International Journal of Advances In Case Reports

INCREASING TREND IN CAESARIAN SECTION RATE –THE NEED FOR CLINICAL EVALUATION OF LOW RISK AND HIGH RISK INDICATIONS

M.Vijayasree*

hospitalstelangana@gmail.com

Rising trend, Caesarian section, High risk, Maternal and fetal morbidity.

The incidence of caesarean sections is rising throughout the globe. Identification of a high risk pregnancy by coopland score helps the obstetrician to identify patient at high risk and also elaborate a prognosis of pregnancy. The present study was conducted to evaluate maternal and perinatal outcomes in high and low risk pregnancies.: In the present study of 100 cases of high risk caesarean section were evaluated and compared with 100 cases of low risk caesarean sections over a period of two years. The results were analyzed in context of the goals set under the safe motherhood initiative. In the study period 4903 patients delivered and 1380 (28.11%) underwent caesarean section. The incidence of CS varied from 26.61% to 57%. Maximum number of patients in both high & low risk group 96% & 98% were in the age group of 17-35 years. 80% in the study group and 70% in control group had adequate pelvis, while 4% and 6% respectively had inadequate pelvis.24% cases in the study group and 28% cases in the control group had past history of previous section. Most common associated medical disorder in both the groups was anaemia 28%, 20% respectively. 68% cases in the study group and 22% cases in the control group presented with obstetric complication. 62% cases of the high risk group and 14% cases of the low risk group had intraoperative complications in the form of adhesions, scar dehiscence, PPH, bleeding. 50% cases in the study group and 10% in the control group had postoperative maternal morbidity like pyrexia, UTI, paralytic ileus, wound sepsis, pulmonary edema, DIC, CCF and HELLP syndrome. In high risk group 2% neonatal death, while these figure was 0% in control group. 42% babies in the high risk group and 12% babies in the low risk group had perinatal morbidity in the form of low birth weight, prematurity, respiratory distress syndrome and birth asphyxia. There was no maternal mortality reported in high risk and low risk groups. Since there are many complications associated with caesarian section both for the mother and the baby, we have to judiciously select the cases for surgery especially in a primigravida.