Primary cesarean section: a critical analysis.

A detailed analysis of 465 primary cesarean sections (10.4% of total deliveries) performed at St. Mary's Health Center during 1977 and 1978 was undertaken. Cephalopelvic disproportion, malpresentation, and fetal distress were the 3 most common primary indications for cesarean section. An analysis of the effects of fetal monitoring seemed to indicate that the procedure was not a significant factor in increased use of cesarean section.