AN AUDIT OF CAESAREAN SECTION IN DISTRICT HEADQUARTER TEACHING HOSPITAL, GOMAL MEDICAL COLLEGE D. I. KHAN

Abstract

Abstract
Background: There is a global concern for rise in CS rate over the past few years. C-Section (CS)
deliveries are not only associated with high morbidity and mortality but also prolonged hospital stay
and a general financial burden. Objective: To analyze the rate and frequency of different indications
of CS in DHQ teaching hospital D. I. Khan-KPK, Pakistan. Place and duration: This cross sectional
study was conducted at the Gyne and Obs department of DHQ hospital D.I.K. from January 2015 to
December 2020. Patients and Methods: A total of 25884 delivery cases were entertained during the
study period. Detailed gynecological and obstetrical history was recorded using a pre designed
questionnaire format with an informed consent. All the base line investigations were carried out. Strict
fetometernal monitoring was done during labour period. Prostein E2 tablets were used for induction
using Bishof score. Clinical record of all patients including mode of delivery and indications were
analyzed in terms of percentage and frequencies. Results: Out of 25884 patients enrolled in the study,
11.6% (n=3009) were delivered by CS 88.4% (n=22875) delivered by vaginal birth. Rate of CS ranges
from 8.9% to 12.5% between January, 2015 to December, 2020. Whereas the mean rate calculated was
11.6%. Audit of different indications of CS for January 2015 to December 2020. Audit was divided
into two broad categories for an emergency and an elective CS. The most common indication for an
emergency CS was primary breech (10.80%) followed by fetal distress (7.80%), obstructed labour
(7.40%), cephalo pelvic disproportion (5.54%), and previous-I (6.60%). The most common indications
for an elective CS were previous-I (6.05%), previous-II (4.20%), cephalo pelvic disproportion (4.03%),
breech (2.50%) and previous-III (2.1%). Conclusion: We concluded from our findings that rate of CS
was low at our unit but still it needs to be closely monitored and audited so as to take measures to keep
the check on CS rates. Assisted vaginal breech delivery should be encouraged to reduce CS rate for this
indication.