DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20181896

Characteristics of deliveries at a tertiary care hospital in Turkey: results from a retrospective analysis (2012-2016)

Eren Pek, Fatma Beyazit

Abstract


Background: Although the choice of a particular method of birth delivery by the pregnant woman is a modern, complex and controversial subject all over the world, the rate of caesarean delivery has risen to nearly 50% in western countries. Apart from medical reasons, several non-medical factors are also involved in this choice, and they comprise the socioeconomic conditions, ethical/legal concerns and psychological and cultural characteristics of the patients and doctors. In this study, we aimed to evaluate the demographic and clinical characteristics of pregnant women who gave birth in a tertiary care hospital between October 2012 and June 2016.

Methods: The patients’ charts of pregnant women who presented to the Canakkale Onsekiz Mart University hospital between October 2012 and June 2016 and who gave birth through either vaginal or caesarean delivery were retrospectively analysed. The patients’ age, delivery type, weeks of pregnancy at delivery, number of pregnancies and caesarean indications were recorded.

Results: In this study, we retrospectively analysed 2012 pregnant women. The mean age of the pregnant women was 28.9 ±5.4 years. The mean gravida and parity of pregnant women were 1.9±1.0 and 1.5±0.7, respectively. Regardless of the delivery type, the mean pregnancy weeks were found to be 38.6±1.9 weeks. The mean pregnancy weeks of patients undergoing caesarean delivery were 38.4±1.8 weeks. The primary caesarean rates were 52.81%. The most common caesarean delivery indications were foetal distress, cephalopelvic disproportion and presentation anomalies.

Conclusions: The steady increase in caesarean delivery rates has become a major cause of concern worldwide. The reasons for this phenomenon are mostly related to advanced age; foetal distress, especially one that is detected in continuous foetal monitoring; intrauterine growth retardation; presentation anomalies and multiple gestation. To avoid unnecessary caesarean births, mothers, especially nulliparous mothers, should be persuaded to undergo vaginal delivery.


Keywords


Caesarean delivery, Delivery, Pregnancy, Vaginal birth

Full Text:

PDF

References


Zandvakili F, Rezaie M, Shahoei R, Roshani D. Maternal Outcomes Associated with Caesarean versus Vaginal Delivery. J Clin Diagn Res. 2017;11(7):QC01-QC04.

Loke AY, Davies L, Li SF. Factors influencing the decision that women make on their mode of delivery: the Health Belief Model.BMC Health Serv Res. 2015;15:274.

American College of Obstetricians and Gynecologists. ACOG committee opinion no. 559: Cesarean delivery on maternal request. Obstet Gynecol. 2013;121(4):904-7.

Grivell RM, Dodd JM. Short- and long-term outcomes after cesarean section. Expert Rev Obstet Gynecol. 2011;6(2):205-15.

Elshani B, Daci A, Gashi S, Lulaj S.The incidence of caesarean sections in the university clinical center of kosovo. Acta Inform Med. 2012;20(4):244-8.

Sauve RS, Molnar-Szakacs H, McCourt C. Highlights of the Canadian perinatal health report 2003. Paediatr Child Health. 2004;9(4):225-7.

Okabayashi K, Ashrafian H, Zacharakis E, Hasegawa H, Kitagawa Y, Ahtanasiou T, et al. Adhesions after abdominal surgery: a systematic review of the incidence, distribution and severity. Surgery Today. 2014;44(3):405-20.

Dickens BM, Cook RJ. The legal effects of fetal monitoring guidelines. Int J Gynaecol Obstet. 2010;108:170-3.

Brennan DJ, Robson MS, Murphy M, O’Herlihy C. Comperative analysis of international cesarean delivery rates using 10-group classification identifies significant variation in spontaneous labor. Am J Obstet Gynecol. 2009:201(3): 308.e1-8.

Niino Y. The increasing cesarean rate globally and what we can do about it. Biosci Trends. 2011;5:139-50.

Dodd JM, Crowther CA, Huertas E, Guise JM, Horey D. Planned elective repeat caesarean section versus planned vaginal birth for women with a previous caesarean birth. Cochrane Database Syst Rev. 2013;(12):CD004224.

Robson M, Hartigan L, Murphy M. Methods of achieving and maintaining an appropriate caesarean section rate. Best Pract Res Clin Obstet Gynaecol. 2013;27:297-308.

Merrill BS, Gibbs CE. Planned vaginal delivery following cesarean section. Obstet Gynecol. 1978;52(1):50-2.

Birara M, Gebrehiwot Y. Factors associated with success of vaginal birth after one caesarean section (VBAC) at three teaching hospitals in Addis Ababa, Ethiopia: a case control study. BMC Pregnancy Childbirth. 2013;13:31.

American College of Obstetricians and Gynecologists. ACOG Practice bulletin no. 115: Vaginal birth after previous cesarean delivery. Obstet Gynecol. 2010;116(2 Pt 1):450-63.

Chauhan SP, Magann EF, Wiggs CD, Barrilleaux PS, Martin JN Jr. Pregnancy after classic cesarean delivery. Obstet Gynecol. 2002;100(5 Pt 1):946-50.

Menacker F, Hamilton BE. Recent Trends in Cesarean Delivery in the United States. NCHS Data Brief. 2010;(35):1-8.

Martin JA, Hamilton BE, Osterman MJK. Births in the United States, 2015. NCHS Data Brief. 2016;258:1-8.

Barber EL, Lundsberg L, Belanger K, Pettker CM, Funal EF, Illuzzi JL. Indications contributing to the increasing cesarean delivery rate. Obstet Gynecol. 2011;118(1):29-38.

Tekirdağ AI, Cebeci R. Cesarean ratios in education hospitals. JOPP. 2010;2(1):21-6.

Bakırcı Y. The factors that affect indications of caesarean section, distribution of caesarean section indications and examination of vaginal delivery in Gazi University School of Medicine, Department of Obstetrics and Gynecology between years from 1988 to 2009. Gazi University, Ankara, Turkey. Council of Higher Education Thesis Center. Thesis no: 2010;247898.

Benli AR, Benli NC, Usta AT, Atakul T, Koroglu M. Effect of maternal age on pregnancy outcome and cesarean delivery rate. J Clin Med Res. 2015;7(2):97-102.

Rendtorff R, Hinkson L, Kiver V, Dröge LA, Henrich W. Pregnancies in Women Aged 45 Years and Older -a 10-Year Retrospective Analysis in Berlin Geburtshilfe Frauenheilkd. 2017;77(3):268-275.

Gareen IF, Morgenstern H, Greenland S, Gifford DS. Explaining the association of maternal age with cesarean delivery for nulliparous and parous women. J ClinEpidemiol. 2003;56(11):1100-10.

Parrish KM, Holt VL, Easterling TR, Connell FA, LoGerfo JP. Effect of changes in maternal age, parity, and birth weight distribution on primary cesarean delivery rates..JAMA. 1994;271(6):443-7

Mathews TJ, MacDorman MF. Infant Mortality Statistics from the 2005 Period Linked Birth/ Infant Death Data Set. Natl Vital Stat Rep. 2008;57(2):1-32.

Hamilton BE, Martin JA, Osterman MJ, Curtin SC, Mathews TJ. Births: Final Data for 2014. Natl Vital Stat Rep. 2015;64 (12):1-64.

Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Mathews TJ. Births: Final Data for 2015. Natl Vital Stat Rep. 2017;66 (1):1-70.