A Study of Indications and Outcomes of Cesarean Section in a Tertiary Care Hospital

Background: Cesarean section (CS) is one of the most frequently performed obstetric surgical procedures and plays an important role in reducing maternal and neonatal morbidity and mortality when vaginal delivery poses risks. However, the rising rate of cesarean deliveries has become a major concern worldwide. The present study was undertaken to evaluate the indications and outcomes of cesarean section in a tertiary care hospital.

Materials and Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynecology of a tertiary care teaching hospital over a period of 24 months (January 2023 to December 2024). A total of 1,250 deliveries were recorded during the study period, among which 512 women underwent cesarean section. Data regarding maternal demographic characteristics, indications for cesarean section, and maternal and neonatal outcomes were collected using a structured data collection form and analyzed using descriptive statistical methods.

Results: Out of 1,250 deliveries, 512 (41%) were cesarean sections and 738 (59%) were vaginal deliveries. The majority of cesarean deliveries occurred in women aged 21–30 years (60%). Emergency cesarean sections constituted 70% of the cases, while 30% were elective procedures. The most common indication for cesarean section was previous cesarean section (28%), followed by fetal distress (24%), cephalopelvic disproportion (14%), and failed induction of labor (11%). Postoperative complications were relatively low, with 87% of women experiencing no complications. Most newborns (88%) had birth weight ≥2.5 kg, 92% had Apgar scores ≥7 at 5 minutes, and 11% required NICU admission.

Conclusion: Cesarean section accounted for a substantial proportion of deliveries in the tertiary care hospital, largely due to the referral of high-risk pregnancies. Previous cesarean section, fetal distress, and cephalopelvic disproportion were the most common indications. Maternal complications were low and neonatal outcomes were generally favorable. Careful evaluation of indications and promotion of safe vaginal birth after cesarean (VBAC) may help optimize cesarean section rates.