DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20162659

A one year study on evaluation of pattern of caesarean section and its outcome before and after introduction of Janani Suraksha Yojna and maternal ambulances services

Alka Patel, Beenu Kushwah, Anuradha Mishra

Abstract


Background: The steady rise in caesarean section rates is an emerging area of concern in mother-child healthcare and a matter of international attention. During last decade Janani Suraksha Program and maternal ambulances services have brought many significant changes in maternal and perinatal outcomes in India, one of which is significantly increased number of institutional deliveries, this may have brought a difference in pattern of cesarean sections as well. Present study has analyzed caesarean section trend before and after introduction of Janani Suraksha Yojna (JSY) and maternal ambulance services at our institute.

Methods: A structured proforma was filled up for every case and results were recorded on excel sheet. All the cases included in study were further divided in group 1 (deliveries done in year 2004-2005), group 2 (deliveries done in year 2014-2015) before and after introduction of JSY and maternal ambulance services respectively. Comparative analysis between study group1 and group 2 was done using Pearson Chi square test.

Results: In group1, total deliveries during study period were 6050, out of which 562 (9.28%) were caesarean deliveries. In group 2, total deliveries was 8674, out of which 1182(13.62%) were caesarean deliveries. The most common indication for which the rise in caesarean section rate is seen in our study was repeat caesarean section, in group 1 was 21.7% and in group 2 was 32.2%, followed by failed medical induction.

Conclusions: The rate of caesarean section has increased after introduction of JSY and maternal ambulance services which may be a direct consequence of increase in institutional deliveries.


Keywords


JSY, Maternal ambulance services, Caesarean section incidence

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References


Tampakoudis P, Assimakopoulos E, Grimbizis G, Zafrakas M, Tampakoudis G, Mantalenakis S, et al. Caesarean section rates and indications in Greece: data from 24 year period in a teaching hospital. ClinExpObstetGynecol. 2004;31:289-92.

Lee SI, Khang YH, Lee MS. Women's attitudes towards mode of delivery in a society with high caesarean section rates. Birth. 2004;31:108-16.

Hamilton BE, Ventura SJ, Martin JA, Sulton PD. Preliminary births for 2004. Health E-Stats. 2005(15). Available at http://www.cdc.gov/nchs/data/hestat/prelimbirths04/prelimbirths04health.htm.

Thomas J, Paranjothy S. The national sentinel caesarean section audit report. RCOG press, 2001. Available at https://www.rcog.org.uk/globalassets/documents/guidelines/research--audit/nscs_audit.pdf.

Belizan JM, Althabe F, Barros FC, Alexander S. Rates and implications of caesarean sections in Latin America. BMJ. 1999;319:1397-402.

Leitch CR, Walkers JJ. Caesarean section rates. BMJ. 1994;308:133-4.

Kambo I, Bedi N, Dhillon BS, Saxena N. A critical appraisal of cesarean section rates at teaching hospitals in India. Int J Gynaecol Obstet. 2002;79(2):151-8.

Naidu PNJ. Obset Gynecol India. 1962;12:549.

Chakravarty J. Obset Gynecol India. 1971:21.

Kumar A, Thakur S. Maternal complications in caesarean section deliveries. J Obstet Gynecol India. 1996;20:36-40.

Usha S. A clinical study of caesarean section, 1980.

Unnikrishnan B, Rakshith P, Aishwarya A, Nithin K, Rekha T, Prasanna P, et al. Trends and indications for caesarean section in a tertiary care obstetric hospital in coastal South India. AMJ. 2010;3(12):821-5.

Geidam AD, Audu BM, Kawuwa BM, Obed TY. Rising trend and indications of caesarean section at the university of Maiduguri Teaching Hospital, Nigeria. Ann Afr Med. 2009;8:127-32.

Subedi S. Rising rate of cesarean section- a year review. Journal of Nobel Medical College. 2012;1(2):72-6.

Haider G, Zehra N, Munir AA, Haider A. Frequency and indication of caesarean section in a tertiary care hospital. Pak J Med Sci. 2009;25(5):791-6.

Hafeez M, Yasin A, Badar N, Pasha MI, Akram N, Gulzar B. Prevalence and indication of caesarean section in a teaching hospital. JIMSA. 2014;27(1):15-6.

Mutihir JT, Daru PH, Ujah IAO. Elective caesarean sections at the Jos university teaching hospital. Trop J ObstetGynecol. 2005;22(1):39-41.

Sobade AA, Archibong EI, Eskander M. Primary caesarean section in nulliparous and grand multiparous Saudi women from Abharegion: indication and outcome. WATAM. 2003;22(3):232-5.

Rao B, Ratnam SS, Kumaran A. Changing tends in caesarean section. Obst And Gynae for Postgraduates. 1999;1:145.

Ali L, Tayyab S, Parveen F. Caesarean c-section rate, current trends. J Surg Pak. 2007;12(2):64-6.

Dinas K, Mavromatidis G, Dovas D, Giannoulis C, Tantanasis T, Loufopoulos A, et al. Current caesarean section delivery rates and indications in a major public hospital in Northern Greece. Aust N Z J Obstet Gynaecol. 2008;48(2):142-6.

Ali L, Tayyab S. Caesarean section rate, curremt trends. J Surg Pakistan. 2007;1:62-6.

Choudhary SM, Ayaz A. Efforts to reduce caesarean section Rate. J Surg Pakistan. 2003;8(1):25-30.

Spong CY, Lanndon MB. Risk of uterine rupture and adverse perinatal outcome at term after caesarean delivery. ObstetGynaecol. 2007;110(4):801-7.

Kugler E, Shoham-Vardi I. The safety of a trial of Labour after caesarean section in a grand multiparous population. Arch Gynaecol Obstet. 2008;277:339-49.

Gregory KD, Fridman M, Korst L. Trends and patterns of vaginal birth after cesarean availability in the United States. Semin Perinatol. 2010;34(4):237-43.

McMahon MJ, Luther ER, Bowes WA, Olshan AF. Comparison of a trial of labor with an elective second caesarean section. N Engl J Med. 1996;335:689-95.

Cunningham FG, Bangdiwala S, Brown SS, Dean TM, Frederiksen M, Hogue CJ, et al. National institutes of health consensus development conference statement: vaginal birth after cesarean: New Insights. March 8-10, 2010. Obstet Gynecol. 2010;115:1279-95.

National Center for Health Statistics. Health indicators, 2012. Available at http://www.healthindicators.gov/Indicators/Priorcesareanbirths_1134/Profile/Data. Accessed on 26 July 2012.

Grady D. New guidelines seek to reduce repeat Caesareans. The New York Times, 2010. Available at http://www.nytimes.com /2010/07/22/health/22birth.html. Accessed on 26 July 2012.

Health in the News. New cesarean guidelines: will they really reduce the rate of repeat C-sections? Available at http://www.everydayhealth.com /blog/health-in-the-news/2010/07/23/new-cesarean-guidelines. Accessed on 26 July 2012.

Crowther CA, Dodd JM, Hiller JE, Haslam RR, Robinson JS. Birth after caesarean study group. Planned vaginal birth or elective repeat caesarean: patient preference restricted cohort with nested randomised trial. PLoS Med. 2012;9(3):e1001192.

Sims EJ, Newman RB, Husley TC. Vaginal birth after caesarean: to induce or not to induce. Am J Obstet Gynecol. 2001;184(6):1122-4.

Sanchez-Ramos L, Gaudier FL, Kaunitz AM. Cervical ripening and labour induction after previous caesarean delivery. Clin Obstet Gynecol. 2000;43:513-23.

Delancy T, Young DC. Spontaneous versus induced labour after a previous caesarean delivery. Obstet Gynecol. 2003;102;39-44.

Dunne C, Dasilva O, Schmidta G, Natale R. J Obstet Gynecol. 2009;31(12):1124-30.

Jasia J, Mansoor MH, Mansoor A. Analysis of caesarean sections. Journal of Rawalpindi Medical College (JRMC). 2013;17(1):101-3.

Subhashini R, Uma N. Changing in caesarean delivery. IAIM. 2015;2(3):96-102.

Rahman F, Haque J, Bashir SJ, Bashar A. Trend of caesarean section in a tertiary level of hospital in Bangladesh in one year period, 2015. Available at https://www.researchgate.net/publication/283016574_trends_of_caesarean_section_in_a_tertiary_level_hospital_in_bangladesh_in_1_year_period.

Ugawu EOV, Eobioha KC, Okezie OA, Gwu AOU. A five year survey of caesarean delivery at a Nigerian Tertiary Hospital. Ann Med Health Sci Res. 2011;1(1);77-83.