Caesarean section in obstetric practice of a developing southern Mediterranean island

Caesarean sections have, in some countries, increased to alarming proportions, in recent years. This trend has been evident in the Maltese Islands. The maternal and infant characteristics in cases delivered by Caesarean section are reviewed and statistically compared to those of cases delivered vaginally. Mothers were statistically more likely to be elderly, obese and short, with a history of a poor previous obstetric outcome, and a current pregnancy complicated by hypertension and antepartum haemorrhage. Labour was more likely to have been induced in these patients. The infant was more likely to be of low birthweight or macrosomic. The maternal morbidity was increased as a result of problems of bleeding and sepsis, while a subsequent pregnancy was more likely to require delivery by a repeat operative abdominal delivery.