Analytical study of indications of cesarean section
Keywords:Previous cesarean Section, Fetal Distress, Malpresentations
Background: There has been an increase in rate of cesarean section over last few decades. There are various factors involved in the rise of rate of cesarean section. There has been an increase in primary cesarean section rate, a decrease in VBAC (Vaginal birth after cesarean section) trial, decrease in operative vaginal deliveries (Forceps/Ventouse), increase in litigations, increasing facility of electronic monitoring, and decreasing threshold of patients for bearing labor pains.
Methods: A retrospective study was carried out in 500 patients in the tertiary care hospital). The data were collected in a pre-designed proforma. Data were analysed by using SPSS version 20.0 Software. We have done a retrospective study of different indications of cesarean section amongst 500 patients who underwent cesarean section from March 2015 to June 2015.
Results: In our study, we found out that the most common indication was Previous cesarean section (46.2%), followed by Fetal Distress (13.4%) and malpresentations (11.4%). Non progress of labour (10.2%) and toxaemia of pregnancy (6.6%) were amongst the other indications.
Conclusions: Reduction of number of primary cesarean sections and successful VBAC trials are recommended to keep the rate of cesarean sections to the possible minimum level.
World Health Organization. Appropriate technology for birth. Lancet. 1985;2(8452):436-7.
Hamilton BE, Martin JA, Ventura SJ. National Vital Statistics Reports. 2011;60,1.
Belizan JM, Althabe F, Barros FC, Alexander S. Rates and implications of Cesarean Sections in Latin America: ecological study. BMJ. 1999;319:1397-1402.
Hamilton BE, Ventura SJ, Martin JA, Sulton PD. Priliminary births for 2004: infant and maternal health. Health E-Stats. Released, 2005.
Stanton CK, Holtz SA. Studies in Family Planning, 2006.
Kambo I, Bedi N, Dhillon BS, Saxena AC. A critical appraisal of Cesarean section rates at teaching hospitals in India. Int J Gynaecol Obstet. 2002;79:151-8.
Sreevidya S, Sathiyasekaran BW. British Journal of Obstetrics and Gynaecology, 2003.
Victora CG, Barros FC. Beware: unnecessary cesarean sections may be hazardous. Lancet. 2006;367:1796-7
Tollånes MC. Increased rate of Cesarean sections--causes and consequences. Tidsskr Nor Laegeforen. 2009;129(13):1329-31.
Silver RM, Landon MB, Rouse DJ, Leveno KJ, Spong CY, Thom EA et al. Risk of placenta previa and accrete to number of previous cesarean deliveries. Obtetrics & Gynecology. 2006;107:1226.
Emma L, Lisbet L, Kathleen B, Christian M, Edmund F, Jessica L. Contributing Indications to the Rising Cesarean Delivery Rate. Obstet Gynecol. 2011;118(1):29–38.
Unnikrishnan B, Rakshith P, Aishwarya A, Nithin K, Rekha T, Prasanna P et al. Indications for Cesarean Section in a tertiary care Obstetric Hospital in Coastal South India. Australasian Medical Journal AMJ. 2010;3(12):821-825.
Wang CP, Tan WC, Kanagalingam D, Tan HK. Why we do cesears: a comparison of trends in cesarean section delivery over a decade. Ann Acad Med Singapore. 2013;42(8):408-12.
Guise JM, Eden K, Emeis C, Denman MA. Vaginal birth after cesarean: new insights. Evidence Report/ Technology Assessment Jorunal. 2010;(191):1-397.
Hofmeyr GJ, Kulier R. External cephalic version for breech presentation at term. Cochrane Database Syst Rev., 2012.
Leung C, Pun WC. Term breech trial. Lancet. 2001;357(9251):225.
Hannah ME , Hannah WJ, Hewson SA, Hodnett ED, Saigal S, Willan AR. Planned cesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Term Breech Trial Collaborative Group. Lancet. 2000;356(9239):1375-83.