Publication:

Rising trend of caesarean section in a tertiary hospital over half decade: a retrospective study

Background Cesarean section (CS) rates are increasing worldwide; however, it can lead to significant increase in maternal and infant morbidity and mortality. This study aimed to determine the rates and trend of cesarean sections in Jammu (Jammu and Kashmir), India.

Methods This was a retrospective hospital record-based study done in patients who were admitted in Government Medical College Jammu (Jammu and Kashmir) India in the Department of Obstetrics and Gynecology during the study period from Jan 2012 to Dec 2017 and data of CS was collected. The trends and indications for CS over the 5-year period were analyzed with SPSS 12.0 software.

Results During the study period, annual number of deliveries in GMC Jammu increased from 14592 (2012) to 20417 (2017). CS rates increased from 4817 (33.01%) to 8378 (41.03%) with a hike of 8.02%. Commonest indication for CS was post CS pregnancies (25.43%-34.24%) followed by non-progress of labor (NPOL), fetal distress, breech presentation, antepartum hemorrhage, cephalo-pelvic disproportion (CPD) and severe pregnancy induced hypertension (PIH).

Conclusions This study indicates that rapid socio-economic changes and the outlook towards medical intervention by the women, families and society are largely responsible for rising trend of CS. Other factors that have been reported for this are fear of pain; concerns about genital modifications after vaginal delivery; misconception that CS is safer for the baby; fear of medical litigation and lower tolerance to any complications or outcomes other than the perfect baby are responsible for the current high incidence of caesarean section in many states and urban centres with post cesarean pregnancy being the largest contributor. From doctors point of view, it is a defensive medicine to have better outcome.