Professional paper
NEONATAL AND MATERNAL OUTCOME IN CESAREAN SECTION AT VARAŽDIN COUNTY HOSPITAL
Aleksandra Špoljarić
Martina Jerbić-Cecelja
Ljiljana Gal-Geček
Zoran Pitner
Abstract
There has been a rapid increase in the number of cesarean section performed at maternity hospital in Varaždin. The aim was to ivestigate the consequences of increased rate of caesarean sections in term of fetal and maternal outcome. Methods. The authors reviewed the records of 366 cesarean sections in singleton pregnancies performed between 1998 and 1999 and compared them to those 463 between 2000 and 2001. Results. The frequency of sections rose in term pregnancies from 9.67% to 13.41%, the rise proved to be statistically significant (p<0.01). The 33.89% of premature births are delivered by cesarean section between 2000 and 2001 compared to 18.79% between 1998 and 1999 (p<0.01). The remarkable increase in the use of cesarean section for low-birth weight prematures (from 25.8% to 43.1%, p<0.05) and term infants (from 10.9% to 28.3%, p<0.01) and for dystrophic children at term (from 11.3% to 25.9%, p<0.01) was observed. The 53.0% rate of cesarean delivery for term breech presentation in 2000 through 2001 is significantly higher then the 34.3% rate observed earlier (p<0.01). Elective cesarean deliveries rose from 17.2% to 20.9% (p>0.05). Dystocia was the leading cause for cesarean in term pregnancies, followed by fetal distress and previous cesarean. In preterm pregnancies, due primarily to increasing incidence of hypertension and intrapartum haemorrhage, fetal distress was less common indication between 2000 and 2001. Neonatal asphyxia in preterm deliveries occured at lower rates in the period with higher cesarean rates (26.7% compared to 50.0%, p<0.05), the difference being not signifficant at term. The neonatal mortality rate was 1.36% between 1998 and 1999, compared to 1.29% between 2000 and 2001. The frequency of postcesarean endometritis, wound infections and anemia was not different among groups. Cesarean section maternal mortality was 1 death per 829 operations, caused by pulmonary embolism in 2001. Conclusion. Cesarean section is still a major operation and the procedure is associated with substantial maternal mortality. Our study provides little evidence that the use of cesarean section improves perinatal outcome.
Keywords
cesarean section; neonatal morbidity and mortality; maternal morbidity and mortality
Hrčak ID:
15524
URI
Publication date:
1.6.2003.
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