Caesarean section in term nulliparous women at Wellington Hospital in 2001: a regional audit.
OBJECTIVE
The aims of this audit were to determine the frequency of caesarean section (CS) in the Wellington region for term nulliparous women, to evaluate the local demographic and clinical factors associated with CS, and to assess the quality of clinical care.


METHODS
Nulliparous women with singleton live pregnancies and a gestational age greater than and equal to 36 weeks who had a CS in Wellington Hospital during 1 January 2001 to 30 June 2001 were identified using a computerised database. The Hospital records were reviewed. Demographic and clinical factors associated with CS were analysed and assessed against standards from the literature.


RESULTS
A total of 743 women with a singleton live pregnancy greater than and equal to 36 weeks delivered during the period. 209 women met the criteria and 201 files were available. The estimated corrected CS rate was 27%. Thirty-six women (5%, 36/743) had an elective CS, and 165 (22%, 165/743) had an emergency CS. Dystocia (48%), suspected fetal compromise (23%), and malpresentation (20%) represented the most common indications for CS. A significant proportion of CS were performed without meeting the standards.


CONCLUSIONS
In term nulliparous women, the indications for CS and the compliance with recognised standards from the literature were very similar to those observed in other industrialised countries.
Sangalli
Michel
M
Consultant Obstetrician and Gynaecologist, Women's Health Service, Wellington Hospital, Wellington South, New Zealand. Michel.Sangalli@ccdhb.org.nz
Guidera
Alice
A
D000328:Adult; D001724:Birth Weight; D001946:Breech Presentation; D002585:Cesarean Section / Q000706:statistics & numerical data*; D004420:Dystocia / Q000601:surgery; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008485:Medical Audit; D009520:New Zealand; D010298:Parity; D011247:Pregnancy; D011787:Quality of Health Care