Objective: To evaluate the existence of a trend in incidence and indications for cesarean section (CS) and changes in maternal and feto- neonatal morbidity and mortality. Methods: Between 1981 and 1990, 1,395 of 8,695 pregnant women underwent a CS in our department. For each woman the following data were recorded: gestational age at delivery, indications for CS, maternal infectious morbidity, perinatal mortality, neonatal neurologic morbidity. Results: The CS rate increased steadily from 13.7% in 1981 to 20.8% in 1990, showing a significant trend. Among indications a significant contribution to the increasing rate was shown for previous scar. No maternal death occurred during the period examined. Maternal infectious morbidity was recorded in 3.9% of the patients. No correlation was shown between the CS rate and that of neonatal hypoxic-ischemic encephalopathy. Conclusions: Although CS in our institution proved to be a safe intervention, concern is growing about the increasing rate of CS. While the advantages of this increase for both mother and fetus remain to be proved, programs to lower the CS rate need to be implemented with special reference to repeated CS which most contributed, in our experience, to the increasing CS rate.
Cesarean section trend: A 10-year review of incidence, indications and risk in a university hospital
COCILOVO, Giorgio;VESCE, Fortunato;MOLLICA, Gioacchino
1993
Abstract
Objective: To evaluate the existence of a trend in incidence and indications for cesarean section (CS) and changes in maternal and feto- neonatal morbidity and mortality. Methods: Between 1981 and 1990, 1,395 of 8,695 pregnant women underwent a CS in our department. For each woman the following data were recorded: gestational age at delivery, indications for CS, maternal infectious morbidity, perinatal mortality, neonatal neurologic morbidity. Results: The CS rate increased steadily from 13.7% in 1981 to 20.8% in 1990, showing a significant trend. Among indications a significant contribution to the increasing rate was shown for previous scar. No maternal death occurred during the period examined. Maternal infectious morbidity was recorded in 3.9% of the patients. No correlation was shown between the CS rate and that of neonatal hypoxic-ischemic encephalopathy. Conclusions: Although CS in our institution proved to be a safe intervention, concern is growing about the increasing rate of CS. While the advantages of this increase for both mother and fetus remain to be proved, programs to lower the CS rate need to be implemented with special reference to repeated CS which most contributed, in our experience, to the increasing CS rate.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
