Premium
Changing Patterns of Caesarean Section
Author(s) -
FRCOG Javaid H. Rizvi,
MRCOG Sipra R. Chaudri
Publication year - 1988
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1988.tb01678.x
Subject(s) - caesarean section , medicine , obstetrics , perinatal mortality , incidence (geometry) , section (typography) , pregnancy , fetus , physics , genetics , advertising , optics , business , biology
EDITORIAL COMMENT: This paper was accepted for publication because it presents data from one hospital in which, over a period of 10 years, the perinatal mortality rate fell by about 50% with only a modest increase in the Caesarean section rate from 8% to 9.9%. The authors outline the relative changes in elective and emergency Caesarean section in their hospital and examine the changing indications for Caesarean section. The variables discussed are important although the explanation for the change in practice remains elusive — for example it is difficult to understand how an increase in the primary Caesarean section rate (from 5.7% to 7.2%) was not followed by a commensurate increase in the incidence of repeat Caesarean section (from 2.3% to 2.7%). Summary: There has been a substantial rise in the rate of Caesarean section in the last 20 years. There are many reasons for this increase, but it has been argued that the fall in perinatal mortality justifies a higher Caesarean section rate. In this retrospective study 7,274 deliveries were reviewed and 650 Caesarean sections were analysed. There was only a marginal increase in the rate of Caesarean section (1.9%) during the 2 biennial periods studied (1974–1975 and 1984–1985), but overall perinatal mortality rate dropped by half during the second study period. This study confirms that in recent years the indications for Caesarean section have altered, but the marked rise in the Caesarean section rate cannot be explained purely on medical grounds and is certainly not solely responsible for the very significant drop in the perinatal mortality rate.