The rate and indication of caesarean section in a tertiary care teaching hospital eastern India

Authors

  • Ratan Kumar Das Department of Pediatrics, IMS and SUM Hospital, Siksha O Anusandhan University, Bhubaneswar, Odisha, India
  • K. Trimal Subudhi Department of Pediatrics, IMS and SUM Hospital, Siksha O Anusandhan University, Bhubaneswar, Odisha, India
  • Ranjan Kumar Mohanty Department of Pediatrics, IMS and SUM Hospital, Siksha O Anusandhan University, Bhubaneswar, Odisha, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20182963

Keywords:

Caesarean section, Caesarean rates, Indications of CS

Abstract

Background: Caesarean section is one of the most widely performed surgical procedures in obstetrics worldwide. It was mainly evolved as a lifesaving procedure for mother and foetus during the difficult delivery. To analyze the rate and indications for C-Section and associated maternal morbidity and mortality were the main objectives of present study.

Methods: This retrospective study was conducted over a period of one year from 1st May 2017 to 30th April 2018 at the Department of Pediatrics and OBG, IMS & SUM Medical college and Hospital, Bhubaneswar (Odisha), eastern India. Data of Patients who delivered by C-Section in our hospital during the defined study period was recorded and a statistical analysis of various parameters namely, the caesarean section rates, its indications, the patient’s morbidity and mortality was done.

Results: The total numbers of women delivered over the study period were 1619, out of which C-Sections were 574.The overall CS rate was 35.45%. Previous LSCS was the leading indication to the CS rate (29.96%) followed by arrest of labour (13.94%), CPD (11.84%), foetal distress (10.97%), breech presentation (5.74%), oligohydroaminous/IUGR (5.21%), failed induction of labour (5.21%), pregnancy induced hypertension(PIH) (4.87%) and multifetal gestation (3.84%), prematurity (3.31%). 12.01% patients had various complications mainly infection (6.27%) and hemorrhage (3.48%). There was no mortality during this period.

Conclusions: Being a tertiary care hospital, a high rate of Caesarean deliveries was observed, Individualization of the indication and careful evaluation, following standardized guidelines, practice of evidenced-based obstetrics and audits in the institution, can help us limit CSR.

References

National Institutes of Health state-of-the-science conference statement. Cesarean delivery on maternal request. Obstet Gynecol. 2006;107:1386-97.

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.

Belizán JM, Cafferata ML, Althabe F, Buekens P. Risk of patient choice caesarean. Birth. 2006;33:167-9.

Caughey AB, Cahill AG. Safe prevention of the primarycesarean delivery. Obstetric Care Consensus. 2014;1:2-19.

Stanton C, Ronsmans C. Recommendations for routine reporting on indications for caesarean delivery in developing countries. Birth. 2008; 35:204-11.

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.

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.

Subhashini R, Uma N. Changing trends in Caesarean delivery. IAIM. 2015;2(3):96-102.

Yadav RG, Maitra N. Examining cesarean delivery rates using the Robson’s ten group classification. J Obstet Gynecol India. 2016;66(1):1-6.

Manjulatha B, Sravanthi TP. Caesarean section rates in a Teaching Hospital: a ten-year review. IOSR J Dent Med Sci. 2015:14(8):1-5.

Shabnam S. Caesarean section delivery in India. Causes and concerns, international union for the scientific study of population, session 221, assessments of facility-based delivery services. Available at https://iussp.org/sites/default/files/event_call_for_papers/Caesarean%20section%20delivery%20in%20India_0.pdf

Shiba M, Sachin P, Niranjan M, Janki M. Trends in cesarean delivery: rate and indications. J Obstet Gynecol. 2014:64(4):251-4.

Barber EL, Lundsberg LS, Belanger K. Indicationa contributing to the increasing cesarean delivery rate. Obstet Gynecol. 2011:118(1):29-38.

Ba aqeel. Cesarean delivery rates in Saudi Arabia: a ten-year review. Ann Saudi Med. 2009:29(3):179-83

Tolla’nes MC. Increased rate of Caesarean sections-causes and consequences. Tidsskr Nor Laegeforen. 2009:129(13):1329-31.

WHO Statement on caesarean section rates, 2015, WHO reference number: WHO/RHR/15.02. Available at http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/cs-statement/en/.

Caesarean section rates and indications in sub Saharan. Africa: a multi-country study from medecins sans frontiers: PLoS One. 2012:7(9):e44484.

WHO Euro Health for all database, 2014. Available at http://data.euro.who.int/hfadb/(53).

Samdal LJ, Steinsvik KR, Pun P, Dani P, Roald B, Stray-Pedersen B, Bohler E. Indications for Cesarean Sections in Rural Nepal. J Obstet Gynaecol India. 2016;66(1):284-8.

Jawa A, Garg 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;5:3466-9

Preetkamal, Kaur H, Nagpal M. Is current rising trend of cesarean sections justified? Int J Reprod Contracept Obstet Gynecol. 2017;6:872-6.

Yadav S, Kaur S, Yadav SS, Thakur B. Analysis of caesarean rate, indications and complications: review from medical college Ambala, Haryana, India. Int J Reprod Contracept Obstet Gynecol. 2016;5:3326-9.

Saxena N, Sharma B. Gupta V, Negi KS. A six year appraisal of caesarean delivery at a teaching hospital in Uttarakhand. Int J Reprod Contracept Obstet Gynecol. 2016;5:4369-72.

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;5:1364-7.

Chavda D, Goswam K, Dudhrejiva K A cross sectional study of 1000 lower segment cesarean section in obstetrics and gynecology department of P. D. U Medical College, Rajkot, Gujarat, India. Int J Reprod Contracept Obstet Gynecol. 2017;6(4):1186-91.

Nikhil A, Desai A, Vijay K, Bhumika K, Riddhi P. Analysis of trends in LSCS rate and indications of LSCS: a study in a Medical College Hospital GMERS, Sola, Ahmedabad. Int J Pharm Bio-Sci. 2015;2(1):1-5.

Bade P, Kendre V, Jadhav Y, Wadagale A. An analysis of indications for caesarean section at government medical college, Latur. Intern J Recent Trends Sci Technol. 2014;11(1):6-8.

Padmaleela K, Thomas V, Prasad KV. An analysis of the institutional deliveries and their outcomes in government teaching hospitals of Andhra Pradesh, India. IJHSR. 2013;3(5):76-81.

Liu Y, Li G, Chen Y, Wang X, Ruan Y, Zou L et al. A descriptive analysis of the indications for caesarean section in mainland China. BMC Pregnancy Childbirth. 2014;12:14:410.

Santhanalakshmi C, Gnanasekaran V, Chakravarthy AR. A retrospective analysis of cesarean section in a tertiary care hospital. Int J Sci Res. 2015;4:2097-9.

Bhasin SK, Rajoura OP, Sharma AK, Metha M, Gupta N. Kumar S et al. A high prevalence of caesearn section rate in East Delhi. Indian J Comm Med. 2007;32(3):222-4

Kambo I, Bedi N, Dhillon BS, Saxena NC. A critical appraisal of caesarean section rates at teaching hospitals in India. Int J Gynaecol Obstet. 2002;79(2):151-8.

Balci O, Gezginc K, Acar A. The outcome analysis of cesarean section cases in one-year period. Gynecol Obstet Reprod Med. 2007;13:26-28.

Vaginal birth after caesarean (VBAC): resource overview, 2016. Available at http://www.acog.org/Womens-Health/Vaginal-BirthAfter-Cesarean-VBAC.

Green JE, Meclean F, Usher SR. Caesarean section study of latin American Hospital. Am J obstet Gynaecol. 1982;142.

Mylonas I, Friese K. Indications for and risks of elective caesarean section. Dtsch ArztebI Int. 2015;112(29-30):489-95.

Downloads

Published

2018-08-24

Issue

Section

Original Research Articles