Analysis of current trends in caesarean section in a tertiary care hospital

In the background of increasing rates of caesarean sections, this study was done to find the current trends of the surgery. Aim: To study 500 consecutive caesarean sections in a tertiary referral maternity hospital in South India to understand the current trends in caesarean. Objective: 1.        To find out the incidence of caesarean sections and the pattern of the indications 2.        To find the pattern of age distribution, parity, period of gestation, intra operative & post operative complications, fetal & maternal outcome in caesarean sections & 3.        To compare elective and emergency caesarean sections Method: This was a prospective study carried out in a District Maternity hospital in South India. We included 500 consecutive caesarean sections from the time of commencement of the study. The various characteristics of the patient & newborn profile, the surgical indications & complications were noted and compared in elective & emergency caesarean sections & the statistical significance was noted by applying Chi square test. Results: The incidence of caesarean section was found to be 30.1% in our study. Of the total 500 cases studies, 68.2% were emergency sections. Most elective cases were in parous women (69.1%); whereas most emergency cases were in nulliparous women (68.03%). Commonest indication for caesarean section was previous caesarean section in the elective group; while in the emergency group, it was meconium and fetal distress. Intra operative complications and perinatal mortality were significantly more in emergency cases. Post operative morbidity was seen in 16.2% cases. Conclusion: There is a need to avoid unwarranted surgeries, mainly primary caesarean section and also the need to give trial of scar in carefully selected cases so that the caesarean rate stabilizes with good maternal and fetal outcome. Keywords: Caesarean trends, Caesarean section incidence, Indications of caesarean, Complication rate of LSCS