One-Year Trend of Caesarean Rate in a Border Static Hospital in India

BMJ Open

ObjectiveOur objective was to describe trends in caesarean section (CS) rates, characteristics of women delivering by CS, reasons for CS and impact of CS on perinatal mortality, in a rural Indian population.DesignSecondary data analysis using a prospective population-based registry.SettingFour districts in Eastern Maharashtra, India, 2010 to 2013.Participants39 026 pregnant women undergoing labour and delivery.Main outcomesCS, single most likely reason, perinatal mortality.ResultsOverall, 20% of the women delivered by CS. Rates increased from 17.4% in 2010 to 22.7% in 2013 (p<0.001) with an absolute risk increase from 1% to 5% during this time-period. Women aged 25+ years old, being nulliparous, having at least a secondary school education, a body mass index 25+ and a multiple gestation pregnancy were more likely to deliver by CS. Perinatal mortality was higher among babies delivered vaginally than those delivered by CS (4.5% vs 2.7%, p<0.001). Prolonged and obstructed labour ...

Health Policy and Planning, 2002

Caesarean section rates have been increasing worldwide, raising the question of the appropriateness of the selection of cases for the procedure. This paper examines the levels and correlates of delivery-related complications and caesarean section deliveries in 18 selected states of India in terms of specific maternal and institutional factors, using data from the National Family Health Surveys, 1992-93. Goa (15.3%) and Kerala (13.7%) were the two states with relatively higher caesarean section rates. There is reason to believe that current rates are part of a rising trend. This cannot be attributed entirely to the rise in institutional deliveries alone because of the strong association between caesarean sections and private sector institutions. Apart from the fact that the states of Kerala and Goa have relatively high caesarean section rates, in Andhra Pradesh, Bihar, Gujarat, Karnataka, Punjab and Uttar Pradesh the risk of undergoing caesarean section in private sector institutions is four or more times that in the public sector. It is possible that this extremely useful surgical procedure is being misused for profit purposes in the private sector in several states. There is therefore a need to examine this phenomenon using data disaggregated by the nature of caesarean sections, i.e. whether it was an elective or an emergency caesarean section along with the reasons for the choice.

IP Innovative Publication Pvt. Ltd, 2017

In the background of increasing rates of caesarean sections, this study was done to find the current trends of the surgery. Aim: To study 500 consecutive caesarean sections in a tertiary referral maternity hospital in South India to understand the current trends in caesarean. Objective: 1. To find out the incidence of caesarean sections and the pattern of the indications 2. To find the pattern of age distribution, parity, period of gestation, intra operative & post operative complications, fetal & maternal outcome in caesarean sections & 3. To compare elective and emergency caesarean sections Method: This was a prospective study carried out in a District Maternity hospital in South India. We included 500 consecutive caesarean sections from the time of commencement of the study. The various characteristics of the patient & newborn profile, the surgical indications & complications were noted and compared in elective & emergency caesarean sections & the statistical significance was noted by applying Chi square test. Results: The incidence of caesarean section was found to be 30.1% in our study. Of the total 500 cases studies, 68.2% were emergency sections. Most elective cases were in parous women (69.1%); whereas most emergency cases were in nulliparous women (68.03%). Commonest indication for caesarean section was previous caesarean section in the elective group; while in the emergency group, it was meconium and fetal distress. Intra operative complications and perinatal mortality were significantly more in emergency cases. Post operative morbidity was seen in 16.2% cases. Conclusion: There is a need to avoid unwarranted surgeries, mainly primary caesarean section and also the need to give trial of scar in carefully selected cases so that the caesarean rate stabilizes with good maternal and fetal outcome.

Journal of Health Population and Nutrition, 2011

The steady rise in caesarean section rates is an emerging area of concern in mother-child healthcare and a matter of international attention, since the trend is no longer confined to western industrialized countries. Crude and caesarean section-related perinatal mortality and case-fatality rates may well serve as public-health indicators. Monitoring time-trends in caesarean section rates has been considered a useful approach in the recognition of this rapidly-changing health policy and in estimating the magnitude of this problem. The study examined the observed time-trends in caesarean section rates in relation to perinatal mortality rates and maternal case-fatality rates in a hospital setting in Mumbai, India, using 1957-1998 data on retrospective cohort. Both overall rates and those specific to type of delivery were assessed. During 1957-1998, the caesarean section rates in the Nowrosjee Wadia Maternity Hospital (NWMH) increased from 1.9% to 16%, with the most significant rise over the past decade. The perinatal mortality rate showed a significant reduction from 69 per 1,000 in 1957 to 36 per 1,000 in 1992 and remained steady in the 1990s despite the higher caesarean section rates. The caesarean section rate in the NWMH rose by almost 10-fold during . No improvement in perinatal outcome was observed beyond a caesarean section rate of 10%, but the perinatal mortality rate in caesarean births increased significantly due to a more liberal use of caesarean sections in preterm deliveries and those that yielded low-birth-weight babies.

2016

One of the most alarming features of modern obstetrics is the relentless increase in c-section rates. Medical, institutional, legal, psychological and socio-demographic factors play a contributing role. Although c-sections can be lifesaving, c-section rates above the WHO recommended 15% raises global concern.India is also not excluded from this trend. It is time to realize that c-sections not only put both the mother and child at risk, but also pose huge economic burden compared to normal vaginal delivery. This study was designed to identify the maternal risk factors associated with csections. A hospital based case control design was approached. 360 mothers, all consenting 180 consecutive mothers who had c-section in singleton pregnancies and 180 mothers with singleton spontaneous vaginal deliveries were selected from postnatal ward. Data was collected using a pre-tested questionnaire. Out of the 11 variables examined, 7 were found statistically significant. Mothers who had a previo...

Australasian Medical Journal, 2010

BackgroundIncreasing Caesarean Section (CS) rates is a concern in the health care systems all over the world, in a developing country an increase in the CS rate has major implications on the limited health care resources, this study was carried out with an objective to find out the trends and indications of CS in a government hospital. Method A hospital based retrospective study was carried out in a tertiary Government-run hospital specializing in Obstetrics and Gynaecology and all deliveries conducted from Jan 1st 2009 to Dec 31st 2009 were included, the data was collected using a pro forma designed based on the recommendations for routine reporting on caesarean delivery in developing countries. ResultsThere were 7543 deliveries in the study period with 1756 being CS, giving a rate of 23.27%. Most of the CSs were performed because of a previous CS. Foetal distress, breech presentation and failed induction were the other prominent indications. Placenta praevia and malpresentations w...

2015

Background: Caesarean section (CS) is a common surgical procedure performed in women of reproductive age. The numerous indications for a CS may be due to fetal or maternal problems. Though it is a life saving procedure, it also carries a higher morbidity and mortality than vagina delivery. Method : This is a retrospective study conducted from January 2014 to December 2014 at a secondary health facility located in a rural setting in Ahmednagar. The theatre registers were the sources of data. Results: There were fourteen indications for the 731-caeserean sections performed with previous LSCS being The highest indication. Previous LSCS, Fetal distress, CPD and Oligohydromnios were the major indications for caesarean Section. There were 1 maternal death and 4 stillbirths out of the 731 babies delivered. Conclusion : Changing trends and changing indications are very well can be seen from the study suggesting that “Once a cesarean always a cesarean” is what we seem to achieve in near future.

Growing Concern Over Rising Caesarean Section Rates: Is It a Problem for Low‑ and Middle‑Income Countries Only?, 2022

Review Article IntroductIon The problem A caesarean section (CS) is a surgical procedure to deliver one or more babies by making an incision on the anterior abdominal wall of the pregnant mother. [1] It is usually performed when normal vaginal delivery (NVD) puts a mother's or baby's life at risk. Other accepted indications may include obstructed labour, breech or abnormal foetal presentation, excessive foetal size, non-reassuring foetal heart rate, increased maternal age and history of previous cesarean delivery. [1-3] Other conditions that might necessitate CS are placenta praevia, placental abruption, placenta accreta, prolapsed cord, maternal age, diabetes, obesity, hypertension, gestational diabetes, pre-eclampsia, eclampsia and maternal preference. [2] There has been considerable concern over the rising rates of CS over the past few decades. [4-8] Annually, an estimated 6.2 million unnecessary CS are performed globally, costing US$ 2.3 billion approximately. [9] In 2015, data from 169 countries showed that, out of 140.6 million live births, there were 29.7 million CS births, which nearly doubled in 15 years. [10] It has been an issue for developed countries and middle-income countries. [2,11] In a research paper, Betrán et al. [12] stated that CS accounted for 18.6% of all births analysing data from 150 countries. Over the 24-year study period (1990-2014), trend analysis of data in 121 countries showed that there had been an average 12.4% increase in the CS rates, with an average annual rate of 4.4% rise. The highest (6.4%) and lowest (1.6%) annual increase rates were observed in Asia and North America, respectively. [12] Verma et al. [1] found CS rates to be as high as 13% in SouthEast The rising caesarean delivery rate is a global concern and is believed by many as a problem in low-income countries exclusively. It has been observed that utilisation of this lifesaving procedure is unusually high in many middle-and high-income countries. Caesarean section (CS) is indicated to save both the mother's and child's life in certain situations. When chosen in the proper indication, it is helpful towards reducing morbidity and mortality in both. There is a vast number of papers evidencing the injudicious use of this necessary procedure. There is an evident disparity in the utilisation of the process too. In some sub-Saharan African countries, women do not have access to or have very minimal access to caesarean delivery due to many factors. On the other hand, certain countries overutilise it. Being a South Asian country, Bangladesh is no different from many other countries, with rising caesarean delivery rates in rural and urban populations. It is of great concern for the Bangladeshi general community and the healthcare workers. There have been claims that it is overutilised injudiciously by the Bangladeshi health force. This review aims to find the facts related to the CSs and compare between the high-, middle-and low-income countries. Being healthcare professionals and medical educators by origin, the authors were explicitly interested in Bangladesh. They conducted the review to contribute to the development of the country's healthcare system.

International journal of reproduction, contraception, obstetrics and gynecology, 2022

INCREASED C SECTION RATES-NATIONAL AND INTERNATIONAL In India, according to data from the District Level Household Survey (DLHS 4) in 2011, the prevalence of CS births in public sector health facilities was 13.7% as compared to 37.9% in private sector health facilities. CS

Clinical Epidemiology and Global Health, 2020

Prevalence and determinants of the use of caesarean section (CS) in the dichotomy of 'public' and 'private' health facilities in West Bengal. India

Journal of Medical Science And clinical Research, 2020

Background: Caesarean section is a surgical operation to deliver a baby or babies by means of an incision through the abdomen and uterus. The World Health Organization (WHO) has recommended an ideal caesarean section (CS) rate as 10-15%. Methods: This is a retrospective study of all the caesarean deliveries performed between 1 st

2001

Caesarean section rates have been increasing world-wide raising the question of the appropriateness of the selection of cases for the procedure.This paper examines the levels and correlates of delivery related complications and caesarean section deliveries in eighteen selected states of India in terms of specific maternal and institutional factors, using data from the National Family Health Surveys,1992-93.Goa (15.3 per cent)and Kerala (13.7 per cent)were the two states with relatively higher caesarean section rates.There is reason to believe that the current caesarean section rates are part of a rising trend.This can not be attributed entirely to the rise in institutional deliveries alone because of the strong association between caesarean sections and private sector institutions. Apart from the fact that the states of Kerala and Goa are having relatively high caesarean section rates, in Andhra Pradesh, Bihar, Gujarat, Karnataka, Punjab and Uttar Pradesh the risk of undergoing caes...

International Journal of Community Medicine and Public Health, 2016

Background: 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.

2015

Background: Caesarean section (CS) is a common surgical procedure performed in women of reproductive age. The numerous indications for a CS may be due to fetal or maternal problems. Though it is a life saving procedure, it also carries a higher morbidity and mortality than vagina delivery. Method: This is a retrospective study conducted from January 2014 to December 2014 at a secondary health facility located in a rural setting in Ahmednagar. The theatre registers were the sources of data. Results: There were fourteen indications for the 731-caeserean sections performed with previous LSCS being the highest indication. Previous LSCS, Fetal distress, CPD and Oligohydromnios were the major indications for caesarean Section. There were 1 maternal death and 4 stillbirths out of the 731 babies delivered. Conclusion: Changing trends and changing indications are very well can be seen from the study suggesting that "Once a cesarean always a cesarean" is what we seem to achieve in near future.

Journal of Evolution of Medical and Dental Sciences

BACKGROUND The drastically increasing rate of Caesarean section (CS) is a topic of constant worry and analysis throughout the world. In order to understand the degree to which Caesarean section may be preventable, it is important to know why Caesarean sections are performed. Due to nonexistence of any standard classification for indications of Caesarean section, indications for the same vary among institutions. We wanted to evaluate the rates and predictors of Caesarean section among institutional deliveries in a tertiary care hospital in an economically backward rural area. METHODS This was a cross-sectional prospective study. Pregnant women who underwent Caesarean section (CS) between June 2019 and December 2019 at BLDE (DU) Shri. B. M. Patil Medical College Hospital and Research Centre, Vijayapur, Karnataka, were recruited for the study. Demographic and obstetric data including indications of Caesarean section and pregnancy outcomes were collected and analysed. RESULTS The mean a...