The indications of primary ceasearean sections have been undergoing a gradual change over the last few decades.
Besides the obstetric causes, several other medical, social, ethical, economic and medicolegal factors play an important role in the rising trend of ceasearean section.
This study was conducted how to safely reduce the rate of primary caesearean section in both primiparous and multiparous women by analysis of its indications and to improve maternal and perinatal outcome.
1. To study the indications for the primary cesarean section in (Emergency &Elective/obstetrical and non-obstetrical indications) in both primiparous & multiparous women.
2. To study the maternal and fetal outcome after primary cesarean section.
3. To curtail primary cesaerean section in future by proper analysis of its Indications by conducting LSCS audit.
Material and Methods: This prospective Cross sectional study was carried out in a tertiary care hospital, Chennai between March 1, 2018 to February 28, 2019. This study includes both nulliparous and multiparous women who are undergoing caesaerean section for the first time.
Results: Total number of deliveries during one year period was 6718. Total no of caesearan sections during that period was 3229. Total number of primary caesearean sections was 1970. During my study period Cesaerean section rate was 48.06%. Primary ceasearean section rate was 36%. There was no maternal mortality in our study. Most common maternal morbidities are Paralytic ileus and puerperal fever seen in 18 cases each. 252 (42%) babies were admitted in NICU. Most common indications for NICU admissions were meconium aspiration syndrome and low birth weight. Perinatal mortality in the study was 7.9%. Perinatal mortality was high in patients with antepartum hemorrhage.
Conclusion: Incidence of primary lscs was 36% at the 1st phase of study. By conducting LSCS AUDIT, pitfalls were identified during the 2nd phase, pitfalls are overcome by various training programmes and strict induction protocols in 3rd phase, at the end of the study during 4th phase we reduced the primary LSCS rate to 22%. And LSCSAUDIT is now ongoing to maintain and further safe reduction of primary ceaserean section.