CAESAREAN SECTION RATE AND INDICATIONS AT SULAIMANI MATERNITY TEACHING HOSPITAL WITH REVIEW OF LITERATURE
DOI:
https://doi.org/10.17656/jsmc.10217Keywords:
Caesarean Section, C-Section, Normal Vaginal Delivery, Incidence, KurdistanAbstract
Background
Caesarean section (C-section) is a frequent obstetric intervention for saving the lives of women and their newborns from childbirth-related complications.
Objectives
The aim was to know the rate and indications of C-section in the Kurdistan-Iraq.
Patients and Methods
Retrospectively-collected data from a single large public institution, Maternity Teaching Hospital, in Kurdistan-Iraq was analysed. All women giving birth in 2016 with a known birth outcome were included. Those who underwent C-section were identified, and indications were recorded. Data analysed using descriptive statistics. A review of literature looking at rate and indication of C-section was performed.
Results
Five thousand and eight hundred sixty (38.4%) of mothers who gave birth from 15235, required C-section. The total number of born-baby was 18573; of them, 259 babies died (1.4%)—(192, 74.1%) following Normal Vaginal Delivery and (67, 25.9%) during C-section. 27% of mothers were primigravida, and the rest were multigravida. Emergency C-section was performed in 4106 (70.1%). The history of ≥2 C-sections was the main indication for C-section (25.7%) followed by breech presentation (13.9%), fetal distress (12.5%), failure of progress (11.9%), failure of induction (11.8%), antepartum haemorrhage (8.3%) and pre-eclampsia (6.8%). There were three maternal mortalities (0.01%), but no maternal mortality following C-section
Conclusion
With the continued war against the Islamic state and economic turmoil, health service in Kurdistan suffered most, but with the goodwill of healthcare professionals, our institution showed comparable results to places elsewhere. Monitoring of clinical indications of C-section is needed to ensure the rational use of the procedure.
References
Guptal M, Saini V. Caesarean Section: Mortality and Morbidity. J Clin Diagn Res. 2018;12(9):QE01-QE06. DOI: https://doi.org/10.7860/JCDR/2018/37034.11994
Betrán AP, Merialdi M, Lauer JA, Bing Shun W, Thomas J, Van Look P, et al. Rates of caesarean section: analysis of global, regional and national estimates. Paediatr Perinat Epidemiol. 2007;21(2):98–113. DOI: https://doi.org/10.1111/j.1365-3016.2007.00786.x
OECD. Health at a Glance 2013: OECD indicators. OECD publishing, doi: http://dx.doi.org/10.1787/health_glance-2013-en. DOI: https://doi.org/10.1787/health_glance-2013-en
Festin MR, Laopaiboon M, Pattanittum P, Ewens MR, Henderson-Smart DJ, Crowther CA. Caesarean section in four South East Asian countries: reasons for, rates, associated care practices and health outcomes. BMC Pregnancy Childbirth. 2009;9(1):17.
Boatin AA, Schlotheuber A, Betran AP, Moller AB, Barros AJD, Boerma T, et al. Within country inequalities in caesarean section rates: observational study of 72 low and middle income countries. BMJ. 2018;360:k55. doi: 10.1136/bmj.k55. DOI: https://doi.org/10.1136/bmj.k55
Festin MR, Laopaiboon M, Pattanittum P, Ewens MR, Henderson-Smart DJ, Crowther CA. Caesarean section in four South East Asian countries: reasons for, rates, associated care practices and health outcomes. BMC Pregnancy Childbirth. 2009;9(1):17. DOI: https://doi.org/10.1186/1471-2393-9-17
Rosenfield A, Min CJ, Freedman LP. Making Motherhood Safe in Developing Countries. N Engl J Med. 2007;356(14): 1395-7. DOI: https://doi.org/10.1056/NEJMp078026
World Health Organization. Appropriate technology for birth. Lancet. 1985;2:436. DOI: https://doi.org/10.1016/S0140-6736(85)92750-3
Molina G, Weiser TG, Lipsitz SR, Esquivel MM, Uribe-Leitz T, Azad T, et al. Relationship Between Cesarean Delivery Rate and Maternal and Neonatal Mortality. JAMA. 2015;314(21):2263–70. PMID: 26624825 DOI: https://doi.org/10.1001/jama.2015.15553
Royal College of Obstetricians and Gynecology. External Cephalic Version and Reducing the Incidence of Term Breech Presentation (Green-top Guideline No. 20a) https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg20a/Accessed September 8, 2018.
Penn Z, Ghaem-Maghami S. Indications for caesarean section. Best Pract Res Clin Obstet Gynaecol. 2001;15(1):1–15. DOI: https://doi.org/10.1053/beog.2000.0146
Aminu M, Utz B, Halim A, Van Den Broek N. Reasons for performing a caesarean section in public hospitals in rural Bangladesh. BMC Pregnancy Childbirth. 2014;14(1):130. DOI: https://doi.org/10.1186/1471-2393-14-130
Gholitabar M, Ullman R, James D, Griffiths M. Caesarean section: summary of updated NICE guidance. BMJ. 2011;343:d7108. DOI: https://doi.org/10.1136/bmj.d7108
Gynecologists ACoO. ACOG Practice bulletin no. 115: Vaginal birth after previous cesarean delivery. Obstet Gynecol. 2010;116(2 Pt 1):450-63. DOI: https://doi.org/10.1097/AOG.0b013e3181eeb251
Abdel-Aleem H, Amin A, Shokry M, Radwan R . Therapeutic amnioinfusion for intrapartum fetal distress using a pediatric feeding tube. Int J Gynaecol Obstet. 2005;90(2):94–8. DOI: https://doi.org/10.1016/j.ijgo.2005.03.027
Nazneen R, Begum R, Sultana K. Rising Trend of Caesarean Section in a Tertiary Hospital Over a Decade. J Bangladesh Coll Phys Surg. 2011;29(3):126–32. DOI: https://doi.org/10.3329/jbcps.v29i3.9432
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). pii: e001725. DOI: https://doi.org/10.1136/bmjopen-2012-001725
Hartmann KE, Andrews JC, Jerome RN, Lewis RM, Likis FE, McKoy JN, et al. Strategies to reduce cesarean birth in low-risk women. Rockville: Agency for Healthcare Research and Quality (AHRQ). Comparative Effectiveness Review No. 80. 2012.
American College of Obstetricians and Gynecologists (College); Society for Maternal-Fetal Medicine, Caughey AB, Cahill AG, Guise JM, Rouse DJ. Safe prevention of the primary cesarean delivery. Am J Obstet Gynecol. 2014;210(3):179-93. DOI: https://doi.org/10.1016/j.ajog.2014.01.026
Begum T, Rahman A, Nababan A, Emdadul Hoque D, Khan A, Ali T, et al. Indications and determinants of caesarean section delivery: Evidence from a population-based study in Matlab, Bangladesh. PLoS One. 2017; 12(11): e0188074. DOI: https://doi.org/10.1371/journal.pone.0188074
Morris R, Meller C, Tamblyn J, Malin G, Riley R, Kilby M, et al. Association and prediction of amniotic fluid measurements for adverse pregnancy outcome: systematic review and meta-analysis. BJOG. 2014;121(6):686–99. DOI: https://doi.org/10.1111/1471-0528.12589
Ayodeji OF, Kuhn RJP. Abnormal Antepartum Cardiotocography and Major Fetal Abnormalities. Aust NZ J Obsrer Gynaecol. 1986;26(2):120-3. DOI: https://doi.org/10.1111/j.1479-828X.1986.tb01546.x
Kulkarni AA, Shrotri AN. Admission Test: A Predictive Test for Fetal Distress in High Risk Labour. J Obstet Gynaecol Res. 1998 Aug;24(4):255-9. DOI: https://doi.org/10.1111/j.1447-0756.1998.tb00086.x
Kallianidis AF, Schutte JM, van Roosmalen J, van den Akker T. Maternal mortality after cesarean section in the Netherlands. Eur J Obstet Gynecol Reprod Biol. 2018;229:148-52. DOI: https://doi.org/10.1016/j.ejogrb.2018.08.586
Chaillet N, Dumont A. Evidence-based strategies for reducing cesarean section rates: a meta-analysis. Birth. 2007;34(1):53–64. DOI: https://doi.org/10.1111/j.1523-536X.2006.00146.x
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