A five-year review of the rates and indications for cesarean section at Mbale regional referral hospital; a cross-sectional study.

Abstract

Introduction: Globally, there has been an increase in cesarean section rates. This is a public health concern because of the implications it has on the individual, families, and limited health care resources. Current information on the rates and indications for CS in our setting is not known. Objective: The main objective of the study was to review files/charts in Mbale Regional Referral Hospital over the study period. Methods: This was a hospital cross-sectional study, based on a 5 years retrospective chart review. It was conducted in a public hospital setting where 46,575 patient files were included, of these 11,514 were cesarean section deliveries. Trained research assistants extracted data from the patient case files using a structured questionnaire. Descriptive statistics in form of frequency tables, alongside graphs, percentages, means, and standard deviation were computed. Data were analyzed using STATA/SE Version 14.2. Results: The rate of CS during this study was 24.7% (11,514 CS cases out of 46,575 total deliveries). Of these CS deliveries, elective CS deliveries accounted for 372/11,514 (3.2%) while 11,142/11,514 (96.8%) the emergency CS deliveries. Of the 11,514 cesarean section files, 6,466 had complete data and constituted the study sample. The commonest indications for emergency CS were Cephalo pelvic disproportion, macrosomia, and fetal distress, abruptio-placenta, previous scar, and premature rupture of membranes. Conclusion and Recommendations: Results show a progressively increasing CS rate from 2013 to 2018 and the common indications for CS can be screened for during Antenatal visits. This suggests that various stakeholders may need to; sensitize pregnant mothers to always attend antenatal visits, and health workers to always carefully examine pregnant mothers for such indications during antenatal checkups and advise accordingly, so as to scale down CS rate.