Trend of Caesarean Sections in Azad Jammu & Kashmir

Abstract

Introduction: C-section is a major surgical procedure to secure the life of baby and mother when required. Extensive variation in the frequency of C-Section is present between different areas and maternity centers indicating medical ambiguity and disparity in practice.
Objective: To determine the frequency and indication of caesarean section in tertiary care centers of Azad Jammu & Kashmir.
Materials & Methods: The study was conducted at teaching hospitals of Azad Jammu Kashmir Medical College. A total of 1633 Pregnant Women admitted in gynae ward from January-March 2014 were included in the study. Out of these, 71 cases were enrolled after informed consent to evaluate the factors responsible for C-section. Women with inadequate background knowledge, low educational status and from remote areas which were not easily accessible were excluded from this study.
Results: During these three months of study period; there were 1633 deliveries in teaching hospitals of AJKMC. Out of these cases 1020 (62.46%) were vaginal deliveries and 613(37.53% ) were caesarean sections. A total of 71 cases with maternal ages ranged from 18-45 years were evaluated to analyze the factors responsible for rising trend. Out of these observed cases 54.9% were elective and 45.1% were emergency. Social status was poor in 35.2% and middle in 64.7%. Regarding parity primigravida were 38.02% and multigravida were 61.9%.Distance of referral areas ranged 50-150 km. Reasons for caesarean were fetal indication 29.57%, Cephalopelvic disproportion 22.53%,Breech presentation 18.31%,Hypertensive disorder 15.49%. In 10.9% no satisfactory explanation for C-section was found.
Conclusion: The study showed high caesarean section rate of 37.5% in both hospitals which is much higher than the WHO recommended rate of 15%.