title: Caesarean delivery rates, determinants and indications in Makassed Hospital, Jerusalem 1993 and 2002.
abstract: This study investigated the rising rate of caesarean section (CS) deliveries between 1993 and 2002 (9.4% to 14.4%) and associated factors, including indications for CS and sociodemographic and clinical characteristics based on the register of a major Palestinian teaching hospital. Instrumental deliveries declined from 12.6% to 4.4%. Fetal distress decreased as an indication for CS, while previous CS and breech presentations contributed to the increase. Decision-making for CS needs to frame the benefits and risks of the intervention within the context of women's entire reproductive life-cycle and existing standards of care, avoiding unnecessary and costly CS deliveries to reduce iatrogenic complications and conserve resources.
authors.affiliation: Institute of Community and Public Health, Birzeit University, Ramallah, West Bank, Occupied Palestinian Territory.
authors.forename: N
authors.initials: N
authors.lastname: Mikki
authors.forename: N M E
authors.initials: NM
authors.lastname: Abu-Rmeileh
authors.forename: L
authors.initials: L
authors.lastname: Wick
authors.forename: N
authors.initials: N
authors.lastname: Abu-Asab
authors.forename: S
authors.initials: S
authors.lastname: Hassan-Bitar
mesh_terms: D000293:Adolescent; D000328:Adult; D001946:Breech Presentation / Q000601:surgery; D002585:Cesarean Section / Q000639:trends*; D016009:Chi-Square Distribution; D005260:Female; D005316:Fetal Distress / Q000601:surgery; D006302:Health Services Research; D006784:Hospitals, Teaching; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000601:surgery; D016015:Logistic Models; D008485:Medical Audit; D008877:Middle East; D010298:Parity; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011247:Pregnancy; D012959:Socioeconomic Factors; D019564:Unnecessary Procedures / Q000639:trends