Indications and Fetal Outcomes of Caesarean Section in Sindhu Sadabahar Hospital, Sindhupalchok.

Background There has been a sustained increase in the rate of caesarean section in the last few years around the world. Caesarean section (CS) Audit which plays an important role in the analysis of rate, indications and outcomes of caesarean section, helps to modify the trend of caesarean delivery. Objective This study was done to know the indications and outcomes of caesarean section in Sindhu Sadabahar Hospital, Khadichaur, Sindhupalchok. Method A hospital based descriptive study was conducted in gynaecological department of Sindhu Sadabahar hospital, Sindhupalchok over 14 months period from 1st Baisakh 2070 to 30thAshad 2071 (14th April 2013 to 14th July 2014) among 218 women who underwent caesarean section. Result The foetal distress was the leading indication of caesarean section (34%, n=74). Non-progress of labour and prolonged second stage of labour were seen in 15.6% (n=34) women respectively. There was 3.2% (n=7) fresh still birth and 1.8% (n=4) early neonatal death. Total perinatal death was 5% (n=11). There were 12.1% (n=27) low birth weight baby and 9.9% (n=22) macrosomic baby. ≤ 5/10 Appearance, Pulse, Grimace, Activity and Respiration (APGAR) score at five minutes was seen in 35.5% (n=79) neonates. Conclusion This study showed that majority of patients had an emergency cesarean section for foetal distress, nonprogress of labour and prolonged second stage of labour. Prevalence of caesarean section was higher than the caesarean rate (15%) recommended by World Health Organization (WHO). Cesarean sections performed for appropriate medical or obstetric indications are life saving for both the mother as well as the new born.