title: Does a preference for symphysiotomy over caesarean section reduce the operative delivery rate?
abstract: We analysed the data from a hospital that had practiced symphysiotomy and caesarean section (c/s) for many years and where symphysiotomy was acceptable to the parturient women, in order to determine the effects of symphysiotomy on c/s and on the overall operative delivery rates. Regression analysis revealed significant negative correlation between symphysiotomy and c/s (R = -0.610, P = 0.03 at 95% confidence interval [CI]) and a non-significant negative correlation between symphysiotomy and combined operative deliveries (R = -0.108, P = 0.383 at 5% CI). This study has confirmed that, in our environment, the practice of symphysiotomy significantly reduces the c/s rate and may save some women from operative deliveries in subsequent pregnancies. With the widespread aversion for c/s in the developing countries and a preference for symphysiotomy in some communities, symphysiotomy should be offered as an alternative to c/s whenever possible. Urgent revival of the dying skill of symphysiotomy is recommended in developing countries.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria. drponkwo@yahoo.com
authors.forename: Peter O
authors.initials: PO
authors.lastname: Nkwo
authors.forename: Hyacinth E
authors.initials: HE
authors.lastname: Onah
mesh_terms: D002585:Cesarean Section / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006801:Humans; D009549:Nigeria; D011247:Pregnancy; D012044:Regression Analysis; D012189:Retrospective Studies; D013567:Symphysiotomy / Q000706:statistics & numerical data* / Q000639:trends