A cross-sectional study on factors influencing caesarean section rates in a tertiary care hospital, Jhansi (Uttar Pradesh)

Authors

  • Swati Singh Department of Community Medicine, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India
  • Anil Kumar Malhotra Department of Community Medicine, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20213544

Keywords:

Caesarean section, Pregnancy induced hypertension, Gestational diabetes, Polyhydromnios

Abstract

Background: Worldwide rise in caesarean delivery (CD) rates during the last three decades has been a cause of alarm. The rates of such delivery have increased dramatically in recent years from 12% in 1990 to 24% in 2008. Tertiary care centers have high caesarean section rates but areas where health care facilities are not available may have maternal deaths due to lack of C-section facilities. The present study was conducted to determine the prevalence of caesarean section, to assess the association between caesarean section with socio-demographic determinants and maternal risk factors.

Methods: Cross-sectional study was conducted during January 2016 to April 2016. A total of 288 pregnant females admitted in obstetric ward of medical college Jhansi formed the study population, a simple random sampling technique was adopted for the study. A study tool was pre-designed and pre-tested interview schedule. The data collected was entered in MS excel and analyzed using SPSS 24 version.

Results: The study showed that 73 (25.34%) of our study participants have delivered by caesarean section. Caesarean section was significantly associated with literacy, place of residence, education status, socio-economic status and occupation of the husband. Caesarean section was significantly associated with maternal risk factors like obesity, pregnancy induced hypertension, gestational diabetes mellitus and polyhydromnios.

Conclusions: Present study found a high caesarean section rate as compared to the WHO standard. Utilization of antenatal care, better doctor patient communication, doctor’s commitment to reduce the rate of LSCS, may help to reduce the increasing rate of caesarean delivery.

References

Mukherjee SN. Rising caesarean section rate. In J Obstet Gynecol. 2006; 4(56):298-300.

Lopes T, Spirtos N, Naik R, Monaghan J. Bonney's Gynaecological Surgery. 11th ed. Blackwell Publishing Ltd; 2010.

Dutta DC. Textbook of Obstetrics. 8th ed. New Delhi: Jaypee Brothers Publishers; 2015: 669-78.

Althabe F, Belizon JM. LSCS: the paradox. Lancet. 2006;368(9546):1472-3.

Dongen PV. Caesarean section-etymology and early history. South Afr J Obstet Gynaecol. 2009;15(2).

Padmadas SS, Kumar S, Nair SB, Kumari A. Caesarean section delivery in Kerala, India: evidence from a National Family Health Survey. Soc Sci Med. 2000;51(4):511-21.

NIH state-of-the-science conference statement on caesarean delivery on maternal request. NIH Consens Sci Statements. 2006;23(1):1-29.

Halpern SH, Leighton BL. The risks of lowering the caesarean delivery rate. N Engl J Med. 1999:341(1):54-7.

American College of Obstetricians and Gynecologists. (2015). Cesarean birth (C-section). FAQ006. Retrieved June 1, 2016. Available at: https://www.acog.org/womens-health/faqs/cesarean-birth.

National Family Health Survey (NFHS-4), 2015-16: India. Mumbai: IIPS. Available at: https://ruralindiaonline.org/en/library/resource/national-family-health-survey-nfhs-4-2015-16-india.

Lwanga SK, Lameshow S. Sample size determination in health studies-a practical manual: World Health Organization, 2000. Available at: http://apps.who.int/iris/bitstream/handle/10665/40062/9241544058_(p1-22).pdf

WHO. Fact sheet: WHO statement on cesarean section rates, 2015, Available at: http://apps.who.int/iris/bitstream/10665/161442/1/WHO_RHR_15.02_eng.pdf. Accessed on 28 June 2021.

Appropriate technology for birth. Lancet. 1985;2(8452):436-7.

Neuman M, Alcock G, Azad K, Kuddus A, Osrin D, More NS, et al. Prevalence and determinants of caesarean section in private and public health facilities in underserved south Asian communities: cross-sectional analysis of data from Bangladesh, India and Nepal. BMJ Open. 2014;4(12):005982.

Ronsmans C, DeBrouwere V, Dubourg D, Dieltiens G. Measuring the need for lifesaving obstetric surgery in developing countries. BJOG. 2004;111(10):1027-30.

Souza J, Gulmezoglu A, Lumbiganon P, Laopaiboon M, Carroli G, Fawole B, et al. Cesarean section without medical indications is associated with an increased risk of adverse short term maternal outcomes: the 2004-2008 WHO global survey on maternal and perinatal health. BMC Med. 2010;8:71.

Sreevidya S, Sathiyasekaran BWC. High caesarean rates in Madras (India): a population-based cross sectional study. Br J Obstet Gynaecol. 2003;110(2):106-11.

Padmaleela K, Thomas V, Prasad KV. An analysis of the institutional deliveries and their outcomes in government teaching hospitals of Andhra Pradesh, India. Int J Health Sci Res. 2013;3(5):76-81.

Parikh U, Oza PR. Study of rate, trends and determinants of caesarean section among mothers attending a tertiary care center in Ahmedabad, Gujarat, India. Int J Intg Med Sci. 2018;5(2):577-81.

Feng XL, Xu L, Guo Y, Ronsmans C. Factors influencing rising caesarean rates in China between 1998 and 2008. Bull World Health Organ. 2012;90(1):30-9.

Khanal V, Karkee R, Lee AH, Binns CW. Adverse obstetric symptoms and rural–urban difference in cesarean delivery in Rupandehi district, western Nepal: a COHORT study. Reprod Health. 2016;13:17.

Cavallaro FL, Cresswell JA, França GV, Victora CG, Barros AJ, Ronsmans C. Trends in cesarean delivery by country and wealth quintile: cross-sectional surveys in southern Asia and Sub-Saharan Africa. Bull World Health Organ. 2013;91(12):914-22.

Ronsmans C, Holtz S, Stanton C. Socioeconomic differentials in caesarean rates in developing countries: a retrospective analysis. Lancet. 2006;368(9546):1516-23.

Boatin AA, Schlotheuber A, Betran AP, Moller A, Barros AJD, Boerma T, et al. Within country inequalities in caesarean section rates: observational study of 72 low and middle income countries. BMJ. 2018;360:55.

Kominiarek MA, Vanveldhuisen P, Hibbard J, Landy H, Haberman S, Learman L, et al. The maternal body mass index: a strong association with delivery route. Am J Obestet Gyneco 2010;203(3):264.

Jacob L, Taskan S, Macharey G, Sechet I, Ziller V, Kostev K. Impact of caesarean section on mode of delivery, pregnancy-induced and pregnancy-associated disorders, and complications in the subsequent pregnancy in Germany. GMS Ger Med Sci. 2016;14:1612-3174.

Hanna FW, Peters JR. Screening for gestational diabetes: past, present and future. Diabet Med. 2002;19(5):351-8.

American Diabetes Association. Gestational diabetes mellitus. Diabetes Care. 2003;26(1):88-90.

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Published

2021-08-27

How to Cite

Singh, S., & Malhotra, A. K. (2021). A cross-sectional study on factors influencing caesarean section rates in a tertiary care hospital, Jhansi (Uttar Pradesh). International Journal Of Community Medicine And Public Health, 8(9), 4404–4410. https://doi.org/10.18203/2394-6040.ijcmph20213544

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Original Research Articles