Low Primary Cesarean Delivery Rates of a Secondary Health Center in a Seven Year-Period

Aim: To present the indications and primary caesarean section (CS) rates of a secondary level hospital. Material and Method: This is a retrospective review of the births recorded at a secondary health center between March 2009 and December 2015. The number of patients with primary CS and repeat CS, total number of births, caesarean indications, and complications were assessed. Results: A total of 6535 live births were recorded during a seven-year-long study period. The mean age of the patients was determined as 26.7 ± 6.0 years (range of age: 15-47 years). Delivery by CS was performed in 20.5% of the total births. Of the caesarean births, 27.8% were primary CS and 72.2% were repeat CS. The mean primary and repeat CS rates during the study period were calculated as 5.7% and 14.8% respectively. The primary CS rate was 8.8% in 2009 and this number decreased to 4.3% in 2015. The most frequently encountered primary CS indications were malpresentation (33.9%) followed by fetal distress (23.3%) and failure of labour induction (14.8%) respectively. No intestinal injury was determined in any patient who underwent caesarean delivery. In the repeat CS group, only one patient had a bladder injury that was successfully repaired. Discussion: The rates of primary caesarean section determined in this study are very low. These low rates can be attributed to several factors such as informing and encouraging patients about vaginal birth, avoiding CS on maternal request, and applying amniotic membrane stripping at term pregnancies