Background: High cesarean birth rate especially among primigravidas is an international public health concern which makes it utmost essential to be reanalyzed and to study the changing trends in indications.Aim: To analyze the indications of primary cesarean sections.Methods: This is a retrospective hospital record-based study done from 1st January 2019 to 30th June 2022. Results: During the study period, total numbers of deliveries conducted were 13041 of which total number of cesarean section deliveries were 5305 and primary cesarean sections were 2391. The cesarean section rate was 40.68% of which primary cesarean section rate was 45.07%. Most common indication for primary cesarean section was non-progression of labor—23.17% followed by fetal distress—20.85%, obstetrical reasons—17.65%, cephalopelvic disproportion—15.76%, others—14.57%, breech—8%. The rate of primary cesarean section was higher in the age group of 20–30 years with BMI more than kg/m2.Conclusion: There is a significant increase in the total cesarean section rate with primary cesarean section accounting for a significant increase.
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