[Incidence and indication for cesarean section at the Central Military Hospital of Mexico]

During the past two decades cesarean section rate has increased in recent years, various factors have been identified as responsible for increasing of this operation. The objective of this investigation was to determine the frequency, indications and complications of cesarean section performed at Hospital Central Militar (HCM). A prospective open study was performed during 2 years, 6977 pregnant women were included, of these, 5,105 patients (73.16%) had vaginal delivery and 1,872 (26.84%) cesarean sections were performed. The most frequent indications were failure to progress in labor (29.87%), repeated cesarean sections (22.86%) and breech presentation (9.61%). Endometritis was the major cause of positive morbidity (13.24%). Cesarean section rate had a significant increase of 11% in a 12-year period (1982 through 1994), almost of 1% annual. Attempt should make to halt the rise by marking recommendations as vaginal delivery after a previous cesarean section, breech deliveries. Also it is necessary to use appropriate intrapartum electronic fetal heart rate monitoring to avoid increased rates of unnecessary intervention.