Limiting the caesarean section rate in low risk pregnancies is key to lowering the trend of increased abdominal deliveries: an observational study.
BACKGROUND
As the rate of Caesarean sections (CS) continues to rise in Western countries, it is important to analyze the reasons for this trend and to unravel the underlying motives to perform CS. This research aims to assess the incidence and trend of CS in a population-based birth register in order to identify patient groups with an increasing risk for CS.


METHODS
Data from the Flemish birth register 'Study Centre for Perinatal Epidemiology' (SPE) were used for this historic control comparison. Caesarean sections (CS) from the year 2000 (N = 10540) were compared with those from the year 2008 (N = 14016). By means of the Robson classification, births by Caesarean section were ordered in 10 groups according to mother - and delivery characteristics.


RESULTS
Over a period of eight years, the CS rise is most prominent in women with previous sections and in nulliparous women with a term cephalic in spontaneous labor. The proportion of inductions of labor decreases in favor of elective CS, while the ongoing inductions of labor more often end in non-elective CS.


CONCLUSIONS
In order to turn back the current CS trend, we should focus on low-risk primiparae. Avoiding unnecessary abdominal deliveries in this group will also have a long-term effect, in that the number of repeat CS will be reduced in the future. For the purpose of self-evaluation, peer discussion on the necessity of CS, as well as accurate registration of the main indication for CS are recommended.
Department of Obstetrics and Gynaecology, Ghent University Hospital, Belgium. Ilse.Delbaere@UGent.be
Ilse
I
Delbaere
Hendrik
H
Cammu
Evelyne
E
Martens
Inge
I
Tency
Guy
G
Martens
Marleen
M
Temmerman
D000328:Adult; D001530:Belgium / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data* / Q000639:trends; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006304:Health Status; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000706:statistics & numerical data* / Q000639:trends; D008429:Maternal Welfare / Q000706:statistics & numerical data* / Q000639:trends; D018743:Perinatal Care / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011369:Professional-Patient Relations; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D055815:Young Adult