International Journal of Clinical Obstetrics and Gynaecology

Author(s): Mazen Mohammed Alrassad, Sameh Samir Hegazy, Mohammed Zaifer Bawady, Amr Nabih Eisa, Amr Ahmed Mahmoud, Taghreed Alnakeeb and Ahmed Mohamed Kamal Bakr

Abstract: This retrospective audit was conducted to assess the increasing rate of first-time Cesarean Section (CS) and its impact on overall CS frequency, as well as its associated immediate, early, and late complications. The primary objective was to identify contributing factors to first-time CS in Primigravida (PG) and multigravida (MG) women and to recommend strategies to reduce CS rates and associated morbidities. A total of 278 women undergoing their first CS at Kafr Eldawar General Hospital between August 2023 and August 2024 were analyzed. Patient data, including Gestational Age (GA), age, and BMI, were collected under ethical and confidentiality guidelines. The most common indications for CS were unknown causes (41.7%), decreased fetal movement (24.8%), and failed induction of labor (15.8%). Less frequent causes included preeclampsia/eclampsia (6.1%), premature rupture of membranes (5%), breech presentation (3%), antepartum hemorrhage (2.9%), and cord prolapse (0.7%). No significant associations were found between parity and CS causes (P=0.45), or between age and CS causes (p=0.32). PG and MG were nearly equally distributed (48.9% and 51.1%, respectively). The mean age was 30.1 years, mean GA was 38.8 weeks, and mean BMI was 25.3. Compared to studies in low-income countries like Nigeria, Ethiopia, and Peru, where Cephalopelvic Disproportion (CPD) and fetal distress were predominant causes, the unusually high percentage of "unknown causes" in this study suggests gaps in diagnostic practices or record-keeping. The findings highlight the need for better clinical assessment, decision-making, and documentation to prevent unnecessary CS and its long-term consequences, such as increased healthcare burden and maternal morbidity. Educational initiatives and adherence to standard labor monitoring protocols are crucial to reducing unnecessary primary CS rates.

DOI: https://doi.org/10.33545/gynae.2025.v9.i3a.1619

Pages: 06-10 | 95 Views | 30 Downloads

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