Clinical Survey of Cesarean Section / 영남의대학술지

ABSTRACT

Recent reports have noted the increase of and questioned the justification for cesarean section rate in the past decade. This study was carried out retrospectively based on the clinical charts of 510 patients who had been performed cesarean section among 3,357 deliveries at Yeungnam University Hospital from May, 9, 1983 through Nov., 30, 1986. The results were as follows 1. Overall incidence of cesarean section was 15.7% of total deliveries. Of these, 10.9% were by primary cesarean section and 4.7% by repeat operation. There has been a gradual increase in the cesarean section rate. 2. In the distribution of age, the 26-30 aged group was the most prevalent (60.2%). 3. The most common indications for cesarean section were previous cesarean section (30.2%), CPD (26.9%), malpresentation (22.7%), and fetal distress (3.5%). In primipara, CPD was the most frequent and in multipara malpresentation. 4. A great proportion (31.6%) was done at 40th gestational week. 5. In the weight distribution of infants, the group of 3,000-3,499 gm was the most prevalent (39.8%), premature baby was 9.1%, and giant baby was 5.6%. 6. In the type of operation, lower segment transverse cesarean section was the most (97.5%). 7. In the combined surgery, sterilization was the most prevalent and the next was ovarian cystectomy, hysterectomy, and myomectomy in order. 8. In the type of the anesthesia, general anesthesia was 83.5%. 9. Maternal morbidity was 14.7. Among the cause of this morbidity, wound infection was the most and the next was urinary tract infection, fever of unknown origin. and atonic bleeding in order. 10. It was found that 18.4% was maternal morbidity in the patients below 10 gm Hb. In this group, maternal morbidity was markedly increased as the level of Hb was decreased. 11. Maternal morbidity was increased as the duration of ruptured membrane was prolonged. In the group of over 24 hours after rupture of membrane, it was markedly increased (44.4%). 12. Maternal morbidity was increased as the duration of labor was prolonged. In the group of over 12 hours after the onset of labor, it was 24.6%. 13. Maternal morbidity of lower segment transverse cesarean section was the least (14.1%). 14. Maternal morbidity of emergency cesarean section was about two times as much as elective cesarean section.