Rubina Yousaf, Shahnaz Naseer Baloch.
An audit of Cesarean section.
Pak J Med Res Jan ;45(2):28-31.

Objective: 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. Design: A retrospective study. Place and duration: A 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. Subjects and methods: This was a retrospective study. The source of information was the record of labour room, Operation Theater, antenatal & postnatal wards. This record provided the detailed information. Results: 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 & Anesthesia. Conclusion 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 & 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.

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