Caesarean section on demand: a hospital-based study (original) (raw)

Rising trend of caesarean section in a tertiary hospital over half decade: a retrospective study

International journal of reproduction, contraception, obstetrics and gynecology, 2018

The caesarean section (CS) rate has risen rapidly worldwide in recent decades and is a global concern. 1-6 In 1985, the World Health Organization (WHO) recommended that the optimal CS rates should not be higher than 10% to 15% and this recommendation has become a reference up to this day. 7 The levels of 10%-15% were considered high but acceptable at the time. The rise of cesarean births has been the subject of continuing debate. 8 WHO survey from 2004 to 2008 reported a 25.7% average global caesarean section rate, with 27.3% in Asia, 19.0% in Europe and 29.2% in Latin America. 1,2 Recently, European Board and College of Gynecology and Obstetrics (EBCOG) has demonstrate its worry about the fact of only few countries of European Union having CS less than 20%. 9 Data from countries like Iran, Brazil and México show section rates reaching up to 91.9%,

Rising Trend in Caesarean Section Rate: A Community Health Hazard

BJSTR, 2017

Excessive and unnecessary use of caesarean sections is growing as a major problem for women’s health for which both developed as well as developing countries are the victims. There is no evidence to show any benefit either to mother or to infant when the procedure is not medically indicated. For a community the ideal rate of caesarean section beyond which there appears to be a null benefit to either mother or fetus is considered to be between 10%-15%. But recent studies from various countries show a much higher rate of caesarean section. This rate is even higher in private sectors. ‘On demand caesarean section’ or ‘caesarean section on maternal request’ is growing as a new indication for various social or personal reasons. This alarming rate should be stopped as soon as possible. Proper counselling should be given to labouring women. Antenatal education regarding merits and demerits of caesarean section at community level can be an useful tool.

Rising Rate of Caesarean Section – A Global Problem

International Journal of Current Research and Academic Review

Article Info To compare the frequency of Caesarean Section (CS), Emergency and Elective CS, indications of Emergency and Elective CS and obstetrician reasons for supporting women choice for caesarian section between a healthcare setting of Saudi Arabia and Pakistan. The retrospective study analyzed the hospital records of all deliveries during the period January, 2012 till December, 2012 at two settings, Muhammad Medical College Hospital (MMCH), Pakistan and Sabatal Alaya Hospital, Saudi Arabia. Data (demographic information, parity and outcome variables i.e., cesarean section or vaginal delivery, elective cesarean section or emergency cesarean section) from the clinical records were retrieved. Importantly, the indicators for cesarean section mentioned in the clinical notes were also recorded. The present study also included the collection primary data on reasons for supporting women choice for caesarian section from obstetricians of Pakistan and Saudi Arabia. The data was analysed using SPSS version 21 and qualitative variables were compared between women delivered at

Cesarean section on request in a developing country

International Journal of Gynecology & Obstetrics, 2007

Objective: To assess the prevalence of cesarean sections (CSs) and women's reasons for requesting the procedure in a developing country. Method: Pregnant women scheduled for elective CS were interviewed to determine whether the procedure was requested by them or suggested by a physician. The women who personally requested a CS filled out questionnaires before surgery and at the postnatal visit 6 weeks later, and their answers were analyzed. Results: The prevalence of CS on request was 4.4%. Previous infertility and advanced maternal age at first pregnancy were the most common reasons for requesting a CS, but most women said they would prefer a vaginal delivery in subsequent pregnancies. Conclusion: The women who requested a CS in this study did so for reasons different from those put forth by women in developed countries. The view that a CS is the surest way toward a live birth was the critical factor underlying their choice.

Rising trends of caesarean section: a retrospective study

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2019

Background: The indications of Caesarean Section (CS) have been changing over time, along with a visible, much talked about rise in the rate. Without a doubt, C-sections can effectively prevent maternal and perinatal mortality when done for a medical indication. However, little is researched about the extent of maternal indications and the fetal outcomes of C-sections. Method: Data of January to March 2012 and January to March 2017 was obtained by detailed study of the patient files from the Medical Records Department of the hospital. A predesigned proforma was used to record the relevant information. Data was analysed using standard statistical methods. Result: Cephalo Pelvic Disproportion (CPD) and Fetal Distress (FD) remained the major causes of CS in both the groups, being 50.4% in group2012 and 60.5% in group2017. Trends of CS due to maternal demand and tubal ligations are emerging. Though the rise in CS was not significant in the 5 year period having gone up from 45.41% to 48.81%, there was significant increase in deliveries without complications, having jumped up from 74.8% to 88.3%. Conclusion: As per the study, there was non-significant rise in the incidence of C-sections in the time period of study. Major contributory factors observed were CPD and FD, in which it is imperative to perform C- sections. Keywords: Caesarean section, Rising trend, Cephalo Pelvic Disproportion, Fetal Distress, Maternal demand, Tubal ligation.

The Rate and Indication of Caesarean Section in a Tertiary Care Centre

2020

Method: The rate of caesarean section was only slightly higher than recommended by the WHO. Most of caesarean sections were emergency caesarean sections. Data on all live births were collected, including type of delivery, and indication was recorded if cesarean section was done. Total, primary, & repeat cesarean section rates were calculated for each year. The cesarean rate was calculated as the number of cesarean births divided by total live births. The rate for each indication was calculated annually as the number of cesarean births performed for each indication per 1,000 live births. Result: These two groups constituted nearly 87.7% of total C-Sections. Only 3.4% of the cases belonged to the elderly age group of above 35 years. Maximum no. of caesarean sections was in multiparous females (54.3%). Out of 550 caesarean deliveries 76.7% were from urban area. Also, result showed that only 68.7% were booked for antenatal care. Conclusion: The rate of cesarean section has increased ...

Public Health aspects of Cesarean section including overuse and underuse of the procedure

International Research Journal of Public Health, 2019

Research Article IRJPH (2019) 3:30 Public Health aspects of Cesarean section including overuse and underuse of the procedure Caesarean section (CS) is lifesaving medical procedure that is able to avert both maternal and neonatal mortality. However, across the globe an estimated 3.2 million necessary CSs do not happen in low income countries and an estimate of 6.2 million unnecessary CSs happen in middle and high income countries. The overuse and underuse of this procedure driven by both the supply-side (such as resources within the health system, healthcare policy and strategies, health financing systems and perceptions of the healthcare professional) and demand-side (such as socioeconomic status, population preference and perceptions and trust in health system) determinants. There are stark inequities in CS rates between and within regions and countries. Many regions across the globe (Eastern Asia, Northern Europe, Central America, Southern America, Northern America and Oceania) have over double recommended optimal rates, whereas several African regions (Eastern, Middle and Western) have dangerously low rates. Both of these have detrimental impacts on maternal and neonatal outcomes. There is a need now for health policy and decision makers at both national and facility level to try and optimize the CS rates through facilitating strategies that promote positive human relations and encourage standardized evidence based care.

Factors Affecting Trends of Cesarean Section: A Review

Journal of Health, Medicine and Nursing, 2017

Cesarean section rate is rising in both developing and developed countries. The reason for the increase is multifaceted. The clinical and non-clinical factors have explained the wide variation in cesarean delivery rates between and within countries. Changes in maternal characteristics and professional practice styles, increasing malpractice pressure, as well as economic organizational, social and cultural factors have been implicated in this trend. The higher rate of CS is a complex and multidimensional phenomenon. Therefore, programs and interventions should be introduced to decrease the rate of CS like painless vaginal delivery, emotional and educational interventions, improved quality of safe normal vaginal delivery in both private and public settings as well as the change in maternal and professional attitude towards the choice of mode of delivery. Keywords : Cesarean section, cesarean delivery on maternal request, advanced maternal age, maternal socioeconomic status, education...

Caesarean section – desired rate versus actual need

Archives of Medical and Biomedical Research, 2016

According to the World Health Organization, governments have expressed interest in the rise in the numbers of caesarean section births and the potential negative consequences for maternal and infant health. If conducted when medically justified, a caesarean section can effectively prevent maternal and perinatal mortality and morbidity. However, there is no evidence showing the benefits of caesarean delivery for women or infants who do not require the procedure. As with any surgical intervention, caesarean sections are associated with short and long-term risk, which can extend many years beyond the current delivery and affect the health of the woman, her child, and future pregnancies. These risks are higher in women with limited access to comprehensive obstetric care. Unequivocally, the potential risks are higher in women with limited access to comprehensive obstetric care, hence the global health concern.

Caesarean delivery on maternal request: need to redefine in view of intrapartum cases

International Journal of Reproduction, Contraception, Obstetrics and Gynecology

Background: The objective of the study was to analyse the data of caesarean section on maternal request (CDMR) both before labour and intrapartum, in low-income society from a town in India.Methods: It was a retrospective observational study of 9331 caesarean section (CS) cases carried out in different small private maternity hospitals over a period of 20 years. We used the data for auditing the CS cases done on maternal request.Results: Out of 9331 CS cases documented, 216 CS were done on maternal request. The incidence of CDMR was 2.31%. About one third cases were intra-partum. The rising trend of CDMR was observed both before labour and intra-partum.Conclusions: There was a need to redefine CDMR in the view of rise in the incidence of women requesting for CS not only before labour but during lab or also. CDMR is no more confined to highly educated, rich and women from urban area. Less educated, low income group women residing in rural area are also becoming aware that CS can be d...