Caesarean section and its determinants: a hospital based cross-sectional study
Keywords:Caesarean section, Oligohydramnias
Background: The rapid rise in CS rate has become a serious public health issue now-a-days because unnecessary caesareans generate higher expenditure at individual and national levels and have the potential to divert human and financial resources from higher priority intervention. Therefore the present study was carried out to know the indications and determinants of caesarean births in a tertiary hospital of Odisha.
Methods: A hospital based cross-sectional study was conducted among women who delivered by caesarean section in O and G department of MKCG Medical College Hospital, Berhampur from July to October 2016 using a pretested semi-structured questionnaire. The data was analysed using appropriate statistical tests such as proportion, chi square test using SPSS software. P value of less than 0.05 is considered as statistically significant.
Results: Premature rupture of membrane with oligohydramnias was the major indication in 31.4% cases followed by previous CS in 20.1% cases. Out of socio-demographic factors age (P value = 0.001) and educational status of women (P value= 0.042) were significantly associated with type of CS. Foetal presentation (P value= 0.003), interval between labour and CS (P value <0.01) and type of admission (P value = 0.05) were major obstetric determinants of CS.
Conclusions: In order to safeguard the health of mother and child from effects of unnecessary caesarean births, regular antenatal checkups, proper birth preparedness along with timely diagnosis and management of complications is necessary.
Rozzet J, Marwan K. Caesarean section rates in the Arab region: a cross-national study. Health Policy Plan. 2004;19(2):101-10.
World Health Organization, UNFPA, UNICEF and AMDD. MonitoringEmergency Obstetric Care: a Handbook, WHO, Geneva. 2009.
Gibbons L, Belizan JM, Lauer JA, Betran 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;30:1-31.
IIPS and Macro International. National Family Health Survey (NFHS-3), 2005-06, India, Vol. I andVol. II, International Institute for Population Sciences, Mumbai. 2007
Mishra US, Ramanathan M. Delivery-related complications and determinants of caesarean section rates in India. Health Policy Planning. 2002;17(1):90-8.
Sreevidya S, Sathiyasekaran BW. High Caesarean Rates in Madras (India): a Population-based Cross Sectional Study. BJOG. 2003;110(2):106-11.
Padmadas SS, Kumar S, Nair SB, Kumari A. Caesarean section delivery in Kerala, India: evidence from a National Health Survey. Soc Sci Med. 2000;51:511-21.
Unnikrishnan B, Rakshith Prasad B, Amarnath A, Kumar N, Rekha T, Mithra PP, et al. Trends and Indications for Caesarean Section in a tertiary care Obstetric Hospital in Coastal South India. AMJ. 2010;3(12):821-5.
Saluja JK, Roy PK, Mahadik K. Study of Primary Caesarean Section in Multiparous Women NJIRM 2014;5(2):27-9.
Khan R, Blum LS, Sultana M, Bilkis S, Koblinsky M. An examination of women experiencing obstetric complications requiring emergency care: perceptions and sociocultural consequences of caesarean sections in Bangladesh. J Health Popul Nutr. 2012;30(2):159-71.
Gregory KD, Jackson S, Korst L, Fridman M. Caesarean versus vaginal delivery: whose risks? Whose benefits? Am J Perinatol. 2012;29:7-18.