Cesarean section in present-day obstetrics. Presidential address

Area of Science:

• Obstetrics and Gynecology
• Surgical Outcomes Research
• Maternal Health

Background:

• Review of 2,563 cesarean sections performed between 1963 and mid-1975 at Charlotte Memorial Hospital.
• Comparison with earlier hospital data from 1940 onwards, totaling 3,717 cesarean sections by 1975.
• Cesarean section rate observed at 6% during the study period.

Purpose of the Study:

• To evaluate improvements in cesarean section outcomes, including maternal and fetal mortality and morbidity.
• To compare historical trends in cesarean section rates and outcomes.
• To gather expert opinions on current and future cesarean section incidence.

Main Methods:

• Retrospective review of cesarean section records.
• Comparative analysis of data from different time periods.
• Survey of medical schools and obstetricians nationwide via questionnaires.

Main Results:

• Significant reductions in cesarean section-related deaths, morbidity, and complications were observed.
• No maternal deaths occurred in the last 2,225 cesarean sections performed.
• Survey data provided insights into reasons for increased cesarean section rates and future predictions.

Conclusions:

• Cesarean section procedures have demonstrated marked improvements in safety and outcomes over time.
• The study highlights a trend towards improved maternal safety in cesarean sections.
• Expert consensus suggests an ongoing rise in cesarean section rates, necessitating further investigation.