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Background: Rates of caesarean section (CS) in developing as well as developed countries have increased beyond World Health Organization (WHO) recommended level of 15% almost doubling in the last decade. Aim: To assess the rate, indications and early complications of CS delivery at Aljamahiriya hospital, Benghazi, Libya. Methods: A retrospective study involved representative sample of 670 out of 4654 of cases delivered by CS during the year 2009. Data were recorded from the hospital files, and statistical reports of the department of statistics. A predesigned questionnaire was used to collect the data needed for the study including parity, type of CS, indications for emergency and elective CS and early complications that might have led to CS. Results: A total of 16109 deliveries were reported in Aljamahiriya hospital during 2009, 4654 of them were delivered by CS constituting 22.4% of total deliveries. The main indications of emergency CS were fetal distress (38.2%) and previous two scars (22%), while in elective CS the main indication was previous scars (50%). The overall rates of early complications were 2.3% for emergency CS and 3.9% for elective ones; wound infection was reported among 1.8% of cases with elective CS, while post partum hemorrhage constituted the most common complication of the emergency CS (1.1%). Conclusion and Recommendations: The high and unprecedented increase in CS rates reported in this study may be partly due to CSs that are not medically indicated, and suggest that physician practice patterns and patient preferences should be explored. The present study is the first step to document actual practice. It points out for further in depth studies to explore the medical, environmental and social factors contributing to the high rate of CS. In addition, similar studies should be carried out at other hospitals in Libya. The results should be used by the national health authorities to introduce more evidence based practice and so decrease maternal mortality and morbidity.

Rate, Indications and Complications of Caesarean Section at Aljamahiriya Hospital, Benghazi, Libya