TRENDS AND DETERMINANTS OF THE RATE OF CESAREAN SECTION IN THE LABOUR ROOM AT A TERTIARY CARE SETUP

Abstract

Background: Cesarean section is an important obstetric intervention when vaginal delivery poses a risk to the mother or fetus. Objective: To assess the pattern and major determinants of cesarean section among women managed in the labour room of a tertiary care setup and to determine the contribution of different obstetric, maternal, placental, and fetal indications. Methods: This retrospective observational study was conducted in the Obstetrics and Gynaecology department of Services Hospital Lahore from January 2024 to December 2024. Records of cesarean deliveries performed during the specified study period were reviewed. Data were collected from labour room registers, delivery records, operative notes, and patient files using a structured proforma. Results: A total of 2,237 cesarean sections were recorded. The major documented categories PG, PREV1, and PREV1 OR MORE accounted for 534 (23.87%), 668 (29.86%), and 784 (35.05%) cases, respectively, together contributing 88.78% of all cesarean sections. Other clinical and obstetric indications accounted for 251 (11.22%) cases. Among specific indications, failure of induction was the most frequent, occurring in 45 (2.01%) cases, followed by intrauterine growth restriction in 43 (1.92%) and placenta accreta in 37 (1.65%). Fetal and pregnancy related indications accounted for 104 (4.65%) cases, maternal and placental indications for 95 (4.25%), and labor related indications for 52 (2.32%). Conclusion: It is concluded that cesarean deliveries were concentrated within a few major recorded categories, while failure of induction, intrauterine growth restriction, and placenta accreta were the leading specific clinical indications.