scholarly journals Impact of maternal nationality on caesarean section rate variation in a high-income country

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Saheed Shittu ◽  
Lolwa Alansari ◽  
Fahed Nattouf ◽  
Tawa Olukade ◽  
Naji Abdallah
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Reference Group ◽  
Caesarean Section Rate ◽  
Fetal Distress ◽  
Maternity Hospital ◽  
High Income ◽  
Rate Variation ◽  
Cross Sectional ◽  
Medical Indications

Background: Caesarean section (CS) rates have been reported to differ between immigrants and native-born women in high-income countries. Objective: We assessed the CS rate and its relationship with the CS rate in country of nationality and other explanatory factors among women of different nationalities including Qatari women who underwent deliveries at our hospital to generate evidence that will quantify and help explain the observed CS rates in our hospital. Methods: In this retrospective cross-sectional study conducted at the second-largest public maternity hospital in Qatar, Al-Wakra Hospital (AWH), data for all births delivered in 2019 were retrieved from the hospital's electronic medical records. The CS rates and the crude and adjusted risks of Caesarean delivery for mothers from each nationality were determined, and the common indications for CS were analyzed based on nationality. The association between nationality and Caesarean delivery was examined using binomial logistic regression analysis, with Qatari women as the reference group. The correlation between CS rate in country of nationality and observed CS rates in Qatar was also examined using Pearson's correlation. Results: The study population consisted of 4816 births by women of 68 nationalities, of which 4513 births were by women from 25 countries. The highest proportion of deliveries (n-1247, 25.9%) was by Indian women. The frequency of CS was the highest and lowest among Egyptian (49.6%) and Yemeni women (17.9%), respectively. Elective CS was predominantly performed in women of Arab nationalities; the most common indication was a history of previous multiple CSs. Emergency CS was primarily performed in women of Asian and Sub-Saharan African nationalities; the most common indications were failure to progress and fetal distress. For most nationalities, the CS rate in Qatar was associated with those of the countries of nationality. Conclusions: The observed CS rates varied widely among women of different nationalities. The variation was influenced by maternal factors and medical indications as well as the CS rates in the country of nationality. We posit that cultural preferences, acculturation, and patient expectations influenced observed findings. More efforts are required to reduce primary CS rates and to help women make the most informed decisions regarding modes of delivery. Key Message: CS rates varied widely among women of different nationalities. The variation was influenced by medical indications, maternal preferences, and CS rate in countries of nationality. The solution to reducing CS rates should be a culturally informed response.

scholarly journals Evaluation of caesarean section practices according to Robson's 10-group classification at a level two maternity ward in Conakry, Guinea

2019 ◽  
Vol 8 (11) ◽  
pp. 4468
Author(s):  
Daniel W. A. Leno ◽  
Mamoudou E. Bah ◽  
Jerry C. Moumbagna ◽  
Tamba M. Millimouno ◽  
David Lamah ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Medical Center ◽  
Caesarean Section Rate ◽  
Relative Size ◽  
Newborn Care ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Maternity Ward ◽  
Cross Sectional ◽  
Robson Classification

Background: The frequency of caesarean sections (CS) increased dramatically in the world over the last twenty years. The objective of this study was to evaluate caesarean section practices based on Robson classification in an urban referral hospital in Conakry, GuineaMethods: We conducted a cross-sectional study of 2,266 birthing records collected at the maternity ward of the Coronthie Communal Medical Center in Conakry, from January 1st to December 31st 2016. We included in the study all women who had a caesarean section and whose medical records were complete. Robson's classification was used to classify women into 10 groups based on maternal and fetal characteristics. The relative size of each group, its gross caesarean section rate as well as its contribution to overall caesarean section rate and the main caesarean section indications were calculated.Results: In 2016, 769 caesarean sections were performed out of 2,266 deliveries, corresponding to a hospital section rate of 33.9%. Groups 5 (11.0%), 1 (4.8%), and 3 (4.3%) of the Robson classification were the most contributors to registered hospital caesarean section rate. The main indications for caesarean section were uterine scar in group 5 and acute fetal distress in groups 1 and 3.Conclusions: The systematic reference to the Robson classification could help to identify and avoid the relative indications of the caesarean section in urban Guinea. Besides, increasing induction of labor and strengthening providers’ capacities in emergency obstetric and newborn care services could contribute to reduce caesarean section rates in Guinea.

scholarly journals A Descriptive Analysis of the Indications for Caesarean Section in Lumbini Zonal Hospital, Butwal

2018 ◽  
Vol 5 (2) ◽  
pp. 31-34
Author(s):  
Shreedhar Acharya ◽  
Bhaktabatsal Raut
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Caesarean Section Rate ◽  
Descriptive Analysis ◽  
Fetal Distress ◽  
Age Group ◽  
Medical Sciences ◽  
Cephalopelvic Disproportion ◽  
Case Files ◽  
One Year

AIM: This study was done to find out the incidence and to analyse the various indications for caesarean sections at Lumbini Zonal Hospital.MATERIALS & METHODS: This was a hospital based retrospective study done at Lumbini Zonal Hospital, Butwal. The case files of all the women who had caesarean delivery over the period of one year from 2071/4/1 to 2072/3/32 were reviewed. Various indications of caesarean sections were analysed for the incidence, age, parity, elective vs emergency caesareans.RESULTS: Out of 7589 deliveries, 1316 (17.34%) had caesarean section. Most common indications were previous caesarean 275 (20.89%), non progress of labour 245 (18.61%), cephalopelvic disproportion 222 (16.86%), fetal distress 215 (16.33%), etc. Majority of caesarean 1226 (93.16%) was done in the age group of 20-30yrs, primipara 702 (53.34%), and elective caesarean sections 766 (58.2%).CONCLUSION: Caesarean section rate at Lumbini Zonal Hospital was optimal. Most common indication was repeat caesarean. The overall reduction in caesarean section rate can be met through reduction of elective caesarean with the promotion of trial of labour.Study also concludes that there is a relation between working duration and health problems, and the problems increase as the duration at work increases.Journal of Universal College of Medical Sciences, Vol. 5, No, 2, 2017, Page: 31-34

scholarly journals A cross sectional study of 1000 lower segment cesarean section in obstetrics and gynecology department of P. D. U Medical College, Rajkot, Gujarat, India

2017 ◽  
Vol 6 (4) ◽  
pp. 1186
Author(s):  
Dolly Chavda ◽  
Kamal Goswam ◽  
Kavita Dudhrejiya
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Obstetrics And Gynecology ◽  
Sectional Study ◽  
Lower Segment ◽  
Cross Sectional ◽  
Medical College ◽  
Lower Segment Cesarean Section

Background: Though WHO recommends a rate of 10-15% caesarean section for a given hospital, there has been a rising trend worldwide. We estimated the recent incidence of caesarean section in Obstetrics and Gynecology Department, P.D.U. Medical College, Rajkot (Gujarat and correlated these rates with the socioeconomic, demographic, and health variables.Methods: We have studied 1000 cases of lower segment caesarean section (cross sectional study) at Obstetrics and Gynecology Department, P.D.U Medical College, Rajkot (Gujarat) to find out rate of caesarean section, common maternal and fetal indication and complications of lower segment caesarean section.Results: Caesarean section rate of the present study is 19.9%. Most common indication of LSCS was scarred uterus 39.9%.followed by fetal distress 19.1%, malpresentation 18.6%, and failed induction 7.3%. Maternal morbidities and mortalities in emergency LSCS in compare to elective LSCS. Analysis based on Robson’s ten-group showed that group 5 (Previous CS, single cephalic,>37 weeks) made the greatest contribution to total CS rate.Conclusions: Scientific advances, social and cultural changes, and medico legal considerations seem to be the main reasons for the increased acceptability of caesarean sections. The decision to perform a C-section delivery must be chosen carefully and should not be profit oriented. There is a possibility of keeping the rate to minimum by reducing number of primary caesarean sections, by proper counseling of the patients, proper monitoring and patience.

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

2021 ◽  
Vol 8 (9) ◽  
pp. 4404
Author(s):  
Swati Singh ◽  
Anil Kumar Malhotra
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Maternal Risk

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.

scholarly journals An audit of caesarean section rate based on Robson’s ten group classification system

2020 ◽  
Vol 9 (7) ◽  
pp. 2803
Author(s):  
Jishma Jose ◽  
Sendhil Coumary Arumugam ◽  
Syed Habeebullah
Keyword(s):  
Caesarean Section ◽  
Classification System ◽  
Caesarean Section Rate ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Group Classification ◽  
Health Concern ◽  
Initial Structure ◽  
Cross Sectional ◽  
Group 5

Background: Caesarean section (CS) rates are rising worldwide and is a major public health concern. There is lack of evidence supporting the maternal and neonatal benefits with the increasing CS rates. Robson’s ten group classification system serves as an initial structure with which caesarean section rates can be analysed. RTGCS helps us to analyse and allow us to bring changes in our practice.Methods: This was a hospital based cross sectional study conducted over a period of 10 months during the year 2018, which involved 1478 pregnant women, out of which 693 underwent CS, those who underwent CS were grouped according to Robson’s Ten group classification system and the data was collected and analyzed.Results: 693 women underwent CS and the overall section rate was 46.88%. Group 5 (previous LSCS) and Group 2 (nulliparous, >37 weeks, induced) contributed the maximum to the overall CS rates (33.9% and 26.3% respectively). The most common indication for caesarean section was previous LSCS (38%), fetal distress (19.2%) and meconium stained liquor (13.7%).Conclusions: Robson’s ten group classification system helps us in auditing the caesarean section rates. Group 5 and 2 contributes the maximum for caesarean section rates. Encouraging and adequate counselling for VBAC, proper training of obstetricians in CTG interpretation would reduce the caesarean section rates.

scholarly journals Profile of Caesarean Section in Mid-Western Regional Hospital in Nepal

2018 ◽  
Vol 16 (1) ◽  
pp. 84-88 ◽  
Author(s):  
Keshar Bahadur Dhakal ◽  
Sulochana Dhakal ◽  
Saroj Bhandari
Keyword(s):  
Caesarean Section ◽  
Post Partum ◽  
Caesarean Section Rate ◽  
Secondary Data ◽  
Fetal Distress ◽  
Regional Hospital ◽  
Global Public Health ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Western Regional

Background: Rising rate of caesarean section since few decades has been a global public health issue.This study is aimed to determine the rate of caesarean section plus examine the indications and complications of caesarean section.Methods: A retrospective cross-sectional study was conducted using secondary data sources at Mid-Western Regional Hospital in Surkhet, Nepal. Data were collected from patients’records ofthe hospital dating from 16 July 2016 to 15 July 2017. All patients who had delivered their baby by caesarean section were included in this study. Data were analyzed by help of SPSS version 21.Ethical approval was obtained from the hospital authority prior to the study.Results: During the study, out of total 3,694 deliveries, 695 (18.8%) were caesarean section. Most of the caesarean section were emergency than elective (83.0% vs 17.0%). Among all women who underwent caesarean section, majority were from 37 to 42 weeks pregnancy (88.5%), age group between 20 and 24 (42.9%) and multiparous (53.5%).Fetal distress (20.1%) was most common among all major indications of caesarean section. Maternal complications due to caesarean section was low (3.7%). Among all complications, Post-partum hemorrhage (30.5%) was the major maternal complication of caesarean section. Most of newborn babies had APGAR score six or more at one minute (94.5%) and five minutes (97.9%).Conclusions: In our study, caesarean section rate was 18.8%, which is higher than WHO recommendation (10 – 15%). Main indication for caesarean section was fetal distress. Maternal and fetal complications were low.

scholarly journals Indikasi Persalinan Seksio Sesarea

2018 ◽  
Vol 7 (1) ◽  
pp. 11
Author(s):  
Sholikhah Wahyu Subekti
Keyword(s):  
Caesarean Section ◽  
Quality Care ◽  
Caesarean Section Rate ◽  
Referral Hospital ◽  
Health Ministry ◽  
Cross Sectional ◽  
Caesarean Section Delivery ◽  
Referral Hospitals ◽  
The Government ◽  
Medical Indications

According to Health Ministry (2010), 25%-50% of Fertile Women’s death is related to the problems of pregnancy, labor, and childbirth. The government sets up the program Making Pregnancy Safer (MPS), one of which is by caesarean section delivery to reduce the Number of Maternal Mortality. According to Health Ministry at Nofitasari (2011), one of the indicators of quality care in obstetric and gynecology is by Caesarean Section Rate (CSR). For educational hospital or referral hospital the CSR is ≤ 20%, while for non-educational or non-referral hospital is ≤ 15% of total deliveries per year. At Panembahan Senopati Bantul Hospital, there are 3.365 birth cases in 2013 24.63% of them ends with caesarean section delivery. These cases are higher than the standard rate of caesarean section set by Health Ministry for educational or referral hospitals i.e. ≤ 20% of total deliveries per year. The purpose of this study to find out the indications of caesarean section deliveries at Panembahan Senopati Bantul Hospital in 2013. This is a descriptive research with cross sectional design. The location of study is Panembahan Senopati Bantul Hospital. The study is conducted on 2014. The data are taken from the register book of baby births between January 1-December 31 2013. The result shows that the cases of caesarean section at Panembahan Senopati Bantul Hospital was performed on medical indications 97.5%, non-medical indications 2.5%, medical-single indications 90.1%, elective-single 67.2%, and possibility-single 67.1%. Most medical indications were previous caesarean section (22.4%).

scholarly journals Assessment of indications of lower section caesarean section at tertiary care centre: a cross sectional study

2017 ◽  
Vol 4 (4) ◽  
pp. 1253
Author(s):  
Vijay L. Badge ◽  
Sumit Suresh Aggarwal ◽  
Deepti D. Ambalkar ◽  
Arun Humne ◽  
Neethika Raghuwanshi
Keyword(s):  
Caesarean Section ◽  
Care Center ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College

Background: Caesarean section is one of the commonly performed surgical procedures in obstetrics and is certainly one of the oldest operations in surgery. One of the most dramatic features of modern obstetrics is the increase in the caesarean section rate. The present study was conducted to estimate proportion of various indications of LSCS and also to assess socio demographic profile of mothers undergoing caesarean section in a tertiary care centre. Methods: The present cross sectional observational study was conducted at Government Medical College & Hospital, Akola in the post natal ward (PNC). Non probability convenient sampling method was used. All patients admitted to PNC ward after LSCS were included in study. For data collection paper based pre tested, semi –structured questionnaire was used. Results: Previous LSCS was indication for LSCS in 32% cases. Eclampsia, preeclampsia and Anaemia were the indications for LSCS in 19.3%, 8.6% and 5.3% cases respectively. Other common indications includes CPD, meconium stained liquor, fetal distress, breech presentations, twin pregnancy and preterm labour. Conclusions: The proportion of LSCS is more than WHO recommended proportion of LSCS. It may be due to present institute acts as tertiary care center. Still this proportion is high, so encouragement should be given to trial of labour in selected low risk cases and in Primi patients whenever possible. 

Advanced Maternal Age and Pregnancy Outcome at Manipal Teaching Hospital: Cross-sectional Analytical study

2021 ◽  
Vol 6 (1) ◽  
pp. 20-25
Author(s):  
Vibha Mahato ◽  
Pravin Shrestha ◽  
Pradeep Bhattarai
Keyword(s):  
Caesarean Section ◽  
Postpartum Hemorrhage ◽  
Perinatal Outcome ◽  
Maternal Age ◽  
Analytical Study ◽  
Fetal Distress ◽  
Advanced Maternal Age ◽  
Age Group ◽  
Cross Sectional ◽  
Very Advanced Maternal Age

Introduction: Advanced and very advanced maternal age are associated with several adverse maternal and fetal outcome. The objective of this study was to find out the possible association between advance maternal age and adverse pregnancy outcomes at Manipal Teaching Hospital.Methods: A cross sectional analytical study conducted at department of Obstetrics and Gynecology, Manipal Teaching Hospital, Pokhara, Nepal. A total of 198 patient who were ≥30 years and >24 weeks pregnant admitted in obstetric ward were selected. These patient were divided into three groups according to their age (30-34, 35-39 and ≥ 40years). We compared the incidence of adverse maternal and perinatal outcome among these groups. We also calculated odds ratio of maternal and perinatal outcomes in 35-39 years and ≥ 40years women, compared with women aged 30-34 years.Results: Comparison of the three age groups revealed that advanced maternal age constitute a predisposing factor for malpresentation, gestational diabetes mellitus, placenta previa, fetal distress and caesarean section. Whereas, risk of non progress of labour, preterm birth, postpartum hemorrhage, perinatal death and congenital anomalies were increased in very advanced maternal age group. From these, statistical significance was reached in case of greater risk of malpresentation (p=0.01,OR=6.66), fetal distress (p=0.04, OR=2.6) and caesarean section(p=0.02,OR=2.06) in advanced age group when compared to the patients aged 30-34. Furthermore, very advanced age group were higher risk of postpartum hemorrhage (p=0.03, OR=2.47) and congenital anomalies, which were statistically significant (p=0.04, OR=29.57) when compared to the 30-34 years.Conclusion: Advanced and very advanced maternal age is associated with several adverse maternal and perinatal outcome. The risk of perinatal complication begin to increase after the age of 35 but significantly increased after 40 years.

scholarly journals Caesarean birth rates in public and privately funded hospitals: a cross-sectional study

2017 ◽  
Vol 51 ◽  
pp. 101 ◽  
Author(s):  
Bruna Dias Alonso ◽  
Flora Maria Barbosa da Silva ◽  
Maria do Rosário Dias de Oliveira Latorre ◽  
Carmen Simone Grilo Diniz ◽  
Debra Bick
Keyword(s):  
Health Care ◽  
Socioeconomic Status ◽  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Cross Sectional Study ◽  
University Education ◽  
Southeastern Brazil ◽  
Sectional Study ◽  
Cross Sectional ◽  
Health Care Funding

OBJECTIVE: To examine maternal and obstetric factors influencing births by cesarean section according to health care funding. METHODS: A cross-sectional study with data from Southeastern Brazil. Caesarean section births from February 2011 to July 2012 were included. Data were obtained from interviews with women whose care was publicly or privately funded, and from their obstetric and neonatal records. Univariate and multivariate analyses were conducted to generate crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI) for caesarean section births. RESULTS: The overall caesarean section rate was 53% among 9,828 women for whom data were available, with the highest rates among women whose maternity care was privately funded. Reasons for performing a c-section were infrequently documented in women’s maternity records. The variables that increased the likelihood of c-section regardless of health care funding were the following: paid employment, previous c-section, primiparity, antenatal and labor complications. Older maternal age, university education, and higher socioeconomic status were only associated with c-section in the public system. CONCLUSIONS: Higher maternal socioeconomic status was associated with greater likelihood of a caesarean section birth in publicly funded settings, but not in the private sector, where funding source alone determined the mode of birth rather than maternal or obstetric characteristics. Maternal socioeconomic status and private healthcare funding continue to drive high rates of caesarean section births in Brazil, with women who have a higher socioeconomic status more likely to have a caesarean section birth in all birth settings.

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