audit of caesarean section

ABSTRACT

The study was carried out to determine the caesarean section rate, to analyse the indications so that measures can be taken to reduce the caesarean section rate and its associated complications. A retrospective study was carried out over a period of five years from January 2000 to December 2004 at Gynae unit-I Bolan Medical Complex Hospital Quetta affiliated with Bolan Medical College Quetta. The source of information was the record of labour room, Operation Theater, antenatal and postnatal wards. This record provided the detailed information. The frequency of caesarean section during the study period was about 21%. Indications included, Dystocia [19.8%]. Fetal distress [19.6%]. Placenta praevia [18.3%]. Repeat caesarean [15.5%]. Previous one LSCS [for recurrent cause] [8.8%] Previous two or more LSCS [6.7%] Breech presentation [14.5%] and Cephalo pelvic disproportion [12.01%]. Nineteen percent of the total maternal deaths occurred during this period were because of the complications of caesarean section and Anesthesia. High prevalence of illiteracy and poverty in our female population of reproductive age, early marriages, high parity and increased maternal ages along with flaws in the health care system e.g, lack of facilities at the primary and secondary health care system, poor referral chain and departmental polices regarding dealing with commonest indications of caesarean section have been identified as major causes of ever increasing CSR