Indication and complication of caesarean section at tertiary care hospital: a retrospective study
Keywords:Fetal distress, Malpresentation, Previous cesarean section
Background: The incidence of cesarean section is steadily rising. Cesarean delivery has played a major role in lowering both maternal and perinatal morbidity and mortality rates. There are various factors involved in the rise of rate of cesarean section like rising incidence of primary cesarean delivery, identification of high-risk pregnancy, wider use of repeat cesarean section, rising rates of induction of labor and failure of induction, no reassuring fetal status etc.
Methods: A retrospective cross-sectional study was conducted. Data was collected from patient records of the hospital during 1st January 2018 to 30th June 2018. All patients (N= 602) who had delivered their baby by caesarean section were included in the study. Data were analyzed by help of SPSS version 21 after proper compilation.
Results: Among all women who underwent cesarean section, majority were age group between 21 and 30 years (67.1%). Repeat cesarean section (48.5%), followed by fetal distress (18.9%), oligohydramnias (6.6%) and cephalopelvic disproportion (6.5%) were most common among all major indication of cesarean section. Intrapartum complication (2.0%) includes postpartum hemorrhage (1.2%), CS hysterectomy (0.5%), bladder injury (0.3%) and postpartum complication (2.3%) including UTI (0.8), wound infection (0.5%), sepsis (0.5%), lactation failure (0.5%) were major maternal complication of cesarean section.
Conclusions: Reduction of number of primary cesarean section, successful VBAC, individualization of the indication and careful evaluation, following standardized guidelines can help to keep rate of cesarean section to the possible minimum level.
Wagner M. Choosing caesarean section. Lancet.2000;356(9242):1677-80.
Harper V, Hall M. Trends in caesarean section. Current obstet Gynaecol.1991:224-8.
Kambo I, Bedi N, Dhillon Bs. A critical appraisal of cesarean section rates at teaching hospitals in India. Int J Gynaecol Obstet. 2002;79(2):151-8.
Caughey AB, Cahill AG. Safe prevention of the primary cesarean delivery. Obstetric care consensus.2014;210(3):179-93.
Pandya JM, Pandya MJ, Joshi JM, Velani SP. Analytical study of indications of cesarean section. Int J Reprod Contracept Obstet Gynecol 2015;4(5):1460-3.
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.
Jawa A, Garge 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(10):3466-9.
Sarma P, Boro RC, Acharjee PS. An analysis of indications of caesarean sections at Tezpur medical college and hospital, Tezpur (a government hospital). Int J Reprod Contracept Obstet Gynecol.2016;5(5):1364-7.
Dhakal KB, Dhakal S, Bhandari S. Profile of caesarean section in mid- western regional hospital in Nepal. J Nepal Health Res Counc 2018;16(38):84-8.
Mylonas I, Friese K. Indications for and risks of elective caesarean section. Dtsch Arztebl Int.2015;112(29-30):489-95.
Das RK, Subudhi KT, Mohanty RK. The rate and indication of caesarean section in a tertiary care teaching hospital eastern India. Int J Contemp Pediatr. 2018;5(5):1733-9.