ABSTRACT
Background: There seems to be gradual raising trend in cesarean deliveries over decades with associated decrease in perinatal mortality rate. This study was undertaken to compare the caesarean delivery (CS) rates along with its indications over the last decade and to examine whether it is changing.Methods: The aim is to compare the rate and indications of CS in a retrospective manner from the data collected between January 1 and December 31 in the year 2006, 2011, and 2016 in a zonal hospital. The rates and indications of CS were analyzed to find whether they are changing if yes which are the factors contributing for the same. Categorical variables were compared using chi-square test.Results: The CS rate showed an increasing trend from 26 % in 2006 to 27.6 % in 2011 to 32.4 % in 2016. Of the total CS, repeat CS rate was significantly increased from 76 (6.61%) in 2006 to 106 (10.34%) in 2011 to 128 (13.72%). Primary CS percent remained more or less same during the study period. Post cesarean pregnancy (p=0.00001) and fetal distress (p=0.012) showed significant rise as an indication for CS which were major contributor for rise in last decade while failed induction decreased.Conclusions: Over the decade there is increase in the total CS rate mainly attributable to repeat CS while post CS pregnancies and foetal distress were leading cause for CS. There is need for reducing primary CS along with increase in trial of labor after cesarean in properly selected women.
ABSTRACT
Objective To study the pregnancy complication incidences, delivery manners and pregnancy outcomes of senile pregnant women. Methods The medical records of 10 508 cases of pregnant and delivery women, who were hospitalized for delivery in Obstetrical Department of Changhai Hospital of Second Military Medical University from Jan. 2010 to Dec. 2016, were collected and analyzed. According to delivery age, they were divided into the senile group (≥35 years old, n＝1 130) and the non-senile group (35 years old, n＝9 378). Chi-square test was used to compare the incidences of pregnancy complications, cesarean section rate, ratio of cesarean section indications and outcomes of maternal and perinatal infants between the two groups. Results The proportion of senile pregnant women increased from 6.75% (89/1 319) in 2010 to 15.82% (267/1 688) in 2016. The cesarean section rate and the ratio of social factors in the senile group were higher than those in the non-senile group (67.08% [758/1 130] vs 48.51% [4 549/9 378], 42.88% [325/758] vs 10.07% [458/4 549], both P0.01). The incidences of gestational diabetes mellitus, premature rupture of membrane, placenta praevia, placental implantation abnormality and postpartum hemorrhage of the senile group were significantly higher than those of the non-senile group (all P0.05). The incidences of pregnancy-induced hypertension syndrome, pre-eclampsia, chronic hypertension complicating pregnancy of the senile group were significantly higher than those of the non-senile group (all P0.05). The incidences of liver diseases, diseases of urinary system, abnormal thyroid function, thrombotic diseases and malignant tumor complicated with pregnancy were significantly higher in the senile group than those in the non-senile group (all P0.05). For outcome of perinatal infants, the onset rates of asphyxia neonatorum, death of perinatal infants and premature infants were significantly higher in the senile group than those in the non-senile group (all P0.05). Conclusion The risks of pregnancy complications and adverse pregnancy outcomes are increased in senile pregnant women. Appropriate-age pregnancy and perinatal care of senile pregnancy should be advocated in clinic.