In:
Annals of the Academy of Medicine, Singapore, Academy of Medicine, Singapore, Vol. 42, No. 8 ( 2013-8-15), p. 408-412
Abstract:
Introduction: In the United Kingdom, caesarean section (CS) rates have increased from 9% of deliveries in 1980 to 21% in 2001. A similar increase in CS rates has been seen in many developed countries. This is beyond the World Health Organisation’s (WHO’s) recommended level of 15%. This is a worrying trend as the risks of placenta previa, placenta accreta, hysterectomies, bladder and bowel injuries are increased with subsequent CS. We aim to ascertain the commonest indications for CS in a tertiary hospital and make recommendations to decrease future CS rates. Materials and Methods: This retrospective analysis compares the 5 most common indications for CS in 1999 and 2009. CS rates in the 2 study periods are tabulated and analysed as well. Results: In the first study period between January and December 1999, there were 2048 deliveries of which 365 were via CS. In the second study period of a decade later from January to December 2009, there were 1572 deliveries of which 531 were via CS. This gives an increase in CS rate from 17.8% in 1999 to 34% in 2009. The main indications for CS in 1999 were: cephalopelvic disproportion (18.6%), breech (14.2%), non-reassuring fetal status (11.8%), 1 previous CS (11.2%) and pregnancy-induced hypertension/pre-eclampsia/eclampsia (6.6%). The main indications for CS in 2009 were: 1 previous CS (18.1%), non-reassuring fetal status (12.2%), cephalopelvic disproportion (10.5%), 2 or more previous CS (7.9%) and breech (7.7%). Conclusion: There is a significant increase in CS rates over the last decade with an increased percentage of CS done because of a previous CS. This is associated with increased risk of complications as well. Recommendations are suggested with the view to decrease future CS rates. Key words: Breech, Cephalopelvic disproportion, Non-reassuring fetal status, Previous caesarean section
Type of Medium:
Online Resource
ISSN:
0304-4602
DOI:
10.47102/annals-acadmedsg.
DOI:
10.47102/annals-acadmedsg.V42N8p408
Language:
English
Publisher:
Academy of Medicine, Singapore
Publication Date:
2013
detail.hit.zdb_id:
2186627-2
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