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11. An Analysis of Caesarean Birth in A Private Teaching Hospital

1. Rubina Yousaf 2. Saima Jawed 3. Tahira Yasmin 4. Attyia Rashid

1. Assoc. Prof. of Obst. & Gynae, Al  Khidmat  Teaching  Mansoorah Hospital, Lahore 2 & 3. Assoc. Profs. of Obst.

& Gynae, UCMD, Lahore 4. Senior Registrar, Obst. & Gynae, UCMD, Lahore

ABSTRACT

Objective: The objective of this study was to analysis the Caesarean Birth in Private Teaching Hospital. Study Design: Retrospective study

Place and Duration of Study: This study was carried out at the Department of Gynae /Obst Alkhidmat Teaching Mansoorah Hospital, Lahore affiliated with University College of Medicine and Dentistry, Lahore  over a  period of  1 year  from  April 2012 to March 2013.

Materials and Methods: The  study was carried out to analysis the indications and to assess the maternal mortality and mortality as well as  fetal outcome after  C/S. The frequency of caesarean section during the study period  was  about  46%. Indications included, repeat caesarean ( 38.21%), failed inductions (19.9%), fetal distress (15.6%), Ceaphaloplevic disproportions (7.6%) breech presentation (6.36%), APH and PIH (4.7%), Twins and mal presentations (3.82%) and other (3.66%). 

Results: Out of 628 patients (79.62%) were booked patients while (51.6%) patients had elective  cesarean section. Anaemia, UTI,PPH and wound sepsis were  common maternal complications. Two patients 0.31% died due to complications of surgery or anaesthesia. (97.29%) babies were born alive, (1.43%)  were IUD either fresh or macerated while only(1.27%) babies died in the early neonatal period. Although caesarean section rate i.e.46.38% is quite high in our hospital but this is not  a true caesarean section rate  for a specific population. Majority of the  patients who  underwent C/s were  booked, belonging  to educated middle class families having awareness of the complications that may occur during trial  of  labour.

Conclusion: Provision of adequate antenatal health services timely identification of high risk cases use of electronic fetal monitoring; involvement of senior, skilled and experienced personnel in the management of obstetrical emergencies are responsible for the apparently higher rate of caesarean section. In order to reduce C/S rate frequency of trial of labor must be increased with the goal of vaginal delivery but without compromising maternal and fetal health.

Key Words: Caesarean  Section, Caesarean   Section rate, mortality, morbidity APH, PIH and C/S.