Cesarean section: analysis of the experience before and after the National Consensus Conference on Aspects of Cesarean Birth (original) (raw)
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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...
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.
Cesarean Delivery: Background, Trends, and Epidemiology
Seminars in Perinatology, 2006
OBJECTIVE To examine trends in cesarean delivery for the overall population and for women with "no indicated risk" for cesarean section, and to summarize the available literature on "maternal request" cesarean deliveries. FINDINGS Nearly 3 in 10 births were delivered by cesarean section in 2004 (29.1%), the highest rate ever reported in the United States. The overall rate has increased by over 40% since 1996, reflecting two concurrent trends: an increase in the primary rate (14.6% to 20.6%), and a steep decline in the rate of vaginal birth after cesarean (28.3% to 9.2%). There has been a clear increase in primary cesarean delivery without a medical or obstetrical indication, and studies using hospital discharge data or birth certificate data estimate the rate of primary cesarean deliveries with no reported medical or obstetrical indication to be between 3% and 7% of all deliveries to women who had not had a previous cesarean delivery. However, these studies contain no direct information on whether these cesareans were the result of maternal request or because of physician recommendation. There was little data to support the contention that the rise in the cesarean rate was the result of maternal request. CONCLUSION There are no systematic data available on cesarean delivery by "maternal request." However, the rate of primary cesarean delivery is increasing rapidly for women of all ages, races, and medical conditions, as well as for births at all gestational ages. Since a first cesarean section virtually guarantees that subsequent pregnancies will be cesarean deliveries (the repeat cesarean delivery rate is now almost 91%), research is needed on physician practice patterns, maternal attitudes, clinical outcomes for mother and infant (harms, benefits), and clinical and nonclinical factors (institutional, legal, economic) that affect the decision to have a cesarean delivery. Semin Perinatol 30:235-241.
Indications for cesarean deliveries during a 7-year period in a tertiary hospital
Acta médica portuguesa
To analyze the cesarean section rate evolution in a tertiary hospital and the main indications for cesarean section. A retrospective study was conducted at a major academic hospital and included 5 751 women who had a cesarean section from 2005 to 2011. The rates of overall, primary and repeat cesarean sections were analyzed. A linear regression and adjusted R-square were used to access the relative contribution of each indication to the variation in primary cesarean section. During the 7-year period of the study the cesarean section rate decreased from 30.9% to 27.6%. This was due to a decrease in primary cesarean section (21.9% to 18.2%), although an increase in repeat cesarean section was observed (9.0% to 9.4%). Among the indications for primary cesarean section, maternal-fetal indications and malpresentation were the ones that decreased the most with adjusted R-square of 0.70 and 0.55, respectively. The collected data identified that the decrease in the cesarean section rate at ...
FREQUENCY AND INDICATIONS OF CESAREAN SECTION IN A TERTIARY CARE HOSPITAL
Objective: To determine the frequency of cesarean section and to analyze the indications, so as to introduce measures to control the cesarean section rate. Methodology: This descriptive study was conducted in obstetric and gynecology department of Isra university hospital Hyderabad Sindh from 1 st Jan 2007 to 31 st Dce 2007.In this study clinical record of all the patients who underwent cesarean section was analyzed. It included all the pregnant ladies booked in the antenatal clinic and unbooked patients admitted in early labour for whom cesarean section was indicated later. It also included all those cases coming in emergency at any time for which cesarean section was indicated. Clinically diagnosed cases of ruptured uterus proved on laparotomy were not included in the study. Data was analyzed on SPSS version 11 and frequencies as wall as percentages were calculated. Results: During one year study period, 380 cesarean section were performed. The rate of cesarean section was 64.7%. Emergency cesarean section was performed in 225 (59.2%) patients and elective cesarean section in 155 (40.7%). Among 380 patients, 167 (43.9%) were booked while 213 (56.0%) were unbooked. Repeat cesarean section was the commonest indication seen in 73 (19.2%) patients followed by dystocia in 51 (13.4%) patients, fetal distress in 48 (12.6%) and ante partum hemorrhage in 45 (11.8%) patients. Miscellaneous indications contributed to 16 (4.2%) of the cases. Conclusion: Majority of patients who underwent cesarean section was unbooked and had an emergency cesarean section. The commonest indication was repeat cesarean section.
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...
Changed indications for cesarean sections
Acta Obstetricia et Gynecologica Scandinavica, 2010
Objective. The aim of this study was to investigate the indications for cesarean sections in the early 1990s as compared to the middle 2000s. Design. Retrospective cohort study. Methods. Data were collected from original obstetrical records in a tertiary hospital in 1992 and 2005. Results. The total cesarean delivery rate rose from 11% to 20%. The main indications for an elective cesarean in 1992 were a pathological fetal lie or a uterine factor. The dominant indication for an elective cesarean in 2005 was a psychosocial indication defined as maternal fear of childbirth or maternal request without any co‐existing medical indication. Presumed fetal compromise and prolonged labor remained the main indications for urgent and emergency cesareans. No apparent alterations in population characteristics could be identified for these years. Conclusions. The increased rate of elective cesareans for psychosocial indications would reflect altered attitudes towards mode of delivery in the childb...
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.
Cesarean section - changing trends - a National survey
2009
Objectives: To study the changing trends in indications and technics of cesarean section in various parts of India. Methods: A clinical survey was carried out amongst 253 obstetricians from all over India selected at random regarding their practices of cesarean section in terms of indications and technics. Results: Result showed that previous cesarean section, severe pregnancy induced hypertension, failed induction of labor and infertility treated cases are now increasing amongst the indications for cesarean section. In technics, single layer closure (41.11% doctors) and nonsuturing of peritoneum, visceral or both, (35.96% doctors) are now increasing among obstetricians. Polyglycolic acid sutures (vicryl, centicryl, dexon) are replacing catgut for uterine closure. Conclusion: Being a common major surgery any changes in technic for better surgical result are always welcome. Changes in indications are mainly due to litigation fear and better neonatal facilities.