A Study to Evaluate the Rate of Caesarean Deliveries, Various Indications of the Procedure as well as the Associated Maternal Morbidity and Mortality
Authors/Creators
- 1. Associate Professor, Department of Obstetrics and Gynecology, Katihar Medical College and Hospital, Katihar, Bihar, India
Description
Aim: To evaluate the prevalence of cesarean section in a tertiary care hospital. Methods: A retrospective study on women who underwent LSCS over a period of 1 year. Department of Obstetrics and Gynecology, Katihar Medical College and Hospital,Katihar, Bihar, India . Out of the 489 deliveries, 200 were delivered by cesarean section. Variables including age, parity, gestational age, CS timing (elective or emergency), and indications for LSCS were collected from their case records and entered in the proforma. Results: A total of 489 deliveries were performed in the study duration of 1 year, of which 200 cases underwent cesarean section. The LSCS prevalence was 40.89% in our institution. We have assessed the common indications of LSCS performed in this study population. The majority of the LSCS were delivered between 37-40 weeks (69.5%) of gestation. Mode of conception was spontaneous for 96.5%, and 3.5% received infertility treatments the distribution of various indications for LSCS in the study population. LSCS was mostly done for ‘previous LSCS’ indication (87 cases, 43.5%), followed by failure of induction of labor (45 cases, 22.5%). Fetal distress was an indication in 18 cases (9%), Breech presentation in 13 cases (6.5%), PPROM in 11 (5.5%), CPD in 10(5%). Diabetes mellitus was found in 10% of the total LSCS population and pregnancy induced hypertension (PIH) in 4%. It was found that the lower segment was well formed in 90.5%, was thin in 5% and not formed in 4.5% of the study population. Adhesions were observed in 3% and scar dehiscence was present in 1% of cases. Conclusion: Although LSCS indications seen in our institute are the same in most institutions worldwide, efforts should be made to focus on reducing the primary LSCS rates thereby reducing the most common indication of previous LSCS in subsequent pregnancies.
Abstract (English)
Aim: To evaluate the prevalence of cesarean section in a tertiary care hospital. Methods: A retrospective study on women who underwent LSCS over a period of 1 year. Department of Obstetrics and Gynecology, Katihar Medical College and Hospital,Katihar, Bihar, India . Out of the 489 deliveries, 200 were delivered by cesarean section. Variables including age, parity, gestational age, CS timing (elective or emergency), and indications for LSCS were collected from their case records and entered in the proforma. Results: A total of 489 deliveries were performed in the study duration of 1 year, of which 200 cases underwent cesarean section. The LSCS prevalence was 40.89% in our institution. We have assessed the common indications of LSCS performed in this study population. The majority of the LSCS were delivered between 37-40 weeks (69.5%) of gestation. Mode of conception was spontaneous for 96.5%, and 3.5% received infertility treatments the distribution of various indications for LSCS in the study population. LSCS was mostly done for ‘previous LSCS’ indication (87 cases, 43.5%), followed by failure of induction of labor (45 cases, 22.5%). Fetal distress was an indication in 18 cases (9%), Breech presentation in 13 cases (6.5%), PPROM in 11 (5.5%), CPD in 10(5%). Diabetes mellitus was found in 10% of the total LSCS population and pregnancy induced hypertension (PIH) in 4%. It was found that the lower segment was well formed in 90.5%, was thin in 5% and not formed in 4.5% of the study population. Adhesions were observed in 3% and scar dehiscence was present in 1% of cases. Conclusion: Although LSCS indications seen in our institute are the same in most institutions worldwide, efforts should be made to focus on reducing the primary LSCS rates thereby reducing the most common indication of previous LSCS in subsequent pregnancies.
Files
IJTPR,Vol11,Issue6,Article7.pdf
Files
(141.9 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:2ac91f22aeae71fe046383a3df0526b7
|
141.9 kB | Preview Download |
Additional details
Dates
- Accepted
-
2021-10-27
Software
References
- 1. National Institutes of Health state-of-thescience conference statement. Cesarean delivery on maternal request. Obstet Gynecol. 2006;107:1386-97. 2. Gibbons L, Belizán JM, Lauer JA, Betrán AP, Merialdi M, Althabe F. The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage. World Health Report. 2010;30:1-31. 3. Belizán JM, Cafferata ML, Althabe F, Buekens P. Risk of patient choice caesarean. Birth. 2006;33:167-9. 4. Caughey AB, Cahill AG. Safe prevention of the primarycesarean delivery. Obstetric Care Consensus. 2014;1:2-19. 5. Stanton C, Ronsmans C. Recommendations for routine reporting on indications for caesarean delivery in developing countries. Birth. 2008; 35:204-11. 6. Torloni MR, Betran AP, Souza JP, Widmer M, Allen T, Gulmezoglu M, et al. Classification for caesarean section: a systemtic review. PLoS One. 2011;6:e1456. 7. Signh G, Gupta ED. Rising incidence of caesarean section in rural area in Haryana, India: a retrospective analysis. Internet J Gynecol Obetet. 2013;17(2):1- 5. 8. Gibbons LBJ, Lauer JA, Betran AP, Merialdi M, Althabe F. The Global Numbers and Costs of Additionally Needed and Unnecessary Caesarean Sections Performed per Year: Overuse as a Barrier to Universal Coverage. World Health Report Background Paper 30. Geneva: World Health Organization 2010. 9. Betran AP, Torloni MR, Zhang JJ, Gülmezoglu AM. WHO Working Group on Caesarean Section. WHO Statement on Caesarean Section Rates. BJOG. 2016;123(5):667-70. 10. Souza JP, Gülmezoglu AM, Lumbiganon P, Laopaiboon M, Carroli G, Fawole B et al. Caesarean section without medical indications is associated with an increased risk of adverse short-term maternal outcomes: The 2004-2008 WHO Global Survey on Maternal and Perinatal Health. BMC Med. 2010;8(1):71. 11. Jawa A, Garg S, Tater A, Sharma U. Indications and rates of lower segment caesarean section at tertiary care hospital an analytical study. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2016;5(10):3466–3469. 12. IIPS. National Family Health Survey-4 (NFHS-4) 2015–16. India Factsheet. Government of India 2015–16 13. Sreevidya S, Sathiyasekaran BW. High caesarean rates in Madras (India): a population-based cross sectional study. BJOG 2003;110(2):106-11. 14. Nagpal J, Sachdeva A, Sengupta Dhar R, Bhargava VL, Bhartia A. Widespread non-adherence to evidence-based maternity care guidelines: a populationbased cluster randomised household survey. BJOG 2015;122(2):238-47. 15. Mussart N, Qureshi S, Roohi. M. Lower Segment Cesarean Section (LSCS); Professional Med J 2013; 20(6):916-923. 16. Peel A, Bhartia A, Spicer N, Gautham M. "If I do 10-15 normal deliveries in a month I hardly ever sleep at home." A qualitative study of health providers' reasons for high rates of caesarean deliveries in private sector maternity care in Delhi, India. BMC Pregnancy and Childbirth 2018;18(1):1-11.