Salilbindu Chakrabarti, Jayanta Ray, Arindam Mallik
BACKGROUND The most dramatic feature of modern obstetrics is the relentless increase in the caesarean section rate. WHO suggests a caesarean rate of above 15% is unnecessary and unjustified. WHO reviewed and said that most women who need caesarean section should receive it. This escalating caesarean section rate is a major public health problem because it increases the health risk for mothers and babies as well as the cost of health care when compared with normal deliveries. We wanted to determine the demographic and etiological factors which lead to the rising trends of caesarean section in a tertiary center. METHODS It’s a cross sectional observational study among all the subjects undergoing caesarean section in the period of January, 2018 to December 2018, in Agartala Govt. Medical College, in the department of obstetrics and gynaecology. Information regarding socio demographic factors, indication of caesarean section, maternal and neonatal outcome was recorded in pre-designed pretested questionnaire. RESULTS In this study, the commonest indication found for caesarean section is previous caesarean section (68.8%). Most of the subjects were primigravida (43.1%); commonest age group was <20 years (48.4%). Most of the surgeries were emergency operations done during 9-4 pm (51.91%) and mainly done in referred patients (57.02%). CONCLUSIONS High education background of women, low tolerance for labour pain, economically sound state of family are the client related problems for this rising trend and office time working pattern of obstetrician, while reduced skill in assisted vaginal delivery procedures are the provider related factors . Caution is to be exercised in decision making to perform caesarean section especially in primigravida. Better healthcare infrastructure and adequate counselling to mother antenatally help in reducing the increasing trend of caesarean deliveries.
