CHANGING TRENDS IN THE INDICATIONS OF CAESAREAN OVER A DECADE AT RIMS GENERAL HOSPITAL, SRIKAKULAM.

Dr. Tulugu Sasikala, Dr. Jyothirmayi Ponnada

Abstract


BACKGROUND: This study was done to evaluate the changing trends in caesarean section over onedecade
period and to determine as to whether increase in caesarean section rate is due to increase in
antenatal surveillance or due to medically complicated pregnancies or conceived with infertility treatment.
MATERIALS AND METHODS: The study was conducted in a 600 bedded Government General Hospital, Government Medical
Collage (RIMS), Srikakulam, Andhra Pradesh. Data was collected retrospectively from database from 2009 to 2018. The rates
and indications of primary and repeat caesarean sections (CS) were analysed among 3476 live births during 2018. Caesarean
section rates have increased as it has become the procedure of choice in high risk pregnancies to prevent prenatal morbidity
and mortality; this has become possible due to improved patient care, availability of effective antibiotics, blood transfusion
services, safer anaesthesia, improved surgical technique and sophisticated neonatal care services.
RESULTS: As medically complicated pregnancies and antenatal surveillance have increased, there was an increase in
caesarean section rate. Caesarean section rate increased from 22.23% in 2009 to 40.56% in 2018. There was an increase in
primary section and repeat sections. Primary caesarean section rate is 54.32% compared to repeat caesarean section rate
which was 45.67%. This increase in caesarean section rate is due to increase in indications like cephalo pelvic disproportion,
pregnancy being associated with medical disorders (PIH, GDM, hypothyroidism) and Malpresentations.
CONCLUSION: Rising rate of caesarean section over one decade is attributed to frequent diagnosis of foetal distress on
electronic foetal heart monitoring, identication of high-risk mother and frequent resort to elective sections in high risk
situations and precious pregnancies and institutional vaginal deliveries.


Keywords


Primary Caesarean Section, Repeat Caesarean Section, Caesarean Rate, Gestational Hypertension, Gestational Diabetes Mellitus, Hypothyroidism,

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