Changing Trends in Caesarean Section Rates in Institute of Obstetrics and Gynaeoclogy - A Comparative Study between the years 2000 & 2006

Mythily, A (2008) Changing Trends in Caesarean Section Rates in Institute of Obstetrics and Gynaeoclogy - A Comparative Study between the years 2000 & 2006. Masters thesis, Madras Medial College, Chennai.

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Abstract

INTRODUCTION: Caesarean section can be defined as the birth of a foetus through a incision in abdominal wall (Laparotomy) and uterine wall (hysterotomy). This definition does not include removal of the foetus from the abdominal cavity in case of rupture of uterus or in case of abdominal pregnancy. The steady rise in caesarean section rates in an emerging area of concern in mother-child healthcare and a matter of international attention, since the trend is no longer confined to western industrialised countries. 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. AIM OF THE STUDY: The aim of the study is 1. To study the changing trends in caesarean section rates between the years 2000 & 2006 in IOG. 2. To study the changing trends in indications for caesarean sections between the years 2000 & 2006 in IOG. 3. To study the maternal and perinatal outcome in caesarean sections in the years 2000 and 2006. MATERIALS AND METHODS: DESIGN OF STUDY - Observational retrospective study. STUDY SETTING: Institute of Obstetrics and Gynaecology, Egmore, Chennai. PERIOD OF STUDY: Years 2000 and 2006. POPULATION: In this study, 7186 caesarean sections done in 2000 were compared with 7448 caesarean sections in 2006 with respect to incidence, indications, age, parity, maternal mortality and perinatal outcome. DATA: All the data were obtained from the medical records department, IOG. Details regarding perinatal and neonatal outcome were obtained from Neonatalogy department, IOG. DATA ANALYSIS: The study is a type of descriptive statistics and data analysis was done using chi-square test. SUMMARY: 1. 7186 cases of caesarean section performed in the year 2000 were studied and compared with 7448 caesarean sections performed in 2006. Total no of deliveries were 20,027 in 2000 and 17,890 in 2006. Incidence of caesarean sections was 35.85% in 2000 and 41.63% in 2006. The increase in the incidence was found to be significant statistically as p is less than 0.01. 2. Maximum no. of patients were found to be in the age group 20-24 yrs. 3. Most of the patients were primiparas in both 2000& 2006. Incidence of caesarean sections was seen increasing in primgravida. 4. 40.86% of patients in the 2000 series underwent repeat caesarean section as compared to 39.09% in the 2006 series, almost the same rate. 5. The increase in caesarean section incidence is therefore mainly contributed by primary caesarean sections which were 4246 in 2000 and 4536 in 2006 and the increase is significant statistically (p0.002). 6. Following were the main indications contributing to the rise in the incidence of primary caesarean sections:a) CPD, b) Foetal distress c) twin gestations d) IUGR e) failed acceleration f) oligohydramnios g) Breech presentations. 7. There is a decrease in caesarean sections for failed induction, BOH and elderly primi in 2006 compared to 2000. 8. VBAC rates have slightly increased from 6.96% in 2000 to 7.35% in 2006. 9. The MMR per 1 Lakh deliveries has shown a increase from 224/1Lakh deliveries in 2000 to 273/ 1 Lakh deliveries in 2006.This may be due to increased referral of complicated cases. There also appears to be a increase in the number of deaths following LSCS, but this increase is only apparent as most of the deaths were due to associated other complications and not directly related to LSCS. 10. There is also a mild increase in PNMR from 63/1000 live births in 2000 to 67 / 1000 live births in 2006. CONCLUSION: The incidence of caesarean section in IOG has steadily increased from 2000 to 2006. This increase is contributed mainly by primary caesarean sections especially in the nulliparous group. In spite of an increase in number of CS rates, the PNMR has not shown a decline in 2006 compound to 2000. Judicious decision making for primary caesarean sections will help reducing the caesarean section rate. Increasing caesarean section rates are a potential burden on health resources with no proven benefit in perinatal mortality and possible increases in maternal morbidity. Hence different measures to reduce CS rates have been proposed.(Walker, 2002).

Item Type: Thesis (Masters)
Uncontrolled Keywords: Changing Trends ; Caesarean Section Rates ; Institute of Obstetrics and Gynaeoclogy ; Comparative Study.
Subjects: MEDICAL > Obstetrics and Gynaecology
Depositing User: Subramani R
Date Deposited: 28 Nov 2017 03:21
Last Modified: 09 Dec 2017 04:13
URI: http://repository-tnmgrmu.ac.in/id/eprint/4128

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