Clinical audit of Caesarean Sections performed at Dr George Mukhari Academic Hospital

Background: Complications during and post Caesarean Sections have been found to contribute significantly to maternal deaths in South Africa. The increase in caesarean section (CS) rates is considered a reason for serious public health concern. Objectives: The study aims to identify reasons for CSs, incidents of adverse maternal and foetal outcomes, and to determine the decision to delivery interval. Methods: Clinical records of women who underwent caesarean deliveries at Dr George Mukhari Academic Hospital (1 March to 31 August 2014) were included in this retrospective study. Descriptive statistics were used to analyse information on CS reasons, maternal, and neonatal outcomes. Results: Of the 5,232 deliveries during the study period, 2,074 (39.6%) were CSs. From the 894 studied cases, 80.9% were emergency CSs, while 19.1% were electives. Primary CSs constituted 69.2%. Foetal distress (33.9%) was the most frequent reason for emergency CS. A previously scarred uterus (59.6%) and foetal macrosomia (20.5%) were the most common reasons for elective CSs. Blood transfusion was the most frequent adverse maternal outcome (47.5%). The most frequent reason for Neonatal Intensive Care Unit admission was respiratory distress syndrome (38.5%). The mean decision to delivery interval for all emergency CS cases was 377.4 (±30.85 minutes). Conclusion: Foetal distress is the most common indication for an emergency CS.