Prevalence and factors associated with caesarean section: a community based cross sectional study in rural parts of Rangareddy district, Telangana, India

Abstract

INTRODUCTIONPregnancy and delivery are generally considered as normal physiological process in women. The type of delivery can be normal, assisted or caesarean section. Caesarean section (CS) is an operative procedure whereby the fetuses after the end of 28 th weeks are delivered through an incision on the abdominal and uterine walls. Rise in incidence of caesarean sections could be due to increased safety of the operation due to improved anesthesia, availability of blood transfusion and antibiotics, other responsible factors such as rising incidence of primary caesarean section, decline in operative vaginal delivery and identification of high risk pregnancy.1 Some of the absolute indications for caesarean section are central placenta previa, contracted pelvis or cephalo pelvic disproportion, pelvic mass obstruction, advanced carcinoma cervix and vaginal obstruction.There are two types of caesarean sections based on time of operation. They are elective and emergency. Elective is when the operation is done at a pre-arranged time during pregnancy to ensure the best quality of obstetric care, anesthesia, neonatal resuscitation and nursing services. Emergency is when the operation is to be done due to an acute obstetric emergency resulting in endangering to lives of mother and child. 2 ABSTRACTBackground: During the last few decades there has been an alarming rise in the incidence of caesarean section (CS). CS is one of the most common major surgical procedures in private health sector. This rise is of immediate concern and a major public health issue to address. Methods: A community based cross sectional study was done wherein 100 women were selected from Yenkapally and Peddamangalaram villages by household survey by convenient sampling technique. A pre designed, pre tested questionnaire was used to get the relevant information by adopting interview technique. Results: Present study found that the total caesarean section rate was found to be 62% of which primary caesarean section rate was 23%. Thirty seven (59.6%) had emergency caesarean section and twenty five (40.4%) had elective caesarean section. The most common indication for emergency section was failed induction (29.7%) and for elective section it was previous caesarean section (84%). Higher socio economic status, higher birth order and associated health problems during delivery were significantly associated with caesarean section (p<0.05). Conclusions: Present study found a high caesarean section rate with majority sections occurred in private sector hospitals.

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

“…14 Among elective caesarean section in the study of Kumar MV et al most common indication was previous caesarean section, followed by cephalopelvic disproportion. 13 In present study also the main indication for elective CS was previous CS but there is rise in elective Primary CS from 2012 to 2016 and the main indication in 2016 was IUGR with oligohydraminos followed by malpresentation. In a study by Verma et al also the commonest indication for elective cesarean section was previous cesarean section (42%) followed by previous 2LSCS (15%), primi breech (15%), and CPD (14%).…”

“…13 In present study the main indication for emergency Primary CS was fetal distress followed by CPD and then Non progress of labour. Jawa et al also studied that Fetal distress, previous LSCS, NPOL (including failed induction) and Hypertensive disorders of pregnancy (HDP) were the leading indications in the emergency CS.…”

Prevalence and determinants of voluntary caesarean deliveries and socioeconomic inequalities in India: Evidence from National Family Health Survey (2015-16)

“…Other studies have confirmed that there is an evident disparity between the two types of health-care services, with greater prevalence of cesarean deliveries in the private sector. 18,[29][30][31] The decision to perform a cesarean section is based primarily on the question of what is best for or may save the lives of the mother and child. The indications for the cesarean section can, therefore, be divided into absolute and relative indications.…”

The Mode of delivery of grand multiparous with post-cesarean single uterine scar in low resources settings: A retrospective cohort study

“…Some studies have shown a relationship between a concomitant increase in maternal age and caesarian section rate, but they suspected influence by care provider and maternal preferences [25], [26], and increasing parity with maternal age [27]. In India, socio-economic class was related to scarred uterus, the rate thereof reducing with poverty [28]. This factor was not investigated in this study.…”

“…In India, socio-economic class was related to scarred uterus, the rate thereof reducing with poverty [28]. This factor was not investigated in this study.…”