A clinical study on indications for caesarean section among primigravida in a tertiary care centre
Abstract
Background: The Primary caesarean section (CS) delivery rate is increasing due to public interest to avoid fetal complications and acceptance by most of the couple to complete their family with one or two children. High cesarean birth rates are an issue of international public health concern. Worries over such increases have led the World Health Organization to advise that Cesarean Section (CS) rates should not be more than 15%, with some evidence that CS rates above 15% are not associated with additional reduction in maternal and neonatal mortality and morbidity.
Aims and Objectives: To find out the indications of caesarean section among primigravida in a tertiary care centre.
Methods: A total of 100 cases were selected for the study who regularly attended outdoor (Booked) and admitted, those who booked in antenatal clinic but admitted as emergency.
Results: The most common age group in the present study was 20-25 years (45%). Among the study cases, 80% were booked, 20 % were unbooked.
Conclusion: Obstetric factors occurring around birth, including obstructed labor and fetal distress were the main reasons leading to Cesarean Section rather than background characteristics assumed to be a risk. The results imply that there is a need for timely and accurate screening of women during obstetric care and, decision to perform cesarean section should be based on clear, compelling and well-supported justifications .Early referral instead of late referral from the periphery hospitals to the tertiary hospital is necessary for trial of vaginal delivery.
Downloads
References
2.Shamshad B. Factors Leading To Increased Caesarean Section Rate. Gomal J Med Sci. 2008;6:1.
3. Panditrao S. Intra-operative difficulties in repeat caesareansections. J Obstet Gynecol India. 2008;58(6): 507–10.
4. Bailey P, Lobis S, Maine D, Fortney JA. Monitoring emergency obstetric care: a handbook. World Health Organization; 2009.
5.Althabe F, Belizán JM. Caesarean section: the paradox. Lancet. 2006;368(9546):1472-3. DOI:10.1016/ S0140-6736(06)69616-5
6. Abu Anza SH, Abu Omar AA. Frequency rate and indications of cesarean sections at Prince Zaid bin Al Hussein Hospital-Jordan. J Royal Med Ser. 2012; 102 (354): 1-5.
7. Betrán AP, Merialdi M, Lauer JA, Bing-Shun W, Thomas J, Van Look P, et al. Rates of caesarean section: analysis of global, regional and national estimates. Paediatr Perinat Epidemiol. 2007; 21(2):98-113. doi:10.1111/j.1365-3016.2007.00786.x
8. Organization for Economic Co-operation and Development O. Health at a Glance 2015: OECD Indicators. OECD Publishing, Paris: OECD; 2015.
9. Organization WH. WHO Statement on Caesarean Section Rates. World Health Organization, Geneva, Switzerland: Department of Reproductive Health and Research; 2015.
10. Richards MK, Flanagan MR, Littman AJ, Burke AK, Callegari LS. Primary cesarean section and adverse delivery outcomes among women of very advanced maternal age. J Perinatol. 2016; 36(4):272-7. doi: 10. 1038 /jp. 2015.204. Epub 2016.
11. Klemetti R, Gissler M, Sainio S, Hemminki E. At what age does the risk for adverse maternal and infant outcomes increase? Nationwide register‐based study on first births in Finland in 2005–2014. Acta obstetricia et gynecologica Scandinavica. 2016; 95 (12): 1368-75.
12. Bayrampour H, Heaman M, Duncan KA, Tough S. Advanced maternal age and risk perception: a qualitative study. BMC Pregnancy Childbirth. 2012; 12(1): 100. doi: 10.1186/1471-2393-12-100.
13. Declercq E, Mac Dorman M, Osterman M, Belanoff C, Iverson R. Pre-pregnancy obesity and primary cesareans among otherwise low‐risk mothers in 38 US states in 2012. Birth. 2015;42(4):309-18. doi: 10.1111/ birt. 12201. Epub 2015 Oct 21.
14. Oakley L, Penn N, Pipi M, Oteng-Ntim E, Doyle P. Risk of Adverse Obstetric and Neonatal Outcomes by Maternal Age: Quantifying Individual and Population Level Risk Using Routine UK Maternity Data. PLoS One.2016;11(10):e0164462. doi: 10.1371/journal. pone. 0164462. eCollection 2016.
15. Timofeev J, Reddy UM, Huang CC, Driggers RW, Landy HJ, Laughon SK. Obstetric complications, neonatal morbidity, and indications for cesarean delivery by maternal age. Obstet Gynecol. 2013;122 (6):1184-95. doi: 10.1097/ AOG. 00000 00000000017.
16. Cleary-Goldman J, Malone FD, Vidaver J, Ball RH, Nyberg DA, Comstock CH, et al. Impact of maternal age on obstetric outcome. Obstet Gynecol. 2005; 105(5): 983-90. doi: 10. 1097/01. AOG. 0000158118. 75532.51
17. Robson M. Classification of caesarean sections. Fetal Matern Med Rev 2001;12:23-39. doi: https://doi. org/10.1017/S0965539501000122
18. J Thomas and the Royal College of Obstetricians and Gynaecologists, clinical effectiveness support unit. The national sentinel caesarean section audit report. London; RCOG press, 2001.
19. Anderson GM, Lomas J. Determinants of the increasing cesarean birth rate. Ontario data 1979 to 1982. N Engl J Med. 1984;311(14):887-92. doi:10. 1056/ NEJM198410043111405
20.Karim F, Ghazi A, Ali T, Aslam R, Afreen U, Farhat R. Trends and determinants of ceasarean section. Surgery Pakistan. 2011;16:1
21. Patel RR, Peters TJ, Murphy DJ; ALSPAC Study Team. Prenatal risk factors for Caesarean section. Analyses of the ALSPAC cohort of 12,944 women in England. Int J Epidemiol. 2005;34(2):353-67. Epub 2005. DOI:10.1093/ije/dyh401
22. Al-Mulhim A. Factors Affecting the Rate and the Indications of Primary Caesarean Section. Bahrain Med Bul. 2001;23(4):160–2.
23. Stivanello E, Rucci P, Lenzi J, Fantini MP. Determinants of cesarean delivery: a classification tree analysis. BMC Pregnancy Childbirth. 2014 28;14(1): 215. doi: 10.1186/1471-2393-14-215.
24. Gutema H, Shimye A. cesarean section and associated factors at mizanaman general hospital, southwest Ethiopia. J Gynecol Obstet. 2014;2(3):37–41. doi: 10.11648/j.jgo.20140203.12
25. D’orsi E, Chor D, Giffin K, Angulo-Tuesta A, Barbosa G, Sousa Gama A, et al. Factors associated with cesarean section in public hospial in Rio de Janeiro, Brazil. Artigo Article. 2006;22(10):2067–78. doi: 10.1186/s12978-015-0114-8
26. Patel RR, Peters TJ, Murphy DJ; ALSPAC Study Team. Prenatal risk factors for Caesarean section. Analyses of the ALSPAC cohort of 12,944 women in England. Int J Epidemiol. 2005;34(2):353-67. Epub 2005 Jan 19. doi:10.1093/ije/dyh401
27. Greenberg MB, Cheng YW, Sullivan M, Norton ME, Hopkins LM, Caughey AB. Does length of labor vary by maternal age? Am J Obstet Gynecol. 2007; 197(4):428.e1-7. doi:10.1016/j.ajog.2007.06.058
28. Mary N, Judith U, Hibbard M. Contemporary Labor Patterns and Maternal Age. Obstet Gynecol. 2013; 122 (5): 1018–2. doi: 10. 1097/AOG. 0b013e 3182a9c92c
29. Alrowaily M, Alsalem F, Abolfotouh M. Cesarean section in a high-parity community in Saudi Arabia: clinical indications and obstetric outcomes.BMC Pregnancy Childbirth. 2014;14(92):1471–2393. doi: https:// doi.org/10.1186/1471-2393-14-92
30. Tsega F, Mengistie B, Dessie Y, Mengesha M. Prevalence of Cesarean Section in Urban Health Facilities and Associated Factors in Eastern Ethiopia: Hospital Based Cross Sectional Study. J Preg Child Health. 2015;2(3):169. doi: 10.4172/2376-127X. 1000169
31. Dewhurt; Textbook of Obstetrics and Gynaecology for Postgraduates (English), Blackwell publishing, 5thEdn, 1995; 392
Copyright (c) 2019 Author (s). Published by Siddharth Health Research and Social Welfare Society
This work is licensed under a Creative Commons Attribution 4.0 International License.
OAI - Open Archives Initiative
Therapoid
