[Comparison of indications for cesarean section in 1985-86 and 2000-01. Analysis of changes].
The aim of this research was a retrospective analysis of indications for caesarean section during last fifteen years and assessing recent trends.


METHODS
1106 pregnancies and deliveries by caesarean section at the Ist Clinic of Obstetrics and Gynaecology, Medical University of Warsaw in 1985-86 (547--I group) and 2000-01 (559--II group) were enrolled in the study. It was performed in order to estimate and evaluate such factors as age of women, mean duration of pregnancy, indications for caesarean section, complications, and general newborn condition.


RESULTS
In 1985-86 and 2000-01 fetal distress was the most frequent indication for delivery via caesarean section (14.35% and 18.57% respectively, p=ns). It was followed by cephalopelvic disproportion (13.99%) and malposition (13.99%) in I group and by pregnant women diseases (14.07%) and malposition (12.45%) in II group. Analysing pathology of the placenta, we established that index of placenta praevia decreased from 2.49% to 0.57% (p < 0.01) and index of abruption of placenta from 2.25% to 0.81% (p = 0.05). Ratio of cases of cephalopelvic disproportion decreased statistically from 13.99% in the I group to 8.76% in the II group (p = 0.006). Index of prolonged labor in the I stage increased from 8.3% to 12.34% (p = 0.027).


CONCLUSIONS
(1) Caesarean section is the surgical method of delivery for women with high risk pregnancy and complicated labor to protect mother and the foetus from the anticipated complications of delivery through natural passages. (2) The overall rate of caesarean section has risen because of widening of the indications. (3) Fetal distress has been the most frequent indication for caesarean section in last fifteen years. (4) Index of indications for cesarean section other than obstetric--ophthalmic, cardiological, neurological and orthopaedic, increased as a result of better health care of pregnant women. (5) Decision to perform caesarean section should be taken in consideration of present clinical situation and future consequences of abdominal delivery.
Krychowska
Alina
A
Studenckie Koło Naukowe przy I Klinice PołoZnictwa i Ginekologii, Warszawie.
Kosińska
Katarzyna
K
Karwan-Płońska
Anna
A
D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D005315:Fetal Diseases / Q000453:epidemiology* / Q000601:surgery*; D005316:Fetal Distress / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D008430:Maternal-Child Health Centers / Q000592:standards; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000601:surgery*; D011044:Poland / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000601:surgery; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D012189:Retrospective Studies; D012307:Risk Factors