RESUMO
This is an analysis of the characteristics of cesarean section operations within the Ministry of Health (SSA) and the implications in relation to maternal and perinatal mortality during the five year period from 1990 to 1995. A descriptive study was undertaken based on cesarean section information obtained from the Statewide (Reporting) System of Basic Information (SEIR) and based on maternal and perinatal mortality information provided by the Ministry's Internal Hospital Committees from 1990 to 1995. This information was analyzed as a chronological series in order to compare the changes in the annual cesarean rates at both national and statewide levels. The Pearson test was used to determine the correlation between the frequency of cesarean sections and maternal and perinatal mortality rates during the same period within a 95 percent confidence interval (p < 0.05). The frequency of cesarean sections was shown to have increased within the SSA hospital system as whole and when considering each state separately. A positive and statistically significant correlation was observed between the frequency of cesarean sections and maternal mortality rates, while the increase in cesarean rates demonstrated no relationship with perinatal mortality rates. The increase in cesarean section rates in the Ministry of Health during the period analyzed exceeded any potential benefits and could have contributed to the increase in maternal morbidity and morbility as well as hospital cost. This increase is worrisome due to the projected tendency for the rates to continue to increase in the next few years if quick and concrete actions are not taken in order to decrease these rates.
