title: Changing trends in indications for caesarean sections in a tertiary hospital.
abstract: OBJECTIVE
  To study the caesarean section rate and the trends in indications for caesarean delivery at the Singapore General Hospital (SGH) during two study periods of 6 months each.
  
  
  METHODS
  The percentages of caesarean sections attributable to specific indications were computed for the first 6 months of 1998 and the last 6 months of 2001. Subgroup analysis of "less common indications" was performed.
  
  
  RESULTS
  In the first half of 1998, 170 caesarean sections were performed giving a rate of 16.77%. 54.12% of women were multiparous. The main indication for caesarean section was dystocia (4.24% of deliveries). Two hundred and sixty caesarean sections were performed in the later half of 2001 giving a caesarean section rate of 25.10%. 53.46% of women were multiparous. The main indication for caesarean section was dystocia (5.41% of deliveries). Increase in caesarean section rate in 2001 was attributed to statistically significant increase in caesarean section for previous caesarean section and placenta previa major. Other changes in practice included shorter operating time which may be related to decision not to perform peritoneal closure.
  
  
  CONCLUSIONS
  Studying indications for caesarean section are useful for hospitals, clinicians and researchers in determining strategies to lower primary and repeat caesarean section rate.
authors.affiliation: Department of Obstetrics and Gynaecology, Singapore General Hospital, Outram Road, Singapore 169608. aileen tan2000@yahoo.com.sg
authors.forename: W C
authors.initials: WC
authors.lastname: Tan
authors.forename: K
authors.initials: K
authors.lastname: Devendra
authors.forename: A S
authors.initials: AS
authors.lastname: Tan
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006801:Humans; D011247:Pregnancy; D012846:Singapore