DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20182504

Study of incidence, trends and determinants of caesarean section in tertiary care hospital of Rajasthan, India

Neelam Sharma, Anshul Jhanwar

Abstract


Background: Lower Segment Caesarean section (LSCS) is recommended when vaginal delivery might pose a risk to the mother or baby. Worldwide rise in LSCS rate during the last three decades, has been the cause of alarm and needs an in-depth study.

Methods: It was a retrospective, observational study conducted in Obstetrics and Gynecology department of Jhalawar medical college, Jhalawar. Data were obtained from medical record database of patients admitted for deliveries from October 2017 to March 2018 over period of six months. The total number of patients delivered and the number of LSCS done were counted to find the incidence of LSCS in our hospital. Age, parity and gestational age of the patients who underwent LSCS were tabulated.

Results: In present study the incidence of LSCS was 31.1%. Of these cases 91% belonged to age group 20 -29 yrs. Emergency LSCS (72.1%) and primary LSCS (66.5%) were more common. The commonest indication of LSCS was previous LSCS in 35% followed by foetal distress, breech presentation, severe oligohydrominos and pre-eclampsia.

Conclusions: In present study LSCS rate was high as compared to the WHO standard. The scheme like Janani Suraksha Yojana (JSY) may have a great impact on accepting institutional deliveries by poor women which may be a reason of the increase of LSCS in India. Utilization of antenatal care, better doctor patient communication, doctor’s commitment to reduce the rate of LSCS, may help to reduce the increasing rate of caesarean delivery.


Keywords


Gestational age, Lower segment caesarean section, Vaginal births

Full Text:

PDF

References


World Health Organisation. Monitoring emergency obstetric care: a handbook. Geneva, Switzerland;2009.

Althabe F, Belizon JM. LSCS: the paradox. Lancet. 2006;368(9546):1472-3.

Van Dongen P. Caesarean section-etymology and early history. South Afr J Obstet Gynaecol. 2009;15(2).

Padmadas SS, Kumar S, Nair SB, Kumari A. Caesarean section delivery in Kerala, India: evidence from a National Family Health Survey. Soc Sci Med. 2000;51(4):511-21.

NIH State-of-the-Science Conference statement on Caesarean Delivery on Maternal Request – NIH Consens Sci Statements. 2006;23(1):1-29.

Oumachigui A. Changing trends in Caesarean Section. Obstet Gynaecol Today. 2002;7:1-5.

Thomas J. Royal college of Obstetrician and gynaecologist: Clinical effectiveness and support unit. The Nation Sentinel LSCS Audit report London. RCOG press, 2001.

Lydon-Rochelle M, Holt VL, Easterling TR, Martin DP. Risk of uterine Rupture during labour among women with a prior caesarean delivery. N Engl J Med. 2001;345:3-8.

Mozurkewick EL. Hutt on EK; Elective repeat caesarean delivery versus trial of labour: A meta-analysis of literature from 1989 to 1999. Am J Obstet Gynecol. 2000;183:1187-97.

Rageth JC, Grossenbecher H. Delivery after previous caesarean: A risk evaluation. Swiss working group of Obstetrics and gynaecologic Institutions. Obstet Gynecol. 1999;93:332-7.

Rafique S, Rana G. Changing trends in caesarean section rate and indications. Pak J Surg. 2012;28(1):60-4.

Nahar K. Indications of caesarean section: study of 100 cases in Mymensingh medical college hospital. J Shaheed Suhrawardy Med Coll. 2009 Dec;1(1):6-10.

Khunpradit S, Patumanond J, Tawichasri C. Risk indicators for cesarean section due to cephalopelvic disproportion in Lamphun hospital. J Med Assoc Thailand. 2005 Oct 28;88:S63.

Karim F, Ghazi A, Ali T, Aslam R, Afreen U, Farhat R. Trends and determinants of caesarean section. J Surg Pak (International). 2011 Jan;16(1):22-7.

Feng XL, Xu L, Guo Y, Ronsmans C. Factors influencing rising caesarean section rates in China between 1988 and 2008. Bull World Health Organization. 2012 Jan;90(1):30-9A.

Zhang J, Troendle J, Meikle S, Klebanoff MA, Rayburn WF. Isolated oligohydramnios is not associated with adverse perinatal outcomes. BJOG: Int J Obstet Gynaecol. 2004 Mar 1;111(3):220-5.