Rate, Indications and Fetal Outcome of Cesarean Section Deliveries at a University Hospital in Cairo

Abstract

Background & Objective(s): Cesarean section (CS) rates increased in different parts of the world. Egypt demographic and Health Survey report (2014) shows that Egypt is the third country worldwide. Caesarean sections are associated with short- and long-term complications. The aim of this study was to measure rate and trend of CS at Ain Shams Maternity Hospital (2011-2015), to identify characteristics of females who delivered by CS during the last two years of the study duration (2014-2015) and to find out risk factors of unfavorable/poor fetal outcome. Methods: A descriptive observational study by record review was performed by randomly selecting 1305 files from hospital archives of 2014 and 2015. Results: Rate of CS increased over 5 years (2011- 2015) from 27.6% to 36.9. CS rate was 36.6% in 2014 and 36.9% in 2015. The majority of cesarean deliveries (80%) were due to maternal causes (out of which 63% were due to previous CS). Half of the fetal causes was due to fetal distress. Multivariate logistic regression revealed that preterm birth (<37 weeks) and maternal health problems necessitating CS, significantly determined fetal outcome. Conclusion: The rate of CS in this study was higher than that recommended by international guidelines. Preterm birth and maternal indications for CS significantly determined fetal outcome. Evidence-based protocols for deliveries should be adopted or updated if present and to have clear criteria as well as a written policy for when a CS should be performed.