked and referred cases. The commonest indication was repeat CS [n 367 - 47.17%], followed by labour dystocia [n 78 - 10.01%], breech presentation [n 77 -9.8%], foetal distress [FD n 72 - 9.2%], cephalo-pelvic disproportion [CPD n 71 - 9.1%], hypertensive disorders of pregnancy [PID n 49 - 6.2%] and antepartum haemorrhage [APH n39 - 5.0%]. The rate of caesarean section was high. The majority of the cases were non-booked and referred patients, who mostly underwent emergency CS. The commonest indication was repeat CS