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The Jordanian cesarean section rate.

Ibrahim M Hindawi1, Zakarya B Meri

  • 1Department of Obstetrics and Gynecology, Royal Medical Services, Amman, Jordan.

Saudi Medical Journal
|December 2, 2004
PubMed
Summary
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The Jordanian cesarean section (CS) rate increased from 8% to 10.9% between 1990-2001, with significant shifts in indications like increased fetal distress and decreased dystocia. This study highlights factors contributing to cesarean rates and suggests policies for optimization.

Area of Science:

  • Obstetrics and Gynecology
  • Public Health
  • Epidemiology

Background:

  • Cesarean section (CS) rates vary globally, influenced by medical indications and healthcare practices.
  • Understanding national trends in CS rates and their underlying reasons is crucial for maternal and child health policy.

Purpose of the Study:

  • To determine the cesarean section rate in Jordan between 1990 and 2001.
  • To analyze the indications for cesarean section in Jordan and compare them with international rates, particularly those in the USA.

Main Methods:

  • A retrospective analysis of 243,271 deliveries across seven major Jordanian military hospitals from 1990-2001.
  • Cesarean deliveries (22,621) were categorized by indication: breech presentation, dystocia, repeat cesareans, fetal distress, and others.

Related Experiment Videos

  • Data from two distinct periods (1990-1992 and 1999-2001) were compared to assess changes in rates and indications, using Chi-Square tests for significance.

    • Main Results:

    • The overall cesarean section rate in Jordan increased from 8% (1990-1992) to 10.9% (1999-2001).
    • Significant increases in CS rates were observed for fetal distress (p=0.000) and breech presentation (p=0.000) when compared to USA rates.
    • Conversely, significant decreases in CS rates were noted for dystocia and repeat cesareans (p=0.000) in the Jordanian population compared to USA data.

    Conclusions:

    • The observed cesarean rate in Jordan is influenced by reduced rates of dystocia, potentially due to improved fetal weight estimation and oxytocin management.
    • Implementing policies such as active management of labor, promoting trial of scar, maintaining vaginal delivery skills for breech presentations, and refining fetal monitoring protocols can help achieve acceptable cesarean rates.