Primary and repeat caesarean sections: comparison of indications.

In this retrospective study, we describe and compare the clinical indications of primary and repeat caesarean sections. We review caesarean deliveries at the Princess Badeea Teaching Hospital in North Jordan performed between 1 January and 26 November 1995 (n=740). The indication for the procedure was extracted based on the surgeon's operative reports. The hospital caesarean rate during the study period was 8.8%; 22.7% of these were repeat procedures (n=168). Elective caesarean delivery was the leading cause of repeat sections, followed by dystocia, others, breech and fetal distress. In contrast, breech presentation, dystocia and fetal distress were the leading indications for primary caesarean section. Ninetynine patients (59%) undergoing repeat caesarean had absolute or relative contraindication to trial of labour. The majority of primary caesarean are clinically indicated. Caesarean section rates can be lowered if we address the repeat elective procedures.