Caesarean section: Evaluation, guidelines and recommendations

Arjun, Gita

doi:10.20529/ijme.2008.043

Cited by 7 publications

(7 citation statements)

References 8 publications

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“…Age and parity were included as risk factors because evidence suggests that maternal age is positively correlated with risk of cesarean, and women with lower parity or who have had a previous cesarean are usually at higher risk of cesarean [1]. High birth weight and maternal obesity were also included as they have been associated with a high risk of cesarean [2,18]. These risk factors were included to account for all cesarean deliveries that might have been medically necessary; the net effect after controlling for these factors indicates procedures that were not necessarily needed and might be a sign of overmedicalization.…”

Section: Methodsmentioning

confidence: 99%

“…Advances in surgical techniques have made cesarean delivery much less risky, encouraging Indian obstetricians to perform more of them [18]. Previous research in India [19] has also found that high rates of cesarean are associated with several factors: availability of facilities and trained obstetricians; source of payment for delivery (through insurance) and place of birth (private institutions); physician practice styles; obstetrician's clinical attitude and fear of litigation; and emphasis on the astrologic calendar with the demand for neonates to be born at a certain time [18,20]. However, the choice to do a cesarean is often made by the obstetric surgeon, who might be partly motivated by profit.…”

Section: Introductionmentioning

confidence: 99%

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Demand and supply factors affecting the rising overmedicalization of birth in India

Leone

2014

International Journal of Gynecology & Obstetrics

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Synopsis:After controlling for risk factors and socioeconomic characteristics, the probability of cesarean delivery in India was driven mainly by supply factors rather than by demand. ABSTRACTObjective: To understand the interaction between health systems and individual factors in determining the probability of a cesarean delivery in India. Methods:In a retrospective study, data from the 2007-2008 District Level Household and Facility Survey was used to determine the risk of cesarean delivery in six states (Punjab, Delhi, Maharashtra, Andhra Pradesh, Kerala, and Tamil Nadu). Multilevel modeling was used to account for district and community effects.Results: After controlling for key risk factors, the analysis showed that cesareans were more likely at private than public institutions (P<0.001). In terms of demand, higher education levels rather than wealth seemed to increase the likelihood of a cesarean delivery. District-level effects were significant in almostall states (P<0.001) demonstrating the need to control for health system factors. Conclusion:Supply factors might contribute more to the rise in cesarean delivery than does demand. Further research is needed to understand whether the quest for increased institutional deliveries in a country with high maternal mortality might be compromised by pressures for overmedicalization.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Demand and supply factors affecting the rising overmedicalization of birth in India

Leone

2014

International Journal of Gynecology & Obstetrics

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“…To study the escalating rate of C/S another study was conducted among 30 medical colleges all over India and results analysed which showed a rate of C/S at 21.8% in 1993-94 and 25.4 % in 1998-99. 7 As seen in 2001 census, the percentage of women who had undergone C/S was found to be highest in Kerala (31.8%) followed by Andhra Pradesh (29.3%) and Tamil Nadu (23.2%) and the lowest rate was observed in Rajasthan and Jharkhand (4.2 % in both the states). 8 The Oldest Obstetrics & Gynaecological department of India, The Eden Hospital of Calcutta Medical College, Kolkata has seen a rise in C/S from 9.5 % in 1973 to 40.1% in 2012.…”

mentioning

confidence: 90%

An analysis of indications of caesarean sections at Tezpur medical college and hospital, Tezpur (a government hospital)

Sarma

Boro

Acharjee

2016

Int J Reprod Contracept Obstet Gynecol

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“…Because of rise in primary caesarean sections, there is a proportionate rise in repeat sections as well. 6 The overall rate of caesarean needs to be reduced and this can be achieved to a small extent by avoiding primary caesarean done without explicit indications and more importantly by resorting to a Trial of Labour after a Caesarean (TOLAC) which is safe for both foetus and mother. 7 But, patients who fail a trial of labour are more likely for complications than who have a successful vaginal birth after caesarean(VBAC) or elective repeat caesarean.…”

Section: Introductionmentioning

confidence: 99%

Prediction of successful vaginal birth after caesarean section based on Flamm and Geiger scoring system a prospective observational study

Sahu

Chaudhary

Sharma

2018

Int J Reprod Contracept Obstet Gynecol

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Background: The aim of this study was to evaluate the adequacy of Flamm and Geiger scoring system in prediction of successful vaginal birth after caesarean section.Methods: A prospective observational study was carried out on 75 pregnant women with previous one caesarean section in department of obstetrics and Gynecology, St Stephen’s hospital, New Delhi over a period of one year.Results: In the present study, out of 75 patients, 40% patients had successful VBAC and 60% patients had emergency LSCS. Among successful VBAC 70% patients had spontaneous vaginal delivery, while 23.3% patients had vacuum assisted and 6.7% had forceps assisted vaginal delivery. Most of the patients with total Flamm and Geiger score < 3 at the time of admission had emergency caesarean section while most of the patients with score >4 had successful VBAC. There were 53.3%, 75%, 85.7% and 100% probabilities of Successful VBAC with total score 4,5,6 and >8 respectively. Mean score for successful VBAC was 5±1.66and for emergency caesarean was 2.97±0.83.Conclusions: As total Flamm and Geiger score increases, a chance of successful VBAC increases. Application of Flamm and Geiger scoring gives fare judgment of successful vaginal birth in TOLAC and reduces the rate of failed trial leading to emergency caesarean section, thus improving outcome in a trial of labor.

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Caesarean section: Evaluation, guidelines and recommendations

Cited by 7 publications

References 8 publications

Demand and supply factors affecting the rising overmedicalization of birth in India

Demand and supply factors affecting the rising overmedicalization of birth in India

An analysis of indications of caesarean sections at Tezpur medical college and hospital, Tezpur (a government hospital)

Prediction of successful vaginal birth after caesarean section based on Flamm and Geiger scoring system a prospective observational study

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