Title: A Retrospective Analysis of Annual Cesarean Section Rate in a Tertiary Care Hospital, KOTA

Authors: Suman Bala, B.L.Patidar, Bhawna Gupta

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i7.168

Abstract

Objective: Caesarean Section is the second commonest surgery done in India after tubectomy and has great impact on maternal and neonatal health. Increasing Caesarean rates have raised the need to study its influencing factors. The objective is to analyze the different indications and frequency of caesarean sections in order to reduce such deliveries in a tertiary hospital.

Methods: This retrospective study was conducted over a period of one year from 1st July 2016 to 30thJune 2017 at the Department of OBG, medical college, Kota (Rajasthan), 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, demographic features, the patient’s morbidity and mortality was done.

Results: The total numbers of women delivered over the study period were 11477, out of which C-Sections were 4545. The overall CS rate was 39.60%. Previous CS was the leading indication to the CS rate (43.07%) followed by fetal distress (11.15%), oligohydroamniosiugr (09.32%), breech presentation (7.50%), cephalopelvic disproportion (CPD) (6.15%) and arrest of labor (04.61%). 15.08% patients had various complications mainly infection (7.50%) and operative injury (3.26%). There was 3mortality during this period.

Conclusions: Being a tertiary care hospital, a high rate of Caesarean deliveries was observed.  Although individualization of the indication and careful evaluation, following standardized guidelines, practice of evidenced-based obstetrics are done in our institute but due to multiple and unavoidable factors cesarean rate is increasing. Audit and feedback is the best way to judge clinical practice and to reduce the frequency of cesarean section in any tertiary setup.

Keywords: Cesarean section(CS), Previous cesarean section, Double loop of cord(DLOC), Fetal distress.

References

1.      F. Gary Cunningham, Normal F. Gant, Kenneth J.et al; “Cesarean delivery and postpartum hysterectomy”. Chapter -23, Textbook of Williams Obstetrics,21st Edn, Newyork; McGraw Hill,2001;538-559pp

2.      UNICEF, WHO, UNFPA, New York: United Nations Children’s Fund, 1997; 1

3.      Hamilton BE, Hoyert DL, Martin JA, Strobino et al, Annual summary of vital statistics:2010-2011. Pediatrics,2013;peds-2012

4.      Belizan J, Althabe F, Barros F, Alexander S; Rates and implications of cesarean section in Latin America; ecological study commentary: all women should  have a choice commentary; British Medical Journal, 1999; 319;1397.

5.      Stanton C, Ronsmans C. Recommen-dations for routine reporting on indications for caesarean delivery in developing countries. Birth. 2008; 35:204-11.

6.      Torloni MR, Betran AP, Souza JP, Widmer M, Allen T, Gulmezoglu M, et al. Classifications for caesarean section: a systematic review. PLoS One. 2011;6:e1456.

7.      Shabnam S. Caesarean section delivery in India: causes and concerns, international union for the scientific study of population, session 221, assessments of facility-based delivery services.

8.      Barber EL, Lundsberg LS, Belanger K. Indications contributing to the increasing cesarean delivery rate. Obstet Gynecol. 2011;118(1):29-38.

9.      Nikhil A, Desai A, Vijay K, Bhumika K, Riddhi P. Analysis of trends in LSCS rate and indications of LSCS: a study in a Medical College Hospital GMERS, Sola, Ahmedabad. Int J Pharm Bio-Sci. 2015;2(1):1-5.

10.  Singh G, Gupta ED. Rising incidence of caesarean section in rural area in Haryana, India: a retrospective analysis. Internet J Gynecol Obstetr. 2013;17(2):1-5.

11.  Karim F; Trends and Determinants of Caesarean Section; Journal of Surgery Pakistan(International) 2011;16(1)

12.  Sarma P, Boro RC, Acharjee PS. An analysis of indications of caesarean sections at Tezpur medical college and hospital, Tezpur (a government hospital). Int J Reprod Contracept Obstet Gynecol. 2016;5:1364-7.

13.  Jawa A, Garg S, Tater A, Sharma U. Indications and rates of lower segment caesarean section at tertiary care hospital-an analytical study. Int J Reprod Contracept Obstet Gynecol 2016;5:3466-9

14.  Santhanalakshmi C, Gnanasekaran V, Chakravarthy AR. A retrospective analysis of cesarean section in a tertiary care hospital. 2015;4:2097-9.

15.  Osman BALCI, Kazım GEZGİNÇ, Ali ACAR. The outcome analysis of cesarean section cases in one-year period. Gynecol Obstet Reprod Med 2007;13:26- 28.

16.  Najam Rehana , Sharma Reena. Maternal and fetal outcomes in elective and emergency cesarean sections at a teaching hospital in north India. A retrospective study. Journal of advance researches in Biological sciences, 2013, Vol.5(1) 5-9.

17.  Ali M ,Hafeez R,Ahmad M. Maternal and fetal outcome ; comparison between emergency cesarean section versus elective cesarean section.The professional 2005;12:32-9. 

Corresponding Author

B.L.Patidar

Assistant professor, Department of Obstetrics and Gynecology, Medical College, Kota

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