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Indicators02:39

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Certain organic substances change color in dilute solution when the hydronium ion concentration reaches a particular value. For example, phenolphthalein is a colorless substance in any aqueous solution with a hydronium ion concentration greater than 5.0 × 10−9 M (pH < 8.3). In more basic solutions where the hydronium ion concentration is less than 5.0 × 10−9 M (pH > 8.3), it is red or pink. Substances such as phenolphthalein, which can be used to determine the pH of a solution, are...
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Indications for increase in caesarean delivery.

Paula da Silva Charvalho1, Mira Hansson Bittár2, Ylva Vladic Stjernholm3

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The caesarean delivery rate in Sweden rose significantly, driven by maternal requests and prolonged labor. Standardized definitions and better follow-up are crucial to reduce unnecessary caesarean births.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal Health
  • Surgical Interventions

Background:

  • Rising global caesarean delivery rates correlate with increased maternal morbidity.
  • Pathological placentation, peripartum hysterectomy, and obstetric bleeding are significant concerns.
  • Understanding caesarean delivery indications is vital for maternal safety.

Purpose of the Study:

  • To investigate the primary indications for caesarean delivery.
  • To analyze trends in caesarean delivery rates and their associated factors.
  • To identify areas for potential reduction in non-medically indicated caesareans.

Main Methods:

  • Retrospective observational study design.
  • Data sourced from the Swedish Pregnancy Register and tertiary hospital obstetric records.
  • Analysis covered the period from the early 1990s to 2015.

Main Results:

  • Caesarean delivery in Sweden increased from 10% to 17% between the early 1990s and 2015.
  • Planned caesareans rose due to maternal request (0.6% to 4.6%), often linked to fear of vaginal delivery.
  • Urgent caesareans increased, primarily due to prolonged labor (2.1% to 5.4%) and imminent fetal asphyxia (2.4% to 2.6%).

Conclusions:

  • Swedish caesarean rates increased alongside decreased instrumental deliveries and more labor inductions.
  • Maternal request and prolonged labor were key drivers for planned and urgent caesareans, respectively.
  • Standardized definitions for maternal request, prolonged labor, and fetal asphyxia are needed to decrease unnecessary caesareans.