title: Factors leading to cesarean section delivery at Felegehiwot referral hospital, Northwest Ethiopia: a retrospective record review.
abstract: BACKGROUND
  Cesarean section is the commonest obstetric operative procedure worldwide. When used appropriately cesarean sections can improve infant and/or maternal outcomes. However, when used inappropriately the potential harm may exceed the potential benefit of cesarean section. Appreciating the limited information in this area the current study assessed the rate and factors associated with cesarean section in Felegehiwot referral hospital, Bahir Dar, northwest Ethiopia.
  
  
  METHODS
  The study was a retrospective analysis of eligible patient records that included 2967 pregnant women who had underwent either cesarean or vaginal delivery from July 1, 2012 to June 31, 2013. The data were double entered to EPI-INFO 3.5.2 and analyzed with SPSS. Binary logistic regression model was fitted to identify independent factors associated with cesarean section.
  
  
  RESULTS
  The proportion of women who underwent cesarean section in this study was 25.4%. Obstructed labor (30.7%), fetal distress (15.9%) and abnormal presentation (13.4%) were the major obstetric indications for cesarean section. The odd of undergoing cesarean section was higher among mothers in rural residence (AOR = 1.63, 95% CI: 1.21, 2.20), mothers reported to have pregnancy risk factors (AOR = 2.31, 95% CI: 1.74, 3.07) and lower among mothers in age category of 15-19 (AOR = 0.63, 95% CI: 0.43, 0.93).
  
  
  CONCLUSIONS
  Obstetric factors occurring around birth, including obstructed labor and fetal distress were the main reasons leading to Cesarean Section rather than background characteristics assumed to be a risk. The results imply that there is a need for timely and accurate screening of women during obstetric care and, decision to perform cesarean section should be based on clear, compelling and well-supported justifications.
authors.affiliation: Strengthening Human Resource for Health Project, iNGO, P.O. Box, 1566, Bahir Dar, Ethiopia. fantuabebe@gmail.com.
authors.forename: Fantu Eyowas
authors.initials: FE
authors.lastname: Abebe
authors.affiliation: Institute of Public Health, University of Gondar, Gondar, Ethiopia. abebawgebeyehu@yahoo.com.
authors.forename: Abebaw Worku
authors.initials: AW
authors.lastname: Gebeyehu
authors.affiliation: Strengthening Human Resource for Health Project, iNGO, P.O. Box, 1566, Bahir Dar, Ethiopia. anegasi@yahoo.com.
authors.forename: Ashebir Negasi
authors.initials: AN
authors.lastname: Kidane
authors.affiliation: Maternal and Child Survival Program, iNGO, Addis Ababa, Ethiopia. gizacheweyassu@yahoo.com.
authors.forename: Gizached Aynalem
authors.initials: GA
authors.lastname: Eyassu
mesh_terms: D000293:Adolescent; D000328:Adult; D001946:Breech Presentation / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D002585:Cesarean Section; D004420:Dystocia / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D004636:Emergency Service, Hospital; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D005316:Fetal Distress / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D016015:Logistic Models; D008499:Medical Records; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011253:Pregnancy in Adolescence; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors; D012423:Rural Health; D062606:Tertiary Care Centers; D055815:Young Adult