A Retrospective Study On Indications Of Caesarean Section In A Tertiary Care Urban Setup

Authors

  • Biswajyoti Guha AMRI Hospital Mukundapur
  • Aparna Mondal AMRI Hospital Mukundapur

DOI:

https://doi.org/10.37506/70e8ed60

Keywords:

Caesarean section, indications, tertiary care

Abstract

Background- A Caesarean Section (CS) is a life saving procedure. It has a beneficial effect on maternal and child health as an alternative to difficult vaginal delivery. Adverse outcomes are postpartum hemorrhage (PPH), surgical site infection, puerperal sepsis, and maternal mortality, and fetal complications like neonatal sepsis, neonatal death, stillbirth, neonatal respiratory distress, a low Apgar score, and preterm birth. In past few decades a remarkable increase has been observed in delivery by caesarean section. This study aimed to find the indications of caesarean section in a private hospital.

Method- A retrospective study was carried out for a period of six months at AMRI Hospital, Mukundapur, Kolkata.  This includes 359 pregnant women, who underwent caesarean sections, both elective and emergency.

Conclusion- Out of 359 pregnant women, 91% (328) were elective caesareans and 9% (31) were emergency caesarean sections. Previous caesarean section 16.15% (58) was found to be the most common indication of caesarean sections. A reduction of primary CS should be given priority. Following labor care guidelines, use of cardiotocography, partography, and patient education will contribute to the reduction of caesarean sections and related complications.

Author Biographies

  • Biswajyoti Guha, AMRI Hospital Mukundapur

    Consultant, Gynaecology and Obstetrics,AMRI Hospital Mukundapur.

  • Aparna Mondal, AMRI Hospital Mukundapur

    AMRI Hospital Mukundapur. 223& 230, Barakhola, Jadavpur Mukundapur, South 24 Parganas Kolkata-700099, West Bengal

References

Antoine C, Young BK. Cesarean section one hundred years 1920–2020: the Good, the Bad and the Ugly. Journal of Perinatal Medicine. 2020 Sep 4;49(1):5–16.

Betran AP, Ye J, Moller AB, Souza JP, Zhang J. Trends and projections of caesarean section rates: global and regional estimates. BMJ Global Health. 2021 Jun;6(6):e005671.

Ministry of Health and Family Welfare Government of India [Internet]. 2015. Available from: http://rchiips.org/nfhs/NFHS-4Reports/India.pdf

Rodgers J, Lee H, Kim R, Mor N, Subramanian SV. Geographic variation in caesarean delivery in India. Paediatric and Perinatal Epidemiology. 2021 Aug 31;36(1):92–103.

Varshini NM, Shirisha P, Vaidyanathan G, Muraleedharan VR. Variations in the prevalence of caesarean section deliveries in India between 2016 and 2021 – an analysis of Tamil Nadu and Chhattisgarh. BMC Pregnancy and Childbirth. 2023 Aug 30;23(1)

Söderquist J, Wijma B, Thorbert G, Wijma K. Risk factors in pregnancy for post-traumatic stress and depression after childbirth. BJOG: An International Journal of Obstetrics & Gynaecology. 2009 Feb 11;116(5):672–80.

Batieha AM, Al Daradakh SA, Khader YS, Basha A, Sabet F, Athamneh TZ and Sheyyab M. Cesarean Section: Incidence, Causes, Associated Factors and Outcomes: A National Prospective Study from Jordan. Gynecology & Obstetrics Case report. 2017;03(03).

Desai G, Anand A, Modi D, Shah S, Shah K, Shah A, Desai, S., and Shah, P. Rates, indications, and outcomes of caesarean section deliveries: A comparison of tribal and non-tribal women in Gujarat, India. Faragher EB, editor. Plos one. 2017 Dec 27;12(12):e0189260.

Gibbons L, Belizán JM, Lauer JA, Betrán AP, Merialdi M, Althabe F. The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage. World Health Report 2010. 2010 Jan 1; 30.

Stützer PP, Berlit S, Lis S, Schmahl C, Sütterlin M, Tuschy B. Elective Caesarean section on maternal request in Germany: factors affecting decision making concerning mode of delivery. Archives of Gynecology and Obstetrics. 2017 Mar 21;295(5):1151–6.

Størksen HT, Garthus-Niegel S, Vangen S, Eberhard-Gran M. The impact of previous birth experiences on maternal fear of childbirth. Acta Obstetricia et Gynecologica Scandinavica. 2013 Feb 22;92(3):318–24.

Nieminen K, Stephansson O, Ryding EL. Women’s fear of childbirth and preference for cesarean section – a cross-sectional study at various stages of pregnancy in Sweden. Acta Obstetricia et Gynecologica Scandinavica. 2009 Jan;88(7):807–13.

Zhang J, Liu Y, Meikle S, Zheng J, Sun W, Li Z. Cesarean Delivery on Maternal Request in Southeast China. Obstetrics & Gynecology. 2008 May 1;111(5):1077–82

Molina G, Weiser TG, Lipsitz SR, Esquivel MM, Uribe-Leitz T, Azad TD, Shah N, Semrau K., Berry WR, Gawande AA, and Haynes AB. Relationship Between Cesarean Delivery Rate and Maternal and Neonatal Mortality. JAMA [Internet]. 2015 Dec 1;314(21):2263. Available from: https://jamanetwork.com/journals/jama/fullarticle/2473490

Ye J, Zhang J, Mikolajczyk R, Torloni M, Gülmezoglu A, Betran A. Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population-based ecological study with longitudinal data. BJOG: An International Journal of Obstetrics & Gynaecology [Internet]. 2015 Aug 24;123(5):745–53. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5014131/

Meara JG, Hagander L, Leather AJM. Surgery and global health: a Lancet Commission. The Lancet. 2014 Jan;383(9911):12–3.

Qin C, Zhou M, Callaghan WM, Posner SF, Zhang J, Berg CJ, and Zhao, G.. Clinical Indications and Determinants of the Rise of Cesarean Section in Three Hospitals in Rural China. Maternal and child health journal. 2011 Dec 13;16(7):1484–90.

Haider G, Nishat Z, Aftab AF, Haider A. Frequency and indications of cesarean section in a tertiary care hospital. Pakistan journal of medical sciences. 2009 Jan 1;25(5):791–6.

Shamshad. Factors Leading To Increased Cesarean Section Rate. Gomal Journal of Medical Sciences. 2008, 6(1):1-5

Boerma T, Ronsmans C, Melesse DY, Barros AJD, Barros FC, Liang J, Moller A, Say L, Hosseinpoor AR, Mu Y., De Lyra Rabello Neto D, and Temmerman, M. Global epidemiology of use of and disparities in caesarean sections. The Lancet [Internet]. 2018 Oct;392(10155):1341–8. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31928-7/fulltext

Mishra VK. Geo-Spatial Analysis of Caesarean Section in India. Open Access Journal of Gerontology & Geriatric Medicine. 2019 Oct 22;5(2).

Mascarello KC, Matijasevich A, Barros AJD, Santos IS, Zandonade E, Silveira MF. Repeat cesarean section in subsequent gestation of women from a birth cohort in Brazil. Reproductive Health [Internet]. 2017 Aug 25;14(1). Available from: https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-017-0356-8

Penn Z, Ghaem-Maghami S. Indications for caesarean section. Best Practice & Research Clinical Obstetrics & Gynaecology. 2001 Feb;15(1):1–15.

Gholitabar M, Ullman R, James D, Griffiths M. Caesarean section: summary of updated NICE guidance. BMJ. 2011 Nov 23;343(nov23 1):d7108–8.

Walker R, Turnbull D, Wilkinson C. Strategies to Address Global Cesarean Section Rates: A Review of the Evidence. Birth. 2002 Mar;29(1):28–39.

Visser GH, Ayres-de-Campos D, Barnea ER, Bernis L de, Renzo GCD, Vidarte MFE, Lloyd I, Nassar AH, Nicholson WK, Shah PK, Stones W, Sun L, Theron G, and Walani SR.FIGO position paper: how to stop the caesarean section epidemic. The Lancet [Internet]. 2018 Oct 13 [cited 2021 Feb 19];392(10155):1286–7. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32113-5/fulltext

Yang J, Chen C, Liu M, Zhang S. Women successfully treated for severe intrahepatic cholestasis of pregnancy do not have increased risks for adverse perinatal outcomes. Medicine. 2019 Jul;98(27):e16214.

Roberts CL, Algert CS, Ford JB, Todd AL, Morris JM. Pathways to a rising caesarean section rate: a population-based cohort study. BMJ Open. 2012;2(5):e001725.

Heffner L. Impact of labor induction, gestational age, and maternal age on cesarean delivery rates. Obstetrics & Gynecology. 2003 Aug;102(2):287–93.

Hartmann KE, Andrews JC, Jerome RN, Lewis RM, Likis FE, McKoy JN, Surawicz TS, and Walker SH. Strategies to Reduce Cesarean Birth in Low-Risk Women [Internet]. PubMed. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 [cited 2024 Apr 22]. Available from: http://www.ncbi.nlm.nih.gov/books/nbk114747/

Caughey AB, Cahill AG, Guise JM, Rouse DJ. Safe prevention of the primary cesarean delivery. American Journal of Obstetrics and Gynecology. 2014 Mar;210(3):179–93.

Chaturvedi S, Upadhyay S, Costa AD, Raven J. Implementation of the partograph in India’s JSY cash transfer programme for facility births: a mixed methods study in Madhya Pradesh province. BMJ Open [Internet]. 2015 Apr 1;5(4):e006211. Available from: https://bmjopen.bmj.com/content/5/4/e006211.short

Vogel JP, Pujar Y, Vernekar SS, Armari E, Pingray V, Althabe F, Gibbons L, Berrueta M, Somannavar M, Ciganda Á, Rodriguez R, Bendigeri S, Kumar JA, Patil SB, Karinagannanavar A, Anteen RR, Ramachandrappa PM, Shetty S, Mallesh MH, KushtagiP, Hofmeyr GJ, Derman R, Goudar S.Effects of the WHO Labour Care Guide on cesarean section in India: a pragmatic, stepped-wedge, cluster-randomized pilot trial.

Pandey D, Bharti R, Dabral A, Khanam Z. Impact of WHO Labor Care Guide on reducing cesarean sections at a tertiary center: an open-label randomized controlled trial. AJOG Global Reports. 2022 Aug;2(3):100075.

Bergholt T, Østberg B, Legarth J, Weber T. Danish obstetricians’ personal preference and general attitude to elective cesarean section on maternal request: A nation-wide postal survey. Acta Obstetricia et Gynecologica Scandinavica. 2004 Feb 16;83(3):262–6.

Cammu H, Martens G, Keirse MJNC. Mothers’ Level of Education and Childbirth Interventions: A Population-based Study in Flanders, Northern Belgium. Birth. 2011 May 20;38(3):191–9.

Khasawneh W, Obeidat N, Yusef D, Alsulaiman JW. The impact of cesarean section on neonatal outcomes at a university-based tertiary hospital in Jordan. BMC Pregnancy and Childbirth. 2020 Jun 1;20(1).

Chugh A, Lal S, Nijhavan T, Biradar P. Evaluation of primary caesarean section and neonatal outcomes in a tertiary care hospital and impact on current obstetric practice. European Journal Of Obstetrics & Gynecology And Reproductive Biology: X. 2023 Sep 1;19:100213–3.

Tefera M, Assefa N, Roba KT, Gedefa L. Adverse Neonatal Outcome are More Common among Babies Born by Cesarean Section than Naturally Born Babies at Public Hospitals in Eastern Ethiopia: A Comparative Prospective Follow-Up Study at Eastern Ethiopia. Global Pediatric Health. 2021 Jan;8:2333794X2110183.

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Published

2025-01-07

How to Cite

A Retrospective Study On Indications Of Caesarean Section In A Tertiary Care Urban Setup. (2025). Indian Journal of Public Health Research & Development, 16(1), 112-117. https://doi.org/10.37506/70e8ed60