DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20181346

Analysis of caesarean section in a tertiary care hospital, Assam, India

Alaka Banerjee, Banasree Bhadra, Kiriti R. Dey

Abstract


Background: One of the commonest surgery performed worldwide is caesarean Section (CS). The World Health Organization (WHO) has identified an ideal caesarean section (CS) rate for a nation of around 10-15%. In recent times the proportion of delivery conducted by caesarean section has increased.

Methods: This is a retrospective study of all the caesarean deliveries performed between 1st January 2010 to 31st December 2018 in the Department of Obstetrics and Gynaecology in Silchar Medical College. The caesarean rate was calculated as: (total number of caesarean deliveries/ total number of deliveries) × 100. The indications for CS included foetal distress, malpresentation, previous caesarean section, multiple gestation, failed induction, failed progression, cephalopelvic disproportion, maternal indications, obstetric indication and foetal indications.

Results: During the study period a total of 75685 patients delivered. 25805 patients had undergone CS with the CS rate being around 34.1%. Majority of the CS (75.6%) were performed as emergency procedure. Maximum number of patients were between 21-30 years (73.24%) and 54.47% were primipara. Majority of the patients (68.37%) belonged to the rural areas. Foetal distress (32.8%) was the commonest indication followed by post caesarean pregnancy (26.76%).

Conclusions: The rate of caesarean section is increasing with time. As primary caesarean section usually determines the lady’s future obstetric course, it is of prime importance to give effort for safe reduction of caesarean. Individualization of the indication and careful evaluation, following standardized guidelines and practice of evidenced-based obstetrics followed by audits in the institution, can help us limit the caesarean rates.


Keywords


Caesarean section, Indications, Rate

Full Text:

PDF

References


Betran AP, Torloni MR, Zhang JJ, Gülmezoglu AM, WHO Working Group on Caesarean Section. WHO Statement on Caesarean Section Rates. BJOG. 2016;123(5):667670.

Zhang J, Troendle J, Reddy UM, Laughon SK, Branch DW, Burkman R, et al. Contemporary cesarean delivery practice in the United States. Am J Obstet Gynecol. 2010;203:326.e1-.e10.

Fioretti B, Reiter M, Betran A, Torloni M. Googling caesarean section: a survey on the quality of the information available on the Internet. BJOG. 2015;122:731-9.

Mukherjee SN. Rising cesarean section rate. J Obstet Gynecol India. 2006;56(4):298-300.

Betrain AP, Merialdi M, Lauer JA, Bing-Shun W, Thomas J, Look VP, et al. Rates of caesarean section: analysis of global, regional and national estimates. Paediatr Perinat Epidemiol. 2007;21(2):98113.

Althabe F, Sosa C, Belizán JM, Gibbons L, Jacquerioz F, Bergel E. Cesarean section rates and maternal and neonatal mortality in low-, medium-, and highincome countries: an ecological study. Birth. 2006;33 (4):270-7.

Belizán JM, Cafferata ML, Althabe F, Buekens P. Risk of patient choice caesarean. Birth. 2006;33:167- 9

Manjulatha B, Sravanthi TP. Caesarean section rates in a Teaching Hospital: a ten-year review. IOSR J Dent Med Sci. 2015;14(8):1-5.

Bhasin SK, Rajoura OP, Sharma AK, Metha M, Gupta N, Kumar S, et al. A high prevalence of caesarean section rate in East Delhi. Indian J Comm Med. 2007;32(3):222-4.

Santhanalakshmi C, Gnanasekaran V, Chakravarthy AR. A Retrospective Analysis of Cesarean Section in a Tertiary Care Hospital. Int J Sci Res. 2013;4(9):2097-9.

Singh G, Gupta ED. Rising incidence of caesarean section in rural area in Haryana, India: a retrospective analysis. Internet J Gynecol Obstet. 2013;17(2):1-5.

Haider G, Zehra N, Munir AA, Haider A. Frequency and indication of caesarean section in a tertiary care hospital. Pak J Med Sci. 2009;25(5):791-6.

Gupta M, Garg V. The rate and indications of caesarean section in a teaching hospital at Jaipur, India. Int J Reprod Contracept Obstet Gynecol 2017;6:1786-92.

Jawa A, Garg S, Tater A, Sharma U. Indications and rates of lower segment caesarean section at tertiary care hospital-an analytical study. Int J Reprod Contracept Obstet Gynecol. 2016;5:3466-9.

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

Liu S, Rusen ID, Joseph KS, Liston R, Kramer MS, Wen SW, et al. Maternal Health Study Group of the Canadian Perinatal Surveillance System. Recent trends in caesarean delivery rates and indications for caesarean delivery in Canada. J Obstet Gynaecol Can. 2004;26(8):735-42.

Nelson JP. Indications and appropriateness of caesarean sections performed in a tertiary referral centre in Uganda: a retrospective descriptive study. The Pan African Med J. 2017;26:64.

Gonen R, Tamir A, Degani S. Variables associated with successful vaginal birth after one caesarean section: a proposed vaginal birth after caesarean section score. Am J Perinatol. 2004;21:447-53.

Kugler E, Shoham-Vardi I. The safety of a trial of Labour after caesarean section in a grand multiparous population. Arch Gynaecol Obstet. 2008;277:339-49.

McMahon MJ, Luther ER, Bowes WA Jr, Olshan AF. Comparison of a trial of labor with an elective second cesarean section. N Engl J Med. 1996;335(10):689- 95.