Rising rate of emergency caesarean sections in low risk pregnancies

Abstract

Background: Worldwide, there has been an upward trend in the number of caesarean sections performed, electively or as an emergency. According to Australian Institute of health and welfare, the caesarean section rates have gone up nationally from 23.3% in 2000 to 31.55% in 2010. Aim: The main aim of the study was to determine the emergency caesarean section (ECS) rates in low risk pregnancies and to identify the common indications, obstetric risk factors and maternal and foetal outcomes associated with ECS. Methods: This was a retrospective study, with data obtained from the medical records of women who delivered in a 193 bed, Swan District Hospital ,peripheral hospital in Perth which provides obstetric and neonatal care to low risk mothers, over a period of six months (between March 2013- August 2013]. The data obtained was further used to identify obstetric risk factors that could have influenced the decisions for ECS. Besides ECS rates, outcomes variables included were maternal postpartum haemorrhage and APGAR scores after 1 and 5 minutes. Results and Conclusions: During the study period of the 713 women who delivered, 109 underwent ECS. The most common indication for ECS was failure to progress, (n=47, 43%). Primigravidas, Induced labour and Gestational age were risk factors associated with ECS. Identifying the risk factors associated with ECS will aid in counselling the women prenatally and antenatally. Risk factors amenable to life style changes can be addressed prenatally thereby aiding the clinician in reducing the overall caesarean section rates.