TRENDS IN CAESAREAN SECTIONS AT TYGERBERG HOSPITAL, SOUTH AFRICA : A 20 YEAR EXPERIENCE

This is a retrospective study of the cesarean sections (CS) done at Tygerberg Hospital in South Africa and of their relationship to the perinatal mortality (PNM) rate. The annual CS rate from 1975 to 1994 was used in this study. Information was obtained from maternity registers and annual department reports. A total of 174713 deliveries were registered within a 20-year period. Some 155257 were booked patients and 19456 were unbooked. The results show a significant difference in CS rate between booked (12.2%) and unbooked (16.9%) patients. The four main indications for CS in 1975 1985 and 1994 were dystocia previous CS breech presentation and fetal distress all in varied percentages. In 1993 there were 224 vaginal breech deliveries and 162 CS for breech presentations; this yields a 41.9% CS rate for breech presentations and 2.3% for all vaginal deliveries. The PNM rate declined from 34.7/1000 in 1975 to 18.4/1000 in 1994. The experience at Tygerberg Hospital demonstrates that the rate of CS delivery can remain constant while the PNM rate drops.