RESUMEN
Increasing cesarean section rates are a major public health concern and the prevention of the first caesarean section, which often leads to repeat operations, is an important issue. Analyzing caesarean sections can help to identify factors associated with variations in caesarean section rates and help to assess quality of obstetrical care. To determine the rate of caesarean section in Mukalla MCH hospital and to evaluate its indications and out come. Retrospective analytical observational study. Obstetrics and Gynecology department of Mukalla MCH hospital. January 1[st] 2005-December 31[st] 2005. Four hundred and ninety six women who underwent caesarean section during the study period. A Performa was constructed to document the details of caesarean sections during the study period. Data entry and analysis was done by using SPSS v11 software computer program. During the study period, of a total 4128 delivery conducted in the department, 496 women had caesarean section. The rote of caesarean section was 12%. Of the 496 caesarean deliveries 364 were emergency [73.4%] and 132 were elective [26.6%]. The main indications in the emergency caesarean sections were cervical dystocia [18.7%], second stage arrest [17.9%], obstructed labour [15.6%] and fetal distress [12.6%]. Emergency section was done due to rupture uterus in 2[0.4%] cases. The main indications in the elective caesarean sections were previous two [27.2%] or three [12.5%] caesarean sections. One hundred seventy four [35.3%] women were primigravida [31.5% sections were emergency], 199 [40.1%] women were gravida 2-4 and 96 [19.3%] women were among gravida 5-9. The mean age of the study group was 27 years. There were no maternal deaths and overall maternal morbidity was about 9.4%. In the group of emergency caesarean section, there were 11 stillbirths [3.4%] while in the elective caesarean section group there was only two [1.6%] recorded stillbirth infant. The rate of caesarean section in Mukalla MCH hospital is within the suggested rate of WHO [5-15%]. The highest rate was seen among primigravida, increasing the risk of repeated caesarean sections in the following pregnancy