Document Type : original article


1 Associated Professor, Infertility Fellowship, Gynecologist, Infectious disease and Tropical medicine research center of Zahedan University of medical sciences, Zahedan, Iran. Endometriosis Research Center, Iran University of medical Sciences, Tehran, Iran.

2 Gynecologist, Zahedan University of medical sciences, Zahedan, Iran.

3 Pediatric Resident, Ali-Ibn-Abitalib Hospital, Zahedan University of medical science, Zahedan, Iran.

4 General practitioner, Ali-Ibn-Abitaleb Hospital Emergency Screen, Zahedan University of Medical Sciences. Zahedan, Iran.


Background: Cesarean section plays an important role in reducing mortality and complications for the mother and fetus, in high-risk childbirths. But the problem with modern midwifery is the high prevalence of cesarean sections. The aim of this study was to investigate the prevalence and causes of cesarean sections in primiparous women.
Methods: In the present descriptive cross-sectional study, all pregnant women referring to Ali-Ibn-Abitaleb Hospital in Zahedan, Iran, for cesarean section during a year from April 2018 to March 2019 were enrolled. The data including the participants’ demographic information and reasons for the cesarean sections were extracted from the patients' files and recorded in a pre-designed form. Data were analyzed using SPSS statistical software, V. 21.
Results: Out of 174 cases, 44.2% of them ended to cesarean section because of maternal causes, among which 27.5% had delivery arrest, 2.5% preeclampsia, 4.6% chorioamnionitis, 3.5% Placental abruption and HELLP syndrome, and CPD was 4.3%. The fetal causes with a prevalence of 55.8% included fetal distress with 19%, placental abruption with 12%, multiple births with 11%, placental and umbilical prolapse with 9.2%, and macrosomia with 4.6%, respectively.
Conclusion: Lack of progression in labor and then fetal distress were, respectively, the most important causes of cesarean delivery in primiparity women. The other maternal reasons comprised the third leading cause of cesarean sections in these women


  1. Cunningham F, Leveno K, Bloom S, Spong CY, Dashe J. Williams obstetrics, 24e: Mcgraw-hill; 2014.
  2. O'Dwyer V, Hogan JL, Farah N, Kennelly MM, Fitzpatrick C, Turner MJ. Maternal mortality and the rising cesarean rate. International Journal of Gynecology & Obstetrics. 2012; 116(2):162-4.
  3. Sharifirad G, Rezaeian M, Soltani R, Javaheri S, Amidi Mm. A survey on the effects of husband’s education of pregnant women on knowledge, attitude and reducing elective cesarean section. 2010.
  4. Gibbons L, Belizán JM, Lauer JA, Betrán AP, Merialdi M, Althabe F. The global numbers and costs of additionally needed and unnecessary cesarean sections performed per year: overuse as a barrier to universal coverage. World health report. 2010; 30(1):1-31.
  5. Ahmad Nia S, Delavar B, Eini Zinab H, Kazemipour S, Mehryar A, Naghavi M. Cesarean section in the Islamic Republic of Iran: prevalence and some sociodemographic correlates. 2009.
  6. MiriFarahani L, AbbasiShavazi MJ. Cesarean sections change trends in Iran and some demographic factors associated with them in the past three decades. Journal of Fasa University of Medical Sciences. 2012; 2(3):127-34.
  7. Excellence NIfC. Cesarean Section–NICE clinical guideline 132. London) (https://www nice org uk/guidance/cg132 accessed May 2016). 2012.
  8. Cunningham FG. Cesarean delivery and peripartum hysterectomy. Williams Obstetrics. 2005:587-606.
  9. Qarekhani P, Sadatian A. Principles of obstetrics & gynecology. Tehran, Noore-Danesh. 2009.
  10. Thomas J, Paranjothy S. The national sentinel cesarean section audit report. National Sentinel Caesarean Section Audit Report. 2001.
  11. Mohseni SM, Sohrabi Z. The trend analysis of cesarean section rate in a hospital, Tehran, Iran. Payesh (Health Monitor). 2011; 10(2):261-4.
  12. Abedian Z, Nikpour M, Mokhber N, Ebrahimi S, Khani S. Evaluation of relationship between delivery mode and postpartum quality of life. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2010; 13(3):47-53.
  13. Gifford DS, Morton SC, Fiske M, Keesey J, Keeler E, Kahn KL. Lack of progress in labor as a reason for cesarean. Obstetrics & Gynecology. 2000; 95(4):589-95.
  14. Flamm BL, Berwick DM, Kabcenell A. Reducing cesarean section rates safely: lessons from a “breakthrough series” collaborative. Birth. 1998; 25(2):117-24.
  15. David H, Norman J, Robin C. Gynecology illustrated. London: Churchill Livingstone Co. 2000.
  16. mohamadbeigi a, tabatabaee sh, mohammad salehi n, yazdani m. Factors Influencing Cesarean Delivery Method in Shiraz Hospitals. Iran Journal of Nursing. 2009; 21(56):37-45.
  17. Jouhari S, Bayati S, Poor Asadi Kheirabadi F, Moradi E. Cesarean Section Rate and Its Cause in Fasa in the Year 2011. Journal of Fasa University of Medical Sciences. 2014; 4(3):295-300.
  18. Khayyatian N, Nasiri S. Prevalence of Cesarean Section and Its Causes in Governmental Obstetric Hospitals of Kashan - 2014. Journal of Health and Care. 2016; 18(1):28-36.
  19. Rahmanian K, Ghasvari M, Rahmanian V. Cesarean, ever to need attention: Prevalence and causes of cesarean section in Jahrom, 1387. Pars of Jahrom University of Medical Sciences. 2011; 9(1):46-54.
  20. Kawakita T, Reddy UM, Landy HJ, Iqbal SN, Huang CC, Grantz KL. Indications for primary cesarean delivery relative to body mass index. American journal of obstetrics and gynecology. 2016; 215(4):515.e1-9.
  21. Boyle A, Reddy UM, Landy HJ, Huang CC, Driggers RW, Laughon SK. Primary cesarean delivery in the United States. Obstetrics and gynecology. 2013; 122(1):33-40.
  22. Toumi M, Lesieur E, Haumonte JB, Blanc J, D'Ercole C, Bretelle F. Primary cesarean delivery rate: Potential impact of a checklist. Journal of gynecology obstetrics and human reproduction. 2018; 47(9):419-24.