Indications for caesarean delivery between 1955 and 2005

Summary INTRODUCTION: We wished to evaluate the changes in the indications and rates of caesarean delivery over the past 50 years (1955–2005) at the Ljubljana Maternity Hospital, the largest maternity hospital in Slovenia and a tertiary center. METHODS: We retrospectively analyzed data obtained from...

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Bibliographic Details
Published in:Wiener Klinische Wochenschrift 2008-12, Vol.120 (23-24), p.761-765
Main Authors: Bregar, Andreja Trojner, Cerar, Vasilij M., Slavec, Zvonka Zupanič, Verdenik, Ivan
Format: Article
Language:English
Subjects:
Cephalopelvic Disproportion - epidemiology
Cephalopelvic Disproportion - surgery
Cesarean Section - trends
Cesarean Section - utilization
Cesarean Section, Repeat - trends
Endocrinology
Female
Fetal Distress - epidemiology
Fetal Distress - surgery
Gastroenterology
Hospitals, Maternity
Humans
Internal Medicine
Labor Presentation
Medicine
Medicine & Public Health
Original Article
Pneumology/Respiratory System
Pregnancy
Retrospective Studies
Slovakia
Utilization Review - statistics & numerical data
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Summary:Summary INTRODUCTION: We wished to evaluate the changes in the indications and rates of caesarean delivery over the past 50 years (1955–2005) at the Ljubljana Maternity Hospital, the largest maternity hospital in Slovenia and a tertiary center. METHODS: We retrospectively analyzed data obtained from delivery records, archived at the Department of Obstetrics and Gynecology, University Medical Center Ljubljana, for the selected years 1955, 1965, 1975, 1985, 1995 and 2005. The records were archived in bound books (1955), folders (1965 and 1975), on microfilm (1985) and in the national perinatal information system (1995 and 2005). Caesarean delivery rates were calculated and indications statistically analyzed. RESULTS: Of the 38.499 reviewed delivery records, 3122 were the records of caesarean deliveries. The caesarean delivery rate was 2.5% in 1955, 4.95% in 1965, 7.36% in 1975, 7.54% in 1985, 11.76% in 1995 and 15.74% in 2005. Overall, 80 different indications were registered and analyzed, 35 with an incidence >1.0%. The most frequently used indications were caesarean after caesarean, cephalopelvic disproportion, acute fetal distress and malpresentation. DISCUSSION: During the 50-year period, the parameters contained in delivery records changed as the result of new approaches and changing attitudes toward the parturient woman, the course of labor and delivery. In 1955 and 1965, maternal indications prevailed, whereas in 1995 and 2005 some new and nonobstetrical indications were introduced and the fetal and maternal indications became equally important. A general observation was that combinations of indications had a constantly high share over the analyzed period, implying that the decision on caesarean delivery was often based on several different indications. The caesarean delivery rate is increasing, therefore obstetricians should, in line with a good clinical practice, base their decisions on well founded arguments.
ISSN:0043-5325
1613-7671
DOI:10.1007/s00508-008-1109-z