Cesarean Section Rate, Indication, Complications, and Outcome in Basrah City

Background: Caesarean section was first used to save the lives of both the mother and the babies, but the rising number of Caesarean deliveries has raised worries. Aim of the study: To estimate the rate, indication, complications, and outcome of the Caesarean sections. Patients and Method: A retrospective cross-sectional study was conducted in the Department of Obstetrics and Gynaecology at Basra Maternity and Child Hospital /Basra Governorate / Iraq, during the period from the 1st of October 2023 to the 1st of July 2024. All pregnant women who underwent Caesarean section during the study period were included in the current study. Results: The number of women who were delivered by Caesarean section was 3990, with a rate of 42.45%. In 1477 (43.7%) patients, the Caesarean section was the first Caesarean section, 1107 (27.7%) had a previous Caesarean section, while 1139 (28.6%) had two or more previous Caesarean sections. The more frequent indications in the first Caesarean section versus repeated Caesarean section were failure to progress in labour (28.3% versus 24.11, P-value=0.036), fetal distress (28.2% versus 26.4%, P-value=0.310), and fetal malpresentation (29.4% versus 27.73%, P-value=0.337. The complications in the first Caesarean section versus repeated Caesarean were extension of the lower segment (0.26% versus 0.63%, P-value=0.073), intraoperative bleeding (0.22% versus 0.40, P-value=0.301), and bladder injury (0% versus 0.05%, P-value=0.289). The percentages of postoperative complications were higher in those with repeated Caesarean sections compared to those with a first Caesarean section, but the difference was not statistically significant. Conclusion: The rate of Caesarean section was 42.45% of the total deliveries; 43.7% of these patients had the first Caesarean section. The main indication of a Caesarean section was failure to progress. The main intraoperative complications include an extension of the lower segment and intraoperative bleeding, while the postoperative complications include postpartum haemorrhage and paralytic ileus