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

Dr.Tulugu Sasikala; Dr.Jyothirmayi Ponnada

Volume : VIII, Issue : XI, November - 2019

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 one-decade 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, 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. CS 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, identification of high-risk mother and frequent resort to elective sections in high risk situations and precious pregnancies and institutional vaginal deliveries.