An audit of caesarean section among Saudi females in Jeddah, Saudi Arabia

Abstract

In this study the case records of 1414 patients who delivered at Alshaty hospital within one year were examined and some important variables related to caesarean section cases and their outcome were discussed. The caesarean section rate was found to be 9.9%. The high number of grand multigravida and primigravida among these Saudi mothers have contributed to this high caesarean section rate. The high emergencies in these sections (73.6%) have resulted in higher incidence of maternal and fetal morbidity namely postoperative pyrexia (37%), maternal anemia (20%) and extensive neonatal resuscitation (34%). The main indications of caesarean section in this hospital were repeated caesarean section (34.3%), failure of progress (19.3%) and fetal distress 12.9%. The relation and interaction between the three groups were thoroughly discussed based on the mechanisms of these indications. It is concluded that the changing trend of indications of caesarean section was mostly related to the change in departmental management rather than change in the characteristics of the patients.

PIP: There has been an increase in the rate of cesarean section in some parts of the world. The rising number of indications for cesarean section, the use of fetal monitors, the current medico-legal climate, the importance of avoiding damage to the baby, and the increased safety of the cesarean section itself are some of the reasons cited for this trend. The authors set out to determine the rate of cesarean section in relation to parity and age, the main indications of cesarean section, and the mortality and morbidity associated with cesarean section to the mothers and their newborns. Alshaty hospital is a general hospital in Jeddah which has approximately 1500 deliveries per year. The case records were examined of 1414 patients who delivered at the hospital over the course of one year to ultimately find a cesarean section rate of 9.9%. A large number of grand multigravida and primigravida Saudi mothers contributed to this high rate. The high incidence of emergency cesarean sections (73.6%) resulted in a higher incidence of maternal and fetal morbidity such as postoperative pyrexia (37%), maternal anemia (20%), and extensive neonatal resuscitation (34%). Repeated cesarean section, failure of progress, and fetal distress were the main indications of cesarean section in the hospital. The authors conclude on the basis of this study that the changing trend of indications of cesarean section was related mainly to the change in departmental management rather than to any change in patients' characteristics.