Determinates of Caesarean Section in Tertiary Care Hospital

Abstract

Caesarean Section is the second commonest surgery done in India after tubectomy and has great impact on maternal and neonatal health. Increasing Caesarean rates have raised the need to study its influencing factors. The objective is to analyse the different indications and frequency of caesarean sections in order to reduce such deliveries in a tertiary hospital. This retrospective study was conducted at the Department of Obstetrics and Gynaecology, Mahatma Gandhi Medical College, Jaipur, from October 1 to December 31, 2015. It comprised review of clinical records of all patients who underwent caesarean section during this period. This included booked, un-booked or referred cases and data regarding the indications, type of caesarean deliveries and demographic features. During the study period, there were 792 deliveries out of which 261 (32.95%) were caesarean. Emergency caesarean section was performed on 150(57.5 %%) and elective caesarean section was performed on 111(42.5%) patients. Overall, 122(46.6 %%) cases were booked and 139(53.3 %%) were un-booked or referred cases. Most of the caesarean sections were carried out due to previous caesarean sections 58(22.2%) followed by foetal distress 49(18.7%), non-progress of labour 32(12.2%), Pregnancy induced hypertension 17(6.51%), breech 15(5.75%), oligohydramnios 16(6.13%), intra uterine growth retardation 10(3.83%), placental abruption 4(1.53%) and placenta previa 5(1.91%). Audit and feedback is the best way to judge clinical practice and to reduce the frequency of caesarean section in any tertiary setup. Previous caesareans were the most common indication of repeat procedure in the study.

Changing trends in indication of cesarean section in a tertiary care centre of Central India

“…12 In present study 71.1% were emergency CS and 28.9% were elective CS. Elective primary CS were less 17% whereas the Elective repeat CS rate was very high 51.9% which suggests that main indication for elective CS was previous CS.…”