Retrospective study of cesarean rate in a tertiary care hospital
Keywords:Caesarean section, Complications, Child birth, Indications
Background: Worldwide there has been an increase in the rate of caesarean delivery due to multiple factors. The main objective of this study is to analyze the various indications of caesarean delivery over a period of 4 years and to evaluate the maternal and fetal outcomes between elective and emergency caesarean section.
Methods: Retrospective study conducted at the Department of Obstetrics and Gynecology, Belgaum Institute of Medical Sciences, Belagavi, India. The study period was from January 2016 - December 2017. The details were taken from case sheets, operation and parturition records and newborn records of 325 patients who underwent caesarean section. The data was analyzed with special reference to the indication of caesarean section, maternal and fetal outcomes among elective and emergency cases.
Results: The incidence of cesarean section was 28%. The commonest indication for C-delivery was repeat cesarean (43%) followed by CPD (15%). Failed induction and Fetal distress were the next common indication (10%) and (7%) respectively. Maternal morbidity was 20% with 1 maternal death (0.1%). The commonest complications were primary hemorrhage and wound infection, intra OP and post OP respectively. The perinatal morbidity and mortality were 10% and 2.26% respectively.
Conclusions: The incidence of ceaserean section is 12.5% in our hospital falling well within the WHO guidelines. Among the indications, previous LSCS is contributing to a greater percentage, which should be reduced by promoting more VBAC. It also emphasizes the need for reducing primary sections. Post-partum haemorrhage has been brought well under control, sepsis still accounts for greater postop morbidity and meconium aspiration is the commonest cause for perinatal morbidity and mortality.
Sreevidya S, Sathiyasekaran BW. High caesarean rates in Madras (India): a population‐based cross-sectional study. BJOG: Int J Obstet Gynaecol. 2003 Feb;110(2):106-11.
WHO Consensus conference on appropriate technology for Birth. Fortaleza, Brazil, 22-26 April 1985. Available at https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(85)92750-3/abstract.
Onankpa B, Ekele B. Fetal outcome following cesarean section in a university teaching hospital. J Natl Med Assoc. 2009;101:578-81.
Mc Carthy FP, Rigg L,Cady L, Cullinane F. A new way of looking cesarean section births. Aust NZJ Obstet Gynecol. 2007;47:316-20.
Ali M, Ahmad M, Hafeez R. Maternal and fetal outcome: comparison between emergency caesarean section versus elective caesarean section. Prof Med J. 2005 Mar;12(1):32-9.
Najam R, Sharma R. Maternal and fetal outcomes in elective and emergency caesarean sections at a teaching hospital in North India. A retrospective study. J Adv Res Med Sci. 2013;5(1):5-9.
Worls Health Organisation. Appropriate technology for birth. Lancet. 1985;2(8452):436-7.
Althabe F, Belizan JM. Caesarean section:the paradox. (comment) Lancet. 2006;368(9546):1472-3.
Bilobrk Josipovic B, Dizdarevic Stojkanovic J, Brkovic I. Analysis of cesarean section delivery at Nova Bila Hospital according to Robson Classification. Coll. Antropol. 2015;1:145-50.
Mukherjee SN. Rising Cesarean section rate. J Obstet Gynecol India. 2004;56:298-300.
Menacker F, Declercq E, Macdorman MF. Cesarean delivery: background, trends, and epidemiology. Semin Perinatol. 2006;30:235-41.