title: Trend in cesarean section rate.
abstract: OBJECTIVE
  To investigate factors influencing the increase in cesarean section CS rates, and to implement control measures.
  
  
  METHODS
  This retrospective analysis reviewed the birth registry of the Department of Obstetrics and Gynecology, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia. We compared the frequency of different indications for CS between January 2007 and December 2008. The numbers of CS studied were 1105 in 2007, while they were 1226 in the year 2008. Thus, the sample size studied was 2331 cesarean deliveries. Approval of the ethical committee for publication was obtained.
  
  
  RESULTS
  The CS rate exceeded the acceptable 15% rate suggested by the World Health Organization (WHO) at our institution, and probably in many other hospitals in Saudi Arabia. Fetal distress, previous single CS, previous multiple CS, and breech presentation were the most common indications for CS.
  
  
  CONCLUSIONS
  This high rate of CS will continue to increase due to the tendency to have large families, and the self-perpetuating character of each CS. Efforts should be made at each hospital level, and nationwide, to control this tendency.
authors.affiliation: Department of Obstetrics and Gynecology, King Fahd Armed Forces Hospital, Jeddah, Kingdom of Saudi Arabia.
authors.forename: Walaa M
authors.initials: WM
authors.lastname: Bondok
authors.forename: Saleh H
authors.initials: SH
authors.lastname: El-Shehry
authors.forename: Samira M
authors.initials: SM
authors.lastname: Fadllallah
mesh_terms: D000328:Adult; D001946:Breech Presentation; D002585:Cesarean Section / Q000639:trends*; D017604:Cesarean Section, Repeat / Q000706:statistics & numerical data; D005260:Female; D005316:Fetal Distress / Q000601:surgery; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies; D012529:Saudi Arabia