Socio-demographic, obstetric and non-obstetric factors influencing the incidence of cesarean section (C-section)

Abstract

Cesarean sections (CS) and regular vaginal births are two processes for childbirth. Cesarean section is an intricate surgery involving numerous risks such as blood loss, organ damage, allergic reaction to anesthesia, infections and blood clots. Now a days rate of CS is increasing in developed countries. The increased rate of caesarean section can be described by socio-economic status (SES), medical and non-medical factors. Socioeconomic status (SES) is linked to a wide range of maternity services including Cesarean section (CS), whereas the most common medical and non-medical factors are labor dystocia, fetal mal-presentation, multiple gestations, suspected fetal macrosomia, placenta previa, placenta abruption, prolonged labor, fetal distress, birth defects, repeated cesareans, chronic health condition, cord prolapse, cephalopelvic dis-proportion (CPD), preeclampsia, bleeding, IUGR (Intrauterine growth restriction), uterine rupture, gestational diabetes, pelvic tumors, vesico-vaginal fistula repair, AP (anterior and posterior) repair and IUD (intrauterine devices).The aim of this study was to determine the rate of CS and socio-demographic, obstetric and non-obstetric factors influencing the incidence of cesarean section (C-section). This study was conducted at Combined Military Hospital (CMH), Peshawar for a period of 8 months. A standardized questionnaire was made by investigator to evaluate social and physiological status, obstetric factors, and non-obstetric- factors. 400 CS patients participated in this study. The findings of this study showed different socio-economic factors (ethnic variances, age occupation, income status) affecting cesarean section (C- section) delivery rates. The highest CS rate (39.25%) was in the age group of 26-30 years and in non-working women (61.5%). Moreover the high education of pregnant females is greatly associated with C-section rates because of the frequent visits for antenatal care during their pregnancy. Frequency of CS in overweight and obese women were found 139 (34.75%) and 198 (49.5%) of the total cases. As far as obstetric code was concerned, nulliparous women (62.5%) are more likely to be delivered by caesarean section as compared to Multipara 36.8% and Grand Multipara 0.8% when labor is induced.