Publication:

Changing trends in cesarean delivery: rate and indications

Background Caesarean section is a time honoured approach which was introduced in clinical practice as a lifesaving procedure both for the mother and the baby. The study was to compare the cesarean delivery rates over last 7 years and to examine the indications contributing to changed trends, if any.

Methods To compare the rate and indications of cesarean delivery over last 7 years. Data were collected in a retrospective manner from all the deliveries that occurred between January 1 and December 31 in 2009, 2012, 2015, in the Department of Obstetrics and Gynaecology at Jhalawar Medical College, Jhalawar, Rajasthan, India. The rate and indications of primary and repeat cesarean sections were analyzed among the live births to estimate the relative contribution of each indication to the overall increase in rate. Repeat caesarean delivery rate increased from 24.66/1000 live births in 2009 to 46.56/1000 live births in 2015. FD, scar tenderness, NPOL mainly contributed to it.

Results The cesarean delivery rate increased from 149.33/1000 live births in 2009 to 234.03/1000 live births in 2015, with an increase in primary cesarean delivery rate from 124.66/1000 live births in 2009 to 187.46/1000 live births in 2015. Fetal distress, non-progression of labor, obstetric indications contributed to this increase.

Conclusions There is significant increase in the total cesarean rate with primary cesarean due to fetal distress accounting for most of the increase.