Risk indicators for cesarean section due to cephalopelvic disproportion in Lamphun hospital.

ABSTRACT

OBJECTIVE: To investigate risk indicators for cesarean section due to cephalopelvic disproportion. SETTING: Department of Obstetrics & Gynecology, Lamphun Hospital. DESIGN: Case-control study. MATERIAL AND METHOD: Cases were 87 pregnant women delivered by cesarean section due to cephalopelvic disproportion at Lamphun Hospital between October 1st, 2003 and June 30th, 2004. Controls were 113 pregnant women delivered by normal labour during the same period. Maternal age, gravidity, parity, maternal height, pre-pregnancy weight, gestational age, weight before delivery, weight gain, symphysis-fundal height, birthweight and newborn gender were mainly focused. Information were obtained from medical records. Groups were compared by t-test and exact probability test as appropriate. Risk indicators were analyzed by odds ratio from univariable and multiviariable logistic regression. RESULTS: Risk indicators significantly associated with cesarean section due to cephalopelvic disproportion included symphysis-fundal height greater than 35 cm. (OR = 9.38, 95% CI = 3.42-25.73); nulliparity (OR = 5.36, 95%CI = 2.24-12.82); maternal height less than 152 cm. (OR = 3.65, 95%CI = 1.63-8.17) and weight gain more than 15 kg. (OR = 2.67, 95%C1 = 1.32-5.39). CONCLUSION: Risk factors for cesarean section due to cephalopelvic disproportion included symphysis-fundal height greater than 35 cm, nulliparity, maternal height less than 152 cm. and weight gain more than 15 kg. Early detection of these risk indicators before delivery helps obstetricians and nurses to recognize potential obstructed labor and prepare for safe delivery in advance.