An Audit of Preterm Caesarean Sections at a Tertiary Care Centre in Gujarat

Introduction: Preterm Caesarean sections are performed when early delivery becomes necessary due to maternal or fetal complications, posing challenges for both maternal and neonatal outcomes. These procedures require careful clinical decision-making to balance the risks and benefits, aiming to prevent adverse outcomes like fetal distress, antepartum hemorrhage, or pre-existing maternal conditions. Auditing preterm Caesarean sections provides valuable insights into the indications, management strategies, and outcomes, helping optimize care in high-risk pregnancies. Material and Methods: This retrospective observational study was conducted at a tertiary care teaching hospital in Gujarat to analyze the incidence, indications, and outcomes of preterm Caesarean sections (CS). It included both elective and emergency preterm CS cases performed before 37 weeks of gestation, focusing on maternal demographics, obstetric details, and maternal and neonatal outcomes. Data were analyzed using descriptive statistics, and the Robson Classification system was applied to categorize cases. Statistical significance was tested to identify meaningful differences between elective and emergency CS groups. Results: In our study on preterm Caesarean sections (CS) at a tertiary care center in Gujarat, 66.7% of women were nulliparous, with 83.3% having no previous uterine scar and 88.3% presenting with cephalic fetal positions. The primary indications for lower segment Caesarean sections (LSCS) included antepartum hemorrhage (11.7%), fetal distress (10%), and sickle cell crisis (11.7%). NICU admissions were necessary for 86.7% of newborns, primarily for observation or further care. Most preterm deliveries involved babies weighing between 1.5-2.5 kg (73.3%), with 96.7% of cases being preterm births. Maternal outcomes were positive, with 93.3% discharged without complications, reflecting the effective management of preterm LSCS cases. Conclusion: Our audit of preterm Caesarean sections at a tertiary care center in Gujarat found fetal distress, antepartum hemorrhage, and prior Caesareans as the primary indications. Most women had favourable obstetric profiles with stable outcomes, highlighting effective perioperative management and the multifactorial nature of neonatal outcomes.