A Dilemma for Modern Obstetrics -Rising Incidence of Caesarean Section Rate

The goal of this study was to look into the rate of caesarean sections (indications, ratios in emergency and elective caesarean sections), as well as the percentage of vaginal births after caesarean sections and instrumental deliveries.

Methods: A one-year retrospective study was conducted in the Department of Obstetrics and Gynecology, Unit 2, Lahore General Hospital, Lahore, from January 1, 2018 to December 31, 2018. During the study period, the data of obstetrical patients who were admitted to the unit and delivered either vaginally or through the abdominal route was recorded, and a statistical analysis of various parameters, such as caesarean section rates, indications, the ratio of emergency and elective caesarean sections, the rate of vaginal births after caesarean section (VBACS), and instrumentation was performed.

During the study period, there were a total of 18183 obstetrical patients admitted. There were 6602 deliveries in total, including 3699 vaginal births and 2765 caesarean procedures. The overall caesarean section rate was 41.88 percent, with 473 elective caesarean sections (17.1 percent) and 2292 emergency caesarean sections (82.89 percent ). The number of vaginal births was 3699 (56.02 percent), the number of VBACS was 98 (2.6 percent), the number of instrumental deliveries such as forcep deliveries was 31 (0.8 percent), and the number of ventouse deliveries was 47. (1.2 percent ). There were 38 (0.102%) twin deliveries and 59 (1.5%) assisted breech deliveries. The costs of elective and emergency caesarean sections with various indications were assessed separately.

Conclusions: In modern obstetrics, the increased prevalence of caesarean section is the most worrisome fact of the decade. A systematic assessment of caesarean sections performed in a tertiary care hospital over the course of a year revealed a high number of sections performed due to foetal distress. It is critical to establish the diagnosis in order to avoid unneeded procedures. The prior scars and indications associated with them are the most essential aspect of the study, thus the goal of concluding it is to take actions to prevent primary caesarean section. To identify the preventable causes of caesarean sections, an annual audit and surveillance of caesarean sections should be performed.

Author (s) Details

Zahra Safdar
Department of Obstetrics and Gynaecology, Lahore General Hospital, Lahore, Pakistan.

Sumera Zaib
Department of Obstetrics and Gynaecology, Lahore General Hospital, Lahore, Pakistan.

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