Current Trend of Caesarean Section in a Tertiary Care Military Hospital

Ismat Ara,Mn Sakhawat Hassain,Rokshana Sultana,Sm Solaiman

doi:10.3329/bmrcb.v44i1.36800

Ismat Ara, Mn Sakhawat Hassain + Show 2 more

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https://doi.org/10.3329/bmrcb.v44i1.36800

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Abstract

Caesarean section rates are increasing worldwide. It contributes to substantial maternal and perinatal morbidity and mortality.South Asian countries including Bangladesh have recorded substantial increases in caesarean sectionrates over the past decade. In Bangladesh, the caesarean incidence rate was 2.6 percent in 2001 and 12.2 percent in 2010. So, the incidence rate increased five times over the last decade.This descriptive cross sectional study was conducted at Combined Military Hospital (CMH), Savar, Dhaka during January 2014 to December 2015, aimed to assess the current trend of mode of deliveries of babies. A total of 1253 pregnant women who attendedthis tertiary level hospital, for their delivery,were enrolled in the study. The study subjects wereselected by simple random sampling. A pretested structured questionnaire was used for data collection. The mean age of respondents was 25.81±4.46 years. Most (72%) of them were between 20-29 years of age. Some thirty nine percent of the respondents completed secondary level of education. The study showed that among 1253 respondents, 70.3% underwent CS and 29.7 % had normal vaginal delivery. Most common indication for caesarean section was previous CS (42.4%) that contributed an increase in total caesarean birth. Lowest incidence was antepartum haemorrhage (0.9%). Prolonged labour and cervical dystocia, hypertensive disorder, malpresentation were also contributing factors for caesarean section. So, previous caesarean birth was the most important factor in making decision about the way of delivery. Based on the study findings, to decrease the rate of caesarean section,careful monitoring of the foetusat all levels of health care facilities for critical decisions are suggested.Bangladesh Med Res Counc Bull 2018; 44(1):15-22

Highlights

Caesarean delivery, known as caesarean section (CS), is a form of childbirth in which a surgical incision is made through a mother's abdomen and uterus to deliver the baby.1It is one of the most common surgical procedures among women
The incidence rate increased five times over the last decade. This descriptive cross sectional study was conducted at Combined Military Hospital (CMH), Savar, Dhaka during January 2014 to December 2015, aimed to assess the current trend of mode of deliveries of babies
Debate continues about how to quantify the need for lifesaving CS, a World Health Organization (WHO) report suggested that the optimal population range for CS rate is between 5% and 15%, This endures as a reference.[5,6]

Summary

Introduction

Known as caesarean section (CS), is a form of childbirth in which a surgical incision is made through a mother's abdomen and uterus to deliver the baby.1It is one of the most common surgical procedures among women. Caesarean section rates are increasing worldwide, albeit unequally: a recent analysis of Demographic and Health Survey (DHS) data in 26 South Asian and sub-Saharan African countries found that rates were highest among the ‘urban rich’ in all countries, and lowest among the ‘rural poor’ in 18 countries.[8] In all countries, fewer than 5% of mothers in the poorest wealth quintile delivered by caesarean.9In areas with very high mortality rates, such as Africa, inadequate availability of CS contributes to substantial maternal and perinatal morbidity and mortality.[10] in many developed countries, concerns exist about high rates of CS, since increasing rates of this procedure show little evidence of further improvement in perinatal outcomes.11South Asian countries have recorded substantial increases in CS rates over the past decade. In Bangladesh, rates rose from 2% (2000) to 17% (2011); in India, from 3% (1992) to 11% (2006); and in Nepal, from 1% (2000) to 5% (2011).[12,13,14]

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