Changing Trends in Indications of lower section Caesarean Section (LSCS) over a Decade in a Tertiary Care Centre: An Institutional Study

Changing Trends in Indications Of lower section Caesarean Section (LSCS)

Abstract

INTRODUCTION: The increase in caesarean section rate has been a global phenomenon. This study focuses on the changing trends in indications for caesarean section over a decade in an urban setup. MATERIAL AND METHODS: In this retrospective cross-sectional study we analysed all cases of caesarean delivery at Cama And Albless Hospital from 1st August 2003 to 31st January 2004 in regarding the patient’s age, parity, indications, associated risks factors, duration of surgery and compared with the data from 1st August 2013 to 31st January 2014. RESULTS: In 2004 group foetal distress, was the leading cause in 35.84% of cases, followed by previous LSCS in 26.57%, PIH 17.29% and CPD 10.77% whereas in 2014 group Previous LSCS was the leading cause in 35.2% of cases, followed by foetal distress14.9% and previous 2 LSCS 10.5%. Considering previous LSCS as an indication, scar tenderness and floating head in labour accounted for 75% of cases in 2014 group. 30 cases (43.48%) underwent LSCS primarily for PIH in 2004 group while 11 cases (26.19%) underwent LSCS in 2014 group. 82.25% cases in 2004 while only 38% in 2014were labelled as foetal distress due to fetal heart abnormalities detected by intermittent manual auscultation and tococardiography.43.31% cases of foetal distress in 2004 group while 40.23% cases in 2014 group were without any associated risk factors. CONCLUSION: In a decade obstetrics has changed from more primary LSCS for relative indications to the challenging task of VBACs in Previous LSCS. Use of precise interpretation of foetal heart tracing, good trial of VBACs and practice of evidence based obstetrics would definitely go a long way in balancing caesarean section rates.