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Cesarean section: a contemporary assessment

J R Evrard, E M Gold, T F Cahill

    The Journal of Reproductive Medicine
    |April 1, 1980
    PubMed
    Summary
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    This study analyzed cesarean section (CS) rates and indications, finding dystocia as the primary reason for primary CS. Complications, particularly sepsis, and low-birth-weight infant incidence were also examined.

    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.

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  • 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.