Trends in Caesarean Section Rate in Siriraj Hospital (1980-1994)

Abstract

Objective To determine trends in caesarean section rate in Siriraj Hospital and the impact on maternal and perinatal mortality rates. Subjects Data of all obstetric patients underwent caesarean section from Department of Obstetrics and Gynaecology, Faculty of Medicine, Siriraj Hospital during 1980 1994.

Results The rate of caesarean section in Siriraj Hospital rose from 6.7 per 100 deliveries in 1980 to 18.3 in 1994. The most common indication was repeated caesarean section which rose from 2.0 per 100 deliveries in 1980 to 5.8 in 1994. Dystocia was the major contributor of the increasing primary caesarean section which rose from 1.9% in 1980 to 5.4% in 1994. Elective caesarean section had recently increased strikingly from 0.6% in 1991 to 1.43% in 1994. Maternal mortality rate declined sharply from 44 per 100,000 deliveries in 1980 to 5.5 in 1984 then increased to 24 in 1988 and then declined again to 5 in 1994. Perinatal mortality rate had been approximately 10 per 1,000 births since 1980 and remained rather constant until 1994.

Conclusion Caesarean section in Siriraj Hospital tended to continuously increase. The most common indication was repeated caesarean section. Dystocia was the most common indication for primary caesarean section. Elective caesarean section was recently increasing strikingly. Maternal and perinatal mortality were not clearly affected by these increasing caesarean section rates.