August 2021 · Volume 10 · Issue 8 Page 3072
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Maurya P et al. Int J Reprod Contracept Obstet Gynecol. 2021 Aug;10(8):3072-3078
www.ijrcog.org
pISSN 2320-1770 | eISSN 2320-1789
Original Research Article
A cross sectional study to evaluate indications and outcomes of
caesarean section in a district hospital of West Bengal
Pratima Maurya
1
*, Sandeep Saini
2
, Bhawna Saini
3
, Mohit Kumar
4
,
Ajit Kumar Adhya
1
, Ranjit Kumar Mondal
1
INTRODUCTION
Caesarean section in medically justified cases can prevent
maternal and perinatal mortality and morbidity. In 1985,
WHO has considered an optimal rate of CS to be between
10% and 15%.
1
As per WHO review, CS rates above 9-
16% are not associated with decrease in maternal and fetal
mortality. Many professional groups are questioning
WHO recommended optimal CS rate by suggesting that
lowering the CS rate may be more harmful for mother and
fetus.
2
There has been an expeditious rise in the CS rate
throughout the world. There is worldwide variation in the
CS rate ranging from 4-65% in USA with some countries
like Brazil going as high as 55.6%.
3,4
Similar rising trends
in CS rate from 21.8% in 1993-94 to 25.4% in 1998-99,
was also noted in study conducted by Indian Council of
Medical Research.
5
The aim of the study was to determine
CS rate at district hospital of West Bengal. It also assessed
DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20212957
1
Department of Obstetrics and Gynecology, North 24 Parganas District Hospital, Barasat, West Bengal, India
2
Department of Nephrology, AIIMS, Rishikesh, Uttrakhand, India
3
Department of Pharmacology, AIIMS, Rishikesh, Uttrakhand, India
4
Department of Anesthesia, AIIMS, Rishikesh, Uttrakhand, India
Received: 22 June 2021
Accepted: 16 July 2021
*Correspondence:
Dr. Pratima Maurya,
E-mail: dr.pratimamaurya@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: There is drastic rise in caesarean section (CS) rate worldwide in last decade as compared to optimal CS
rate (10-15%) recommendation by WHO. This study was conducted to assess incidence and feto-maternal outcome in
CS delivery.
Methods: A cross-sectional study was conducted in pregnant women admitted over one year from September 2017-
August 2018 in West Bengal. Demographic details and indication of CS were recorded along with documentation of
feto-maternal outcomes. Statistical analysis was performed with help of Epi Info (TM) 7.2.2.2. Z-test and corrected Chi
square (χ2) test. p<0.05 was considered to be statistically significant.
Results: Out of total 10831 deliveries, 2914 (27%) women underwent CS. Demographic analysis shows maximum
number of patients to be between 20-25years (51.7%), rural (58%), primigravida (51.3%), term pregnancy (87.7%).
Non-progression of labour or NPL (45%) was most common indication of CS followed by previous CS (26.2%) and
fetal distress (17.9%). Post CS wound infection was seen in 33 (1.1%) women. Two maternal deaths were recorded.
Still born was documented in 0.8% while 6.8% fetus were referred to paediatric ICU.
Conclusions: Rise in CS rates was mainly reported in 20-25 years age group, rural patients, in term pregnancy of
primigravida patients. Most common indication for CS was NPL followed by previous CS and fetal distress. Mostly
patients showed no complication in postpartum period. Only few patients had wound infection, hysterectomy and post-
partum haemorrhage. More than 99% fetus survived without any complications.
Keywords: Caesarean section rates, Caesarean section indications, Fetal distress