부산대학교 도서관

Background: The caesarean section rate has been on the rise worldwide and this is a cause of concern because of increased morbidity and mortality associated with this surgical procedure. The management of Dora Nginza Hospital has often expressed alarm about the increasing number of caesarean sections performed at the institution. The World Health Organization recommends a Caesarean section rate of not more than 15%, and a high rate not necessary equates to good perinatal and maternal outcomes. We investigated modifi able factors to possibly assist in reducing the caesarean section rate at Dora Nginza Hospital. Objectives: To determine the caesarean section rate in Dora Nginza Maternity Unit from January to June 2014 and identify obstetric factors associated with the rate as classifi ed by the Robson 10-Group Classifi cation System. Methods: This was a retrospective, descriptive study. Labour wards and theatre records were used to identify all deliveries from 1st January to 30st June 2014. Patients' records were also retrieved to obtain all relevant patient information and indications for caesarean section. Results: During the study period, there were a total of 3 210 deliveries, of which 1 784 were caesarean section deliveries, resulting in a caesarean section rate of 55.6%. The emergency caesarean section rate was 91.3% and 8.7% were performed as elective cases. According to the Robson 10-Group Classifi cation System, caesarean sections were done more frequently in group 1 (57, 8%), group 2 (58, 4%), group 5 (92, 9%) and group 8(77.3%). The group where Caesarean sections were done less frequently was group 7 (35.4%). Six out of ten fi rst-time mothers (primigravida) who presented to the institution, delivered by caesarean section and most of those with one previous caesarean section ended up with repeat caesarean section. Conclusion: Previous caesarean section, primigravida and induction of labour were factors associated with high caesarean section rates in Dora Nginza Hospital. The rate could be reduced with implementation of new protocol targeting group 1, 2, 3 and 5. [ABSTRACT FROM AUTHOR]