Introduction. The number of caesarean sections (CSs) carried out is risingworldwide, with one of the main fetal indicators for this method of deliverybeing fetal distress. In our department, the rate is reported to be particularlyhigh compared with the literature. Our decision to perform a CS deliveryduring labour is based only on the cardiotocograph (CTG) recording, and sothe aim of this study was to carry out an audit of CSs in fetal distress with aview to analysing this criterion, and to link the CTG findings that diagnosefetal distress to fetal outcome in order to assess the accuracy of the diagnosis.Methods. This is a retrospective and descriptive study of cases, using files,delivery book and electronic medical records which were collected over aperiod of 6 months. Some relevant clinical data were collected and usedto measure clinical distress in the fetus. Some of the results relating to CSincidence and CTG recording have been compared with the literature. Themajor factors leading to emergency CSs were identified. Decision to deliverytime and neonatal outcome were assessed based on Apgar score, cord pH andneonatal intensive care admission.Results. There were 1890 deliveries during the study period, i.e. 1 June 2011to 31 December 2011. Of these, 101 women underwent CSs due to fetaldistress, with 90 (17.4% of total CSs) included in the study. The remaining11 women were excluded as they did not meet study criteria. The mainindicators for CSs were CTG-recording abnormalities and meconium-stainedliquor. One of the major points to emerge was that despite women havingbeen taken for an emergency CS as a result of fetal distress, analysis of thefetal outcome showed that not one of the newborns had low Apgar score(< 7) at 5 minutes.Conclusion. The high rate of CSs for fetal distress in our department isprobably due to a lack of other surveillance methods such as fetal scalp bloodsampling and integrated CTG recording and fetal electrocardiography, but it isalso symptomatic of the fear of medicolegal issues.