A comparison of cesarean section indications and characteristics in 2009 and 2020 in a Saudi tertiary hospital

Abstract

Background: Cesarean section (CS) has been increasing in recent years with a wide range of etiologies. This study aimed to assess the indications, outcomes, and complications of CS in a hospital in Riyadh, Saudi Arabia. Methods: A retrospective cohort study was conducted at King Abdulaziz Medical City. The study included two cohorts including G1 (2009) and G2 (2020). Variables including CS indication, neonatal and maternal complications, CS type, age of the mother, body mass index, parity, gestational age, and neonatal data were assessed. Results: A total of 399 women were recruited and divided into two groups, G1 (n = 199) and G2 (n = 200) with a mean age of 32 ± 6 years. G1 and G2 had significant differences in mean age with 30 ± 6 and 34 ± 5 years, respectively (p ≤ 0.001), which indicated delayed fertility between the groups by 4 years. Moreover, the breech presentation was less likely to occur in G2. Maternal causes, such as repeated c-sections and maternal medical conditions were more likely to happen in G2. Furthermore, postpartum hemorrhage showed an increase of 12% in G2. G2 patients were more likely to be admitted to the neonatal intensive care unit and to the special care baby (p ≤ 0.001), compared to regular nursery admission. Conclusion: Multiple factors contributed to the increase in the CS rate in a Saudi tertiary hospital. The factors were suggested to be previous CS, abnormal fetal heart rate, malpresentation, and maternal or fetal medical condition.