Rising Trends of Cesarean Section Worldwide: A Systematic Review (original) (raw)

Prevalence of Cesarean Section and Its Indications in A Tertiary Care Hospital

Journal of Nepal Medical Association

Introduction: Cesarean section is a surgical procedure performed to deliver fetus through abdominal route. Increasing rate of cesarean section worldwide is an alarming concern for public health and obstetricians due to increase in financial burden and risk to health of the mother in comparison to vaginal delivery. The aim of the study was to find the prevalence of cesarean section and its most common indication in a tertiary care hospital. Methods: This descriptive cross-sectional study was done in a tertiary care hospital, from July 2016 to June 2018 after taking ethical clearance from institutional review board. Convenience sampling was done to reach the sample size. Data was collected and entry was done in microsoft excel, point estimate at 95% CI was calculated along with frequency and proportion for binary data and analysis was done. Results: Out of total deliveries conducted, 862 (36.8%) were CS deliveries, 1477 (63.1%) were vaginal deliveries, and 12 (0.51%) were instrumental...

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...

Indications and determinants of cesarean section: A cross-sectional study

International Journal of Applied and Basic Medical Research, 2020

Background: Cesarean section is one of the most commonly performed surgeries in obstetric practice for saving the lives of women and their newborns from pregnancy-and childbirth-related complications. Its prevalence has increased alarmingly in the last few years, which has motivated this research to identify the indications and determinants, influencing cesarean section delivery in the study area and determine the associated correlates for emergency and elective cesarean sections. Materials and Methods: This was a hospital-based cross-sectional study conducted at a tertiary care center from April 2019 to September 2019. A quantitative tool was designed to capture all the relevant information regarding sociodemographic factors, obstetric characteristics, and indications of cesarean section among the pregnant women delivering at the tertiary care center. Results: A total of 150 women with cesarean deliveries were included in this study. The percentage of primigravida women was significantly higher among emergency than elective cesarean section (χ 2 = 28.19, P = 0.0001). Majority of the women were illiterate or had primary education in emergency cesarean section than elective (χ 2 = 44.9691, P = 0.0001). Majority of the women with no or only one antenatal visit underwent emergency than elective cesarean sections (χ 2 = 42.2195, P = 0.0001). Those females who presented with previous Lower Segment Cesarean Section (LSCS) had greater chances of elective cesarean section, and it was statistically significant (P = 0.004). Conclusion: The increase in cesarean section rate causes burden to the general health system and also strain on the family members. Hence, caution should be exercised in decision-making to perform cesarean section, especially for primigravida, and a comprehensive evidence-based approach needs to monitor the indication of cesarean section.

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.

Changing Trends in the Rates and Leading Indications of Cesarean Sections in a Tertiary Care Hospital

Journal of Saidu Medical College, Swat

Background: Caesarean section is a time honoured approach that evolved to save maternal lives in the times of difficult deliveries. The rise in the rates of caesarean section is a matter of concern as being a major surgery, it is associated with risks that can extend for years and affect the health and future pregnancies of women.Objective: This study is carried out to analyses changing trends in the rates and indications of caesarean sections in the last six years in a Tertiary Care Hospital of Peshawar.Materials and Methods: This retrospective study is carried out by collecting record of all deliveries including indications of caesarean sections of the years 2014,2016 and 2018 of the unit. Results: The caesarean rate was 174/1000 total births for year 2014.It was 143 and 176 per 1000 total births for the year 2016 and 2018. The commonest indication for primary caesarean section was fetal malpresentations with rates as 31.5,30.2 and 29.9 per 1000 total births for 2014,2016 and 2018...

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

A study of rate, indications and maternal morbidity associated with cesarean delivery in a tertiary care hospital

International Journal of Reproduction, Contraception, Obstetrics and Gynecology

Background: Cesarean section is one of the most commonly performed surgical procedures in obstetrics worldwide. Over the last three decades, a tremendous increase in cesarean section rates has been observed globally, which is a cause for concern as procedure is associated with higher morbidity and mortality compared to vaginal delivery. This study was done to analyze the rate and indications for cesarean section and associated maternal morbidity and mortality.Methods: This retrospective study was conducted over a period of 6 months from 1st October 2017 to 31st March 2018 in the department of Obstetrics and Gynecology, Integral Institute of Medical Sciences and Research, Lucknow, India. Data of patients who were admitted for delivery in department of Obstetrics and Gynecology in OPD or emergency were recorded. Statistical analysis of various parameters namely, the cesarean section rates, its indications, the patient’s morbidity and mortality was done.Results: The total numbers of w...

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%,

Prevalence of Cesarean section delivery and associated risk factors

2021

Background: Cesarean section (CS) is a lifesaving procedure in the presence of maternal and fetal complications, but not indicated ones are associated with many adverse outcomes. Objectives: To study the prevalence and indications for cesarean section among the studied group also, studying the association between type of delivery and socio-demographic and obstetrics history of the studied group and comparing the maternal and fetal outcomes in relation to the type of delivery. Methodology: This retrospective study was conducted at Menoufia university hospitals. All records of delivered women at obstetric department during the period from 1 January 2019 to 31 December 2019 were collected. Patient affairs and statistics unit were reviewed for socio-demographic data, obstetric history, type of delivery, reasons of cesarean section, maternal and fetal outcome, and complications. Data were collected, analyzed, and tabulated using SPSS program. Results: Prevalence of cesarean sections was 45.9% and most of which were elective 59.8%. Associated significant risk factors were residence, educational and socioeconomic levels and working status. Post-partum hemorrhage was significantly high in CS delivery, while urinary incontinence and pelvic prolapse were more common with vaginal delivery. The main indication of CS in this study was previous CS 40.1%. Conclusion: Despite CS can be life saving for mother and baby in emergency indications, overuse of CS was associated with maternal and fetal complications. Efforts should be done to reduce the rate of elective CS through proper antenatal care counseling.

The global epidemiology of Caesarean Sections: major increases and wide disparities

2018

This Lancet Series paper, one of three on the high rate of Caesarean Section (CS), describes the global, regional and selected country levels, trends, determinants and inequalities in CS. Based on data from 169 countries representing 98.4% of the world’s births, we estimate that 21.1% (95% uncertainty range 19.9-22.4%) or 29.7 million births occurred through CS in 2015, representing almost a doubling since 2000 (12.1%; 10.9-13.3%). The differences in CS rates between regions in 2015 were tenfold, with a high of 44.3% (41.3-47.4%) in the Latin America and the Caribbean region and a low of 4.1% (3.6-4.6%) in the West and Central African region. The global and regional increases were driven both by increasing coverage of births by health facilities (66.5% of the global increase) and higher CS rates within health facilities (33.5%), with considerable variation between regions. Based on the most recent data, population-based CS rates exceeded 15% of births in 63% of 169 countries, while ...