Title: Rates of primary and repeat caesarean at private institution: what can we do to decrease section rate
Author: Dr Shail Kaur
DOI: https://dx.doi.org/10.18535/jmscr/v6i3.208
Abstract
Background: Increasing rates of caesarean section world over has sparked an interest in measures aimed at curbing this alarming trend. We studied the indications for caesarean sections performed inunit 3 of our institute over a year in order to evaluate a viable intervention. Clinical indications for caesarean were assigned on the basis of operative notes.
Methods: Retrospective analysis of indication for caesarean section in patients undergoing caesarean section in unit 3 of our institution over a period of one year from 1st January 2017 to 31st December 2017.
Results: Totally 496 patients delivered in our unit in the period mentioned, of which, 303 patients had a vaginal delivery (61.09%) and 193 underwent a caesarean section (38.91%). Total 108 patients had a history of at least one previous caesarean section caesarean section. 12 patients had a history previous 2 or more caesarean section. 16 patients were not offered VBAC in view of malpresentation, placenta previa or other contraindications to TOLAC. Of the remaining 80 patients, 42(52.5%) did not agree for TOLAC. 38 patients agreed for TOLAC and of these, 14 (36.84%) had a successful VBAC
Repeat caesarean section in patients who had undergone at least one previous caesarean was by far the most common factor for caesarean section.
Conclusions: The most important intervention that can be implemented to decrease caesarean rates in the long run is curtailing the caesarean section rate in nulliparous women which requires careful auditing and more stringent criteria, guidelines for indication for caesarean section especially in primigravidae.