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Indications associated with increased cesarean section rates in a Swedish hospital
Author(s) -
Florica M.,
Stephansson O.,
Nordström L.
Publication year - 2006
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2005.10.016
Subject(s) - medicine , fetal distress , parity (physics) , obstetrics , cephalic presentation , presentation (obstetrics) , gynecology , pregnancy , fetus , genetics , physics , particle physics , biology
Objective: To analyze the indications and Robson classes associated with the rapid increase in cesarean section (CS) rates at Söder Hospital, Stockholm, Sweden, in the late 1990s. Method: Records of women who underwent CSs in 1994 and 1999 at Söder Hospital were retrospectively reviewed. Diagnostic frequency and Robson class, which takes into account characteristics such as parity, previous deliveries, prematurity, and fetal presentation, were compared for the 2 years. Results: Suspected fetal distress (+ 1.6%; P = .0001), maternal request (+ 1.5%; P < .0001), and labor dystocia (+ 0.8%; P = .03) were associated with the increase in CS rates. The rate of CSs with cephalic presentation and spontaneous onset of labor at term, as well as the rate of CSs following induced labor or elective CSs, increases significantly in both nulliparas and multiparas (Robson classes 1–4) ( P < .02). Conclusion: The increasing CS rate was due to maternal preference and lower thresholds of decision for physicians.