Cesarean section: a contemporary assessment

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Public Health

Background:

• Cesarean section (CS) rates have been rising globally.
• Understanding the indications and outcomes of CS is crucial for obstetric practice.
• Previous studies highlight variations in CS rates and reasons across different institutions.

Purpose of the Study:

• To report the cesarean section (CS) rates and primary indications at a single institution.
• To analyze the incidence of complications, particularly sepsis, associated with CS.
• To examine the relationship between CS and low-birth-weight infant incidence and perinatal death rates.

Main Methods:

• A one-year retrospective study design.
• Inclusion of all women delivered at Women and Infants Hospital of Rhode Island.
• Data collection on delivery mode, indications for primary CS, complications, and infant outcomes.

Main Results:

• The total CS rate was 18.5% (1,011 of 5,467 deliveries), with a primary CS rate of 13.4%.
• Leading indications for primary CS included dystocia (38.8%), breech presentation (14.9%), malposition (11.9%), and fetal distress (11.3%).
• Sepsis accounted for 75% of complications; low-birth-weight infants occurred in 14.2% of primary CS and 6.7% of repeat CS cases; the perinatal death rate was 21.2 per 1,000.

Conclusions:

• Dystocia remains a significant indication for primary cesarean section.
• Sepsis is a major complication, and careful consideration of CS indications is warranted.
• The findings provide insights into current obstetric practices and their impact on maternal and infant outcomes.