Indications and rates of lower segment caesarean section at tertiary care hospital - an analytical study

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 Jan 2016 to 31st Dec 2016 at the Department of OBG, RUHS College of Medical Sciences, Jaipur (Rajasthan), North 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 2959, out of which C-Sections were 931. The overall CS rate was 31.46%. Previous LSCS was the leading indication to the CS rate (36.52%) followed by arrest of labour (13.65%), CPD (12.03%), foetal distress (11.82%), breech presentation (7.52%), oligohydroamnios/IUGR (5.16%) and failed induction of labour (3.54%). 11.60% patients had various complications mainly infection (5.58%) and haemorrhage (3.98%). 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.

Section: The Caesarean Section Indicationssupporting

confidence: 82%

“…19 Average annual CSR in the present study can be compared with the other studies (Table 8). [7][8][9][10]12,[19][20][21][22][23][24][25][26][27][28][29][30][31][32] …”

mentioning

confidence: 99%

The rate and indications of caesarean section in a tertiary care hospital at Jaipur, India

Gupta

Garg

2017

“…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. 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.…”

Section: Discussionmentioning

confidence: 99%

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

Patil

Bhardwaj

Sharma

et al. 2017

Background: This study was carried out to find the rate of Cesarean section (CS) in our institute from 2012 to 2016 and also to find any change in the indications of CS over these five years.Methods: A retrospective analysis of data was done from the records of the patients who underwent CS and the rate of Cesarean section and the indications were noticed.Results: The rate of Cesarean section has increased from 43.85% in 2012 to 48.18% in 2016. There is increase in the number of Primary Cesarean cases from 61.8% in 2012 to 68.4% in 2016.The percentage of Elective CS has increased in last five years from 10.2% in 2012 to 23.6% in 2016 which is due to the drastic increase in Elective Repeat CS from 13.3% in 2012 to 43.4% in 2016. The first and second major indication of Primary CS over the years remained the same i.e. fetal distress and CPD. Other major contributing indications were Non-progress of labour, failed induction and Malpresentation. Oligohydraminos and IUGR, Multiple pregnancy and precious pregnancy have emerged as the major indication in last three years. Previous CS and Previous 2 CS contributed as the main indication for Elective CS.Conclusions: The rate of Cesarean section need to be reduced. The overall main indication for CS was Previous CS and thus Primary CS rate should be reduced. Fetal distress being the main indication for Primary CS should be further confirmed by fetal scalp pH findings and Repeat CS cases should be given more trial of labour.

“…14 were observed by Jawa A et al and Subedi S in their study. 15,16 In present setup trial of labor was not given even after one previous CS until and unless women comes in second stage of labour and this is the cause for increased rate for previous CS and failure to conduct VBAC in our hospital was due to lack of trained human resources. The reluctance to undergo trial of labour after previous CS is probably due to either the obstetrician considering that a repeat CS is much safer, convenient, there is less chance of complications and possible subsequent litigation or due to maternal preference is the cause of increase rate of repeat CS.…”

Section: Discussionmentioning

confidence: 93%

“…15 The gold standard method of estimation of foetal distress is not used in our set up and what we have for foetal monitoring is fetal heart rate monitoring with stethoscope and fetal doppler manually. The accurate method of estimation of foetal distress is foetal scalp pH estimation.…”

mentioning

confidence: 99%

Indications and rate of caesarean delivery at tertiary care hospital: a retrospective study

Sharma¹,

Dogra²

2017

Background: Worldwide there has been an increase in the rate of caesarean delivery due to multiple factors. Objective of the study was to assess the prevalence and different indications of caesarean section in this institute.Methods: The aim of the study is to analyse the rates and indications of lower segment caesarean section (LSCS) in our institution. We conducted a retrospective study over a period of six months; 1st September 2016 to 1st March 2017 at SLBSGMC Mandi at Nerchowk. Total number of patients who delivered in our hospital during the defined study period was recorded and a statistical analysis of various parameters was done.Results: The total number of women delivered over the study period was 2075, out of which caesarean sections (CS) were 473. The overall CS rate calculated was 22.8%. Previous LSCS was the leading indication to the CS rate.Conclusions: Routine obstetric audits should be done to analyse the various indications of emergency and elective caesarean sections so that protocols and guidelines can be implemented to curtail the increasing trend of caesarean delivery.