High Cesarean Section rate in Tertiary care hospital: Are we justified?

  • Nasira Tasnim
  • Shumaila Naeem Department of MCH ,PIMS
  • Muqadar Shah
  • Najma Ayub Senior Registrar
  • Oreekha Amin Department of MCH,PIMS
  • Syed Azra Post gradate Trainee
Keywords: Cesarean section, Pregnancy, Cesarean Section/trends, Infant, Newborn


Background: Rising cesarean section rate is a burning issue worldwide. In Pakistan, increase in cesarean section has occurred with the development of more delivery clinics and hospital in public as well as private sectors.

Objective: The aim of this study was to revisit the rising cesarean rate at a government sector as well as to evaluate the causes behind it.

Methodology: This was a cross-sectional study done in maternal and child Health (MCH) department of Pakistan Institute of Medical Sciences (PIMS) between December 2017 to February 2018. 660 pregnant women presenting for delivery in MCH Unit II through both outpatient department and Emergency department, undergoing cesarean section were included in the study. Data was obtained after obtaining informed consent and ethical approval.

Results: Cesarean section rate was calculated to be 40% with 33.3 % being elective and 66.7% being emergency cesarean section. Out of elective operations, repeat cesarean section accounted to be 59.1%, whereas mal-presentations accounted for 63.4% of all emergency cesarean sections.

Conclusion: The cesarean section rates are rising at an alarming speed. Whereas indications for cesarean section seem to be justified in the current situation, preventable measures and robust guidelines are warranted to manage preventable causes of cesarean sections in Pakistan. The government of Pakistan need to take measures to strengthen existing public health facilities as well as ensure that cesarean sections are performed based upon justified indications in both public and private sector health facilities.

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